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Baloch Z, Yasmeen N, Li Y, Zhang W, Lu H, Wu X, Xia X, Yang S. Knowledge and Awareness of Cervical Cancer, Human Papillomavirus (HPV), and HPV Vaccine Among HPV-Infected Chinese Women. Med Sci Monit 2017; 23:4269-4277. [PMID: 28867818 PMCID: PMC5595099 DOI: 10.12659/msm.903370] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background It is important to understand the knowledge that various groups of a population have about cervical cancer and human papillomavirus (HPV) and their attitudes toward HPV vaccination, as it will ultimately influence their decision-making for or against the acceptability of vaccines and other preventive methods. This study was designed to determine the level of knowledge and awareness about cervical cancer, HPV, and the HPV vaccine among Chinese women in Yunnan province. Material/Methods A survey was conducted in Yunnan province by the Laboratory of Molecular Virology in collaboration with the Yunnan First People’s Hospital in Feb 2015. A total of 388 women were recruited and asked to participate in a questionnaire-based interview that collected information related to their awareness and knowledge about: (1) cervical cancer, (2) HPV and HPV vaccine and willingness to have their children receive vaccination, and (3) demographic characteristics. Results A total of 388 HPV-positive women were included; 300/388 (73.3%) were Han, and 88/388 (22.7%) were other ethnicities. Overall, 204/388 (52.6%) of the women were aware of cervical cancer, with a significant difference between Han women and women of other ethnic groups (168/388, 56.0% and 36/88, 40.9%; P=0.015). Overall, 26.5% of the women were aware of the role of HPV in cervical cancer; 29.0% of the Han women and 18.2% of women of other ethnic groups were aware of this role of HPV (P=0.05). The knowledge that HPV infection leads to cervical cancer was higher among Han women (29.0%) compared to women of other ethnicities (18.2%). Knowledge about the HPV vaccine was very low in all ethnic groups, but the Han women were more willing to allow their children to be vaccinated before they become sexually active. A similar difference has also been found in women from various regions. Conclusions Although level of awareness and knowledge about cervical cancer was moderate, knowledge and awareness of HPV and the HPV vaccine was very low. Targeted communication is very important among populations in which knowledge gaps exist in order to promote dialogue about the vaccine among patients and their healthcare providers.
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Affiliation(s)
- Zulqarnain Baloch
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Nafeesa Yasmeen
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Yuanyue Li
- Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Wenhui Zhang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Hongyu Lu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Xiaomei Wu
- The 1st People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Xueshan Xia
- The Research Center for Molecular Medicine, Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China (mainland)
| | - Shihua Yang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
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The Carolina HPV immunization attitudes and beliefs scale (CHIAS): scale development and associations with intentions to vaccinate. Sex Transm Dis 2013; 37:234-9. [PMID: 19940807 DOI: 10.1097/olq.0b013e3181c37e15] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND No standardized instruments, to our knowledge, exist to assess attitudes and beliefs about human papillomavirus (HPV) vaccination. METHODS We developed the Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS), using data collected on 783 parents who had not yet vaccinated their daughters against HPV. We conducted a principal components analysis of 16 HPV vaccine attitude and belief items, assessed the scale's psychometric properties, and used linear regression to examine the relationship of CHIAS factors and parents' vaccination intentions. RESULTS Analyses identified 4 CHIAS factors, all of which had acceptable scale alphas and 1-year test-retest reliability. In multivariate models, higher vaccination intentions were associated with: believing HPV vaccine is effective (β = 0.06) or has less harmful effects (β = -0.47), perceiving more barriers to access (β = 0.18), and having less uncertainty about the vaccine (β = -0.23) (all P < 0.05). CONCLUSIONS Findings suggest that parent attitudes about HPV vaccine are important to their intentions to vaccinate their adolescent daughters against HPV. The CHIAS offers researchers a compact, standardized measure of important HPV vaccine attitudes and beliefs.
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Longitudinal predictors of human papillomavirus vaccine initiation among adolescent girls in a high-risk geographic area. Sex Transm Dis 2011; 38:197-204. [PMID: 20838362 DOI: 10.1097/olq.0b013e3181f12dbf] [Citation(s) in RCA: 206] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) vaccine uptake is low among adolescent girls in the United States. We sought to identify longitudinal predictors of HPV vaccine initiation in populations at elevated risk for cervical cancer. METHODS We interviewed a population-based sample of parents of 10- to 18-year-old girls in areas of North Carolina with elevated cervical cancer rates. Baseline interviews occurred in summer 2007 and follow-up interviews in fall 2008. Measures included health belief model constructs. RESULTS Parents reported that 27% (149/567) of their daughters had initiated HPV vaccine between baseline and follow-up. Of parents who at baseline intended to get their daughters the vaccine in the next year, only 38% (126/348) had done so by follow-up. Of parents of daughters who remained unvaccinated at follow-up but had seen a doctor since baseline, only 37% (122/388) received an HPV vaccine recommendation. Rates of HPV vaccine initiation were higher among parents who at baseline perceived lower barriers to getting HPV vaccine, anticipated greater regret if their daughters got HPV because they were unvaccinated, did not report "needing more information" as the main reason they had not already vaccinated, intended to get their daughters the vaccine, or were not born-again Christians. CONCLUSIONS Missed opportunities to increase HPV vaccine uptake included unrealized parent intentions and absent doctor recommendations. While several health belief model constructs identified in early acceptability studies (e.g., perceived risk, perceived vaccine effectiveness) were not longitudinally associated with HPV vaccine initiation, our findings suggest correlates of uptake (e.g., anticipated regret) that offer novel opportunities for intervention.
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Hopfer S, Clippard JR. College women's HPV vaccine decision narratives. QUALITATIVE HEALTH RESEARCH 2011; 21:262-77. [PMID: 20841433 DOI: 10.1177/1049732310383868] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Drawing on 38 in-depth qualitative interviews with college women and college health clinicians, we collected human papillomavirus (HPV) vaccine decision narratives to identify the implicit and explicit values underlying HPV vaccine decision making. Narratives of vaccine acceptance and resistance were identified. Vaccine acceptance narratives consisted of four themes: supportive family messages, explicit health care provider endorsement, peer descriptive norms reducing stigma of vaccination, and disease framing (e.g., cancer, HPV) shaping vaccine benefit perceptions. Vaccine resistance narratives consisted of five themes: skepticism of vaccine safety, invoking alternative prevention strategies, articulating stigmatizing HPV messages, overcoming self-efficacy barriers (e.g., cost, availability, time, and fear of parental disclosure), and delay strategies. Common to all decision narratives was that relationship status framed college women's perceptions of HPV susceptibility. Theoretical and practical implications for designing HPV vaccine messages aimed at college-aged women are discussed.
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Affiliation(s)
- Suellen Hopfer
- The Pennsylvania State University, University Park, Pennsylvania 16801, USA.
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Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and the leading cause of cervical cancer. The Food and Drug Administration approved the first human papillomavirus vaccine and has recommended routine vaccination of 11 to 12 year old girls with catch-up vaccination for females 13 to 26 years of age. This primary prevention tool for cervical cancer could significantly reduce cervical cancer, but broad vaccination coverage will be required. Health care providers are in a position to educate parents and teens about the benefits of receiving the recommended HPV vaccine. Mandating the HPV vaccine can be effective in increasing vaccine rates, reducing disease disparities, and decreasing rates of cervical cancer.
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Chapman E, Venkat P, Ko E, Orezzoli JP, Del Carmen M, Garner EIO. Use of multimedia as an educational tool to improve human papillomavirus vaccine acceptability--a pilot study. Gynecol Oncol 2010; 118:103-7. [PMID: 20457469 DOI: 10.1016/j.ygyno.2010.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 04/09/2010] [Accepted: 04/13/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine, through a pilot study, whether use of a video-based educational tool can influence overall human papillomavirus (HPV) vaccine acceptability, views on vaccine mandates, school vaccination, and acceptable age for vaccination. METHODS Written surveys addressing HPV knowledge and vaccine acceptability were administered to study participants from January to March 2007. An initial 32-question survey was completed, followed by an 8-minute educational video, and a post-video assessment. RESULTS Out of 256 subjects, 73.0% watched the video and completed all surveys. Eighty percent of the subjects had heard of HPV, while 65.0% knew, prior to viewing the video, that the vaccine was available. Individual vaccine acceptability increased from 66.7% to 78.0% after the video (p=.0014). Prior to the video, 54.8% of subjects supported mandatory HPV vaccination, with 51.1% supporting school vaccination, and 66.7% accepting vaccination if it were free. After the video, these percentages increased to 72.6% (p<.0001), 65.1% (p<.0001) and 86.6% (p<.0001) respectively. Initially, 56.5% of subjects would vaccinate their child at 15 years of age or younger. After the video, 94.1% approved of vaccination from age 9 (p<.0001). Secondary analysis revealed Hispanics, African Americans, and lower income families were more likely to accept HPV vaccination after the video. A perception that vaccination promotes sex, and whether or not participants talk to their children about sex, did not affect acceptability. CONCLUSION Using an educational video significantly increased overall HPV vaccine acceptability and acceptance in younger age groups. This may be an effective means of increasing awareness and acceptability of HPV vaccination.
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Affiliation(s)
- Eloise Chapman
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston MA, USA
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St John B, Pitts M, Tufts KA. Disconnects between news framing and parental discourse concerning the state-mandated HPV vaccine: implications for dialogic health communication and health literacy. Commun Med 2010; 7:75-84. [PMID: 21462859 DOI: 10.1558/cam.v7i1.75] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In 2007, Virginia became the first state in the US to mandate the human papillomavirus (HPV) vaccine. In 2009, the mandate required that parents of girls entering sixth grade (ages 11-12) vaccinate their daughters or sign the 'opt-out' waiver. This investigation is the first to explore how both the news media and parents framed and responded to the newly-mandated HPV vaccine. This research reveals disjoints between news media framing and parental framing. Implications of these gaps for parental healthcare decision-making are addressed and suggestions are offered for constructing a more dialogic, community-based approach that can increase health literacy regarding the HPV vaccine.
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Affiliation(s)
- Burton St John
- Department of Communication and Theatre Arts, Old Dominion University, Norfolk, VA 23529, USA.
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Barnack JL, Reddy DM, Swain C. Predictors of Parents' Willingness to Vaccinate for Human Papillomavirus and Physicians' Intentions to Recommend the Vaccine. Womens Health Issues 2010; 20:28-34. [DOI: 10.1016/j.whi.2009.08.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 08/31/2009] [Accepted: 08/31/2009] [Indexed: 11/16/2022]
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Kahn JA, Ding L, Huang B, Zimet GD, Rosenthal SL, Frazier AL. Mothers' intention for their daughters and themselves to receive the human papillomavirus vaccine: a national study of nurses. Pediatrics 2009; 123:1439-45. [PMID: 19482752 DOI: 10.1542/peds.2008-1536] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aims of this study were to examine mothers' intention to vaccinate their daughters and themselves against human papillomavirus and to determine which demographic, behavioral, and attitudinal factors were associated with intention to vaccinate daughters. METHODS We surveyed 10,521 US mothers, all nurses, between June 2006 and February 2007. Multivariable logistic regression models were used to determine which of the following factors were associated with a mother's intention to vaccinate a 9- to 12-year-old daughter: demographic factors, gynecologic history, belief that one's daughter should have regular Papanicolaou testing, beliefs about Papanicolaou testing outcomes (3-item scale), and beliefs about human papillomavirus vaccines (7-item scale measuring beliefs about human papillomavirus vaccine efficacy, impact of vaccination on sexual and Papanicolaou screening behaviors, severity of and susceptibility to human papillomavirus, and anticipated clinician recommendations). RESULTS Of the 8832 mothers who completed a survey (84% response rate), 7207 had a daughter. Among mothers with a daughter, 48% intended to vaccinate a daughter if she were 9 to 12 years of age, 68% if she were 13 to 15 years of age, and 86% if she were 16 to 18 years of age. Forty-eight percent intended to receive the vaccine themselves if recommended. In multivariable regression models, variables significantly associated with intention to vaccinate a 9- to 12-year-old daughter included belief that one's daughter should have regular Papanicolaou testing and beliefs about human papillomavirus vaccines. CONCLUSIONS In this first national study of mothers' attitudes about human papillomavirus vaccines, mothers' intention to vaccinate a daughter <13 years of age was lower than intention to vaccinate an older daughter, contrasting with national recommendations to target 11- to 12-year-old girls for vaccination. Educational interventions designed to affect mothers' willingness to vaccinate daughters should focus on human papillomavirus vaccine efficacy, behavioral impact of vaccination, perceived risk of human papillomavirus, and clinician support for vaccination.
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Affiliation(s)
- Jessica A Kahn
- Division of Adolescent Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, MLC 4000, 3333 Burnet Ave, Cincinnati, OH 45229, USA.
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Cates JR, Brewer NT, Fazekas KI, Mitchell CE, Smith JS. Racial Differences in HPV Knowledge, HPV Vaccine Acceptability, and Related Beliefs Among Rural, Southern Women. J Rural Health 2009; 25:93-7. [DOI: 10.1111/j.1748-0361.2009.00204.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women. Obstet Gynecol 2008; 111:1103-10. [PMID: 18448742 DOI: 10.1097/aog.0b013e31817051fa] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate rates of human papillomavirus (HPV) vaccination, factors associated with intention and belief in one's ability (self-efficacy) to receive the vaccine, and prevalence of vaccine-type HPV during the first year after an HPV-6, HPV-11, HPV-16, HPV-18 vaccine was licensed. METHODS Sexually experienced females 13-26 years of age (N=409) were recruited from three primary care clinics, completed a questionnaire, and underwent cervicovaginal HPV DNA testing. Outcome measures were HPV vaccination, intention and belief in one's ability to receive the HPV vaccine in the next year, and prevalence of vaccine-type HPV. Factors independently associated with intention and belief in one's ability to receive the HPV vaccine were determined by logistic regression. RESULTS Five percent of participants had received at least one HPV vaccine dose, 66% intended to receive the vaccine, 65% were confident they could find the time to get vaccinated, 54% believed that they could receive all three shots, and 42% believed that they could afford vaccination. Sixty-eight percent of women were HPV-positive: 9% for HPV-6, 3% for HPV-11, 17% for HPV-16, and 12% for HPV-18. Factors independently associated with intention included believing that influential people would approve of vaccination, higher perceived severity of cervical cancer or genital warts, fewer safety barriers, and pregnancy history. Factors associated with a high belief in one's ability to receive the vaccine included perceived severity of HPV, sexually transmitted disease history, insurance coverage, and fewer practical barriers to vaccination. CONCLUSION Interventions that aim to increase intention and belief in one's ability to receive HPV vaccines, which may lead to higher vaccination rates, should address personal beliefs about vaccination as well as systemic barriers to vaccination. LEVEL OF EVIDENCE III.
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Fazekas KI, Brewer NT, Smith JS. HPV Vaccine Acceptability in a Rural Southern Area. J Womens Health (Larchmt) 2008; 17:539-48. [PMID: 18370586 DOI: 10.1089/jwh.2007.0489] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Karah I. Fazekas
- School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Noel T. Brewer
- School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jennifer S. Smith
- School of Public Health, University of North Carolina, Chapel Hill, North Carolina
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Current World Literature. Curr Opin Obstet Gynecol 2007; 19:596-605. [DOI: 10.1097/gco.0b013e3282f37e31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fonseca H, Greydanus DE. Sexuality in the Child, Teen, and Young Adult: Concepts for the Clinician. Prim Care 2007; 34:275-92; abstract vii. [PMID: 17666227 DOI: 10.1016/j.pop.2007.04.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article discusses basic concepts of sexuality in children, adolescents, and young adults based on development stages. Sexual behavior of adolescents is a common phenomenon, leading to sexually transmitted diseases (STDs) and unwanted pregnancy. Clinicians should provide anticipatory guidance to help with healthy sexuality development while reducing negative aspects of human sexuality. Comprehensive sexuality education should be provided, with emphasis on avoiding unwanted sexual advances (including Internet dangers), bullying, pregnancy, and STDs. Clinicians can teach sexually active patients to use effective contraception and condoms for STD protection. Ensuring full immunization with the hepatitis B vaccine and the human papillomavirus vaccine also is important.
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Affiliation(s)
- Helena Fonseca
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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