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Phongsamart W, Lou PJ, Sukarom I, Wu YH, Zaidi O, Du F, Simon A, Bernauer M. Integrative literature review on human papillomavirus vaccination recommendations in national immunization programs in select areas in the Asia-Pacific region. Hum Vaccin Immunother 2024; 20:2362449. [PMID: 38925146 PMCID: PMC11210899 DOI: 10.1080/21645515.2024.2362449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
There is limited literature on current human papillomavirus (HPV) vaccination in the Asia-Pacific region. This integrative literature review was conducted to describe HPV vaccination programs in Hong Kong, Indonesia, Japan, South Korea, Malaysia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. Program descriptions, recommendations, f unding, and coverage data were extracted. Twenty-five citations were included. As of 2022, eight of the 10 areas of interest include HPV in their national immunization program (NIP) for school-aged girls; full implementation in Indonesia is expected in 2023 whereas Vietnam's NIP does not include HPV. Singapore also includes HPV vaccination for women (18-26 years). None of the HPV vaccination programs include males. In most areas (n = 7), programs include only one vaccine option. While female HPV NIPs are present in the Asia-Pacific region, opportunities remain to strengthen NIPs in broader populations (e.g., males, catch-up cohorts) to expand public health impact and provide gender equity in HPV vaccination.
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Affiliation(s)
- Wanatpreeya Phongsamart
- Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pei-Jen Lou
- Department of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan
| | - Isaya Sukarom
- Outcomes Research, Regional Asia Pacific, MSD Thailand, Bangkok, Thailand
| | - Ying-Hui Wu
- Global Medical and Scientific Affairs, MSD Taiwan, Taipei, Taiwan
| | - Omer Zaidi
- HEOR & Market Access, OPEN Health, Bethesda, MD, USA
| | - Frieda Du
- HEOR & Market Access, OPEN Health, Shanghai, China
| | - Alyssa Simon
- HEOR & Market Access, OPEN Health, Bethesda, MD, USA
| | - Mark Bernauer
- HEOR & Market Access, OPEN Health, Bethesda, MD, USA
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Tsai SA, Lu CY, Chen TI, Huang SP, Chen YC. Adverse events from HPV vaccination in Taiwan. Vaccine 2023; 41:7444-7449. [PMID: 37949754 DOI: 10.1016/j.vaccine.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/28/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
The safety of human papillomavirus (HPV) vaccines has been evaluated continuously in pre-licensure clinical trials, post-marketing surveillance systems, and observational studies. Most studies have found no significant association between serious adverse events and HPV vaccination. However, these studies have focused on Western populations; similar studies focusing on Asian populations are insufficient. Our retrospective cohort study used the HPV-vaccination records of junior high-school adolescent girls aged 12-15 years between 2013 and 2018 in Taiwan's National Immunization Information System and linked them to a registry for beneficiaries in Taiwan's National Health Insurance Database (NHID) to establish the vaccinated group. We selected 19 serious diseases as serious adverse events. We compared the incidence rates of these serious adverse events between the vaccinated group and girls in the same age group population, and we calculated the standardized incidence ratio (SIR) to evaluate the risk of serious adverse events after HPV vaccination. Because of the onset of different types of diseases, we set three periods after the subjects received HPV vaccination: within 3 months, within 1 year, and during the study period (2013-2018). The results showed the incidence rates and the SIRs of 19 selected adverse events. Among the 19 selected serious adverse events, the disease with the highest incidence rate during the study period was fibromyalgia (73.23 cases per million population), and the disease with the lowest incidence rate during the study period was Crohn's disease (0.15 cases per million population). The results showed no statistically significant increases in the risk of 19 selected serious adverse events and indicated no association between HPV vaccination and serious adverse events. Given the benefits and safety of HPV vaccination, our research can reduce concerns about vaccine side effects, inform health policies and improve public and clinician's acceptance of HPV vaccine policy.
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Affiliation(s)
- Sz-An Tsai
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242008, Taiwan.
| | - Chun-Yi Lu
- Department of Pediatrics, National Taiwan University Hospital, Taipei City 100225, Taiwan; College of Medicine, National Taiwan University, Taipei city 100233, Taiwan.
| | - Tzu-I Chen
- Data Science Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan.
| | - Shih-Pei Huang
- Department of Medical Education & Bioethics, Graduate Institute of Medical Education & Bioethics, National Taiwan University College of Medicine, Taipei City 100233, Taiwan.
| | - Yong-Chen Chen
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242008, Taiwan; Data Science Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan; Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan.
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Malik AA, Ahmed N, Shafiq M, Elharake JA, James E, Nyhan K, Paintsil E, Melchinger HC, Team YBI, Malik FA, Omer SB. Behavioral interventions for vaccination uptake: A systematic review and meta-analysis. Health Policy 2023; 137:104894. [PMID: 37714082 PMCID: PMC10885629 DOI: 10.1016/j.healthpol.2023.104894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/22/2023] [Accepted: 08/15/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries. METHODS We included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately. FINDINGS Our results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5-4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3-3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes. INTERPRETATION Our findings indicate that "provider recommendation" and "on-site vaccination" along with other behavioral interventions can be employed to increase vaccination rates globally.
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Affiliation(s)
- Amyn A Malik
- Yale Institute for Global Health, New Haven, CT 06510, USA; Analysis Group, Inc, Boston, MA 02199, USA
| | - Noureen Ahmed
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA
| | - Mehr Shafiq
- Yale Institute for Global Health, New Haven, CT 06510, USA; Columbia University School of Public Health, New York, NY 10032, USA
| | - Jad A Elharake
- Yale Institute for Global Health, New Haven, CT 06510, USA; UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA; The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Erin James
- Yale Institute for Global Health, New Haven, CT 06510, USA
| | - Kate Nyhan
- Yale University, New Haven, CT 06510, USA
| | - Elliott Paintsil
- Yale Institute for Global Health, New Haven, CT 06510, USA; Columbia University Institute of Human Nutrition, New York, NY 10032, USA
| | | | | | - Fauzia A Malik
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA
| | - Saad B Omer
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA.
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Aguolu OG, Malik AA, Ahmed N, Omer SB. Overcoming Vaccine Hesitancy for Future COVID-19 and HIV Vaccines: Lessons from Measles and HPV Vaccines. Curr HIV/AIDS Rep 2022; 19:328-343. [PMID: 36114951 PMCID: PMC9483354 DOI: 10.1007/s11904-022-00622-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The discovery of vaccines significantly reduced morbidity and mortality of infectious diseases and led to the elimination and eradication of some. Development of safe and effective vaccines is a critical step to the control of infectious diseases; however, there is the need to address vaccine hesitancy because of its potential impact on vaccine uptake. METHODS We conducted a narrative review of studies on interventions to address measles and human papillomavirus vaccine hesitancy. We discussed how lessons learned from these studies could be applied towards COVID-19 and future human immunodeficiency virus vaccines. RESULTS We found that there are several successful approaches to improving vaccine acceptance. Interventions should be context specific and build on the challenges highlighted in various settings. CONCLUSION Strategies could be used alone or in combination with others. The most successful interventions directly targeted the population for vaccination. Use of financial incentives could be a potential tool to improve vaccine uptake.
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Affiliation(s)
- Obianuju G. Aguolu
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
| | - Amyn A. Malik
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
| | - Noureen Ahmed
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Yale School of Public Health, Yale University, New Haven, CT USA
| | - Saad B. Omer
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
- Yale School of Public Health, Yale University, New Haven, CT USA
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Wu MH, Lin LJ, Wu CC. Towards the elimination of cervical cancer in Taiwan. J Formos Med Assoc 2021; 121:1188-1190. [PMID: 34865949 DOI: 10.1016/j.jfma.2021.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/23/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mei-Hsuan Wu
- Department of Obstetrics and Gynecology, Medicine College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Li-Ju Lin
- Health Promotion Administration, Ministry of Health and Welfare Division, Taipei, Taiwan.
| | - Chao-Chun Wu
- Health Promotion Administration, Ministry of Health and Welfare Division, Taipei, Taiwan.
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Wijayanti KE, Schütze H, MacPhail C, Braunack-Mayer A. Parents' knowledge, beliefs, acceptance and uptake of the HPV vaccine in members of The Association of Southeast Asian Nations (ASEAN): A systematic review of quantitative and qualitative studies. Vaccine 2021; 39:2335-2343. [PMID: 33781598 DOI: 10.1016/j.vaccine.2021.03.049] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/19/2021] [Accepted: 03/12/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVE Cervical cancer is the second most common malignancy affecting females in Southeast Asia. Human Papillomavirus (HPV) vaccines have been available since 2006. Several Association of Southeast Asian Nations (ASEAN) member countries have since introduced and/or piloted the HPV vaccine with adolescent females. This systematic review was conducted to understand what factors influence parents' acceptance of the HPV vaccine in the region. METHODS Seven databases were searched for qualitative and quantitative studies published up to 16 April 2020. Papers were included if they were peer-reviewed, in English, available in full text, and had a focus on parents' knowledge, beliefs, attitudes and acceptance of the HPV vaccine. Findings were integrated to answer the review question using framework analysis based on the Theory of Planned Behaviour. RESULTS Sixteen publications were included and synthesised under the Theory of Planned Behaviour domains: 1) Knowledge, attitudes and acceptance, 2) subjective norms, and 3) perceived behavioural control. Parents' attitudes to HPV vaccination were positive and acceptance to vaccinate their daughters against HPV was high. The uptake was high when the vaccine was offered for free. CONCLUSION Parents' acceptance and uptake of the HPV vaccine in ASEAN member-countries was high when the vaccine was offered for free even though their knowledge of cervical cancer and HPV was poor. Further research is needed to see how uptake and acceptance can be maintain when the vaccine is not offered for free.
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Affiliation(s)
- Kurnia Eka Wijayanti
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia; Department of Physical Education, Faculty of Sport and Health Education, Universitas Pendidikan Indonesia, Bandung, Indonesia.
| | - Heike Schütze
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia; Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Catherine MacPhail
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Annette Braunack-Mayer
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
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Tang CH, Cheng WF, Jiang JH, You SL, Huang LW, Hsieh JY, Mukherjee P, Van Kriekinge G, Lee C. Cost-Effectiveness Analysis of Human Papillomavirus Vaccination in Adolescent Girls in Taiwan. Asian Pac J Cancer Prev 2019; 20:1377-1387. [PMID: 31127896 PMCID: PMC6857899 DOI: 10.31557/apjcp.2019.20.5.1377] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective: Three vaccines are available to Taiwanese young girls for cervical cancer (CC) prevention. Here we evaluate the cost-effectiveness of the two-dose (2D) AS04-adjuvanted HPV-16/18 vaccine (2D-AS04-HPV-16/18v)+screening compared with a screening programme alone, with 2D human papillomavirus 6/11/16/18 vaccine (2D-4vHPVv)+screening, and with 2D/three-dose (3D) human papillomavirus 6/11/16/18/31/33/45/52/58 vaccine (9vHPVv)+screening, for Taiwan universal mass vaccination. Methods: A static Markov cohort model simulated the natural history of human papillomavirus (HPV) infection and CC screening for a 12-year-old cohort of Taiwanese girls (N=120,000). The model ran in 1-year cycles over the cohort’s lifetime. Vaccine efficacy irrespective of HPV type was considered in the analysis for each vaccine. Input data were obtained from published literature, local databases, government reports and websites, and expert opinion. The analysis incorporated direct medical costs only, with an annual discount rate of 3.0%. The threshold was determined as 1 Gross Domestic Product per capita (New Taiwan dollar [NT$] 727,818; year 2016). Results: The 2D-AS04-HPV-16/18v+screening yielded 0.0365 quality-adjusted life year (QALY) gained at an additional cost of NT$ 5,770 per person compared with the screening programme alone. This resulted in an incremental cost-effectiveness ratio well below the threshold. Compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening, discounted results demonstrated additional QALYs gained at lower cost for 2D-AS04-HPV-16/18v+screening, making it dominant over both 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening. Conclusions: Vaccinating Taiwanese girls with 2D-AS04-HPV-16/18v in addition to screening to prevent CC is cost-effective compared with using a screening programme alone and the dominant option compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening.
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Affiliation(s)
- Chao-Hsiun Tang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Wen Fang Cheng
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jhih-Hua Jiang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - San Lin You
- School of Medicine, College of Medicine, Big Data Research Centre, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Lee-Wen Huang
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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Loke AY, Kwan ML, Wong YT, Wong AKY. The Uptake of Human Papillomavirus Vaccination and Its Associated Factors Among Adolescents: A Systematic Review. J Prim Care Community Health 2017; 8:349-362. [PMID: 29161946 PMCID: PMC5932744 DOI: 10.1177/2150131917742299] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. Methods: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination. Results: Twenty-eight studies were identified and included. The HPV vaccination uptake rate (at least 1 dose) varied significantly among countries, ranging from 2.4% to 94.4%. Scotland achieved the highest uptake of all the studies included in this review, while Hong Kong had the lowest, at 2.4% to 9.1%. This review also showed that adolescents had limited awareness and knowledge of HPV infections and vaccines, even 10 years after the vaccine had become available. Conclusions: It is recommended that barriers to the uptake of the vaccine should be addressed, and that school-based sexual health education of HPV infection and vaccine promotion should be reinforced.
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Affiliation(s)
- Alice Yuen Loke
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Miu Ling Kwan
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR.,2 Tuen Mun Hospital, Hospital Authority, Hong Kong SAR
| | - Yuen-Ting Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Alice Kar Yan Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
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Cho CY, Lo YC, Hung MC, Lai CC, Chen CJ, Wu KG. Risk of cancer in patients with genital warts: A nationwide, population-based cohort study in Taiwan. PLoS One 2017; 12:e0183183. [PMID: 28806741 PMCID: PMC5555692 DOI: 10.1371/journal.pone.0183183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 07/31/2017] [Indexed: 11/18/2022] Open
Abstract
Background Condyloma acuminata currently affects around 1% of sexually active adults, and its incidence is increasing. The coexistence of genital warts (GW) and certain cancers and an association between human papillomavirus (HPV) and various malignancies have been reported. Therefore, we conducted this large national study to analyze the risk of malignancies among men and women with GW in Taiwan. Methods and findings Between January 2000 and December 2013, approximately 3 million patients were reported to the National Health Insurance Research Database of Taiwan. Of these patients, 21,763 were diagnosed with GW. In the same time period, a total of 213,541 cancer cases were reported to the registry, of which 1002 were recorded among patients with GW. The age-specific incidence rates of GW and standardized incidence ratios (SIRs) of malignancies compared to the general population were calculated. Women acquired GW earlier than men, with a mean age at diagnosis of 32.63±12.78 years. The highest incidence rate for both genders peaked at 20–29 years. Of the 1002 patients with GW and malignancies, the SIR was 1.95 (95%CI 1.83–2.07). The most markedly increased risk was found for HPV-related cancers, with a SIR of 9.74 (95%CI 3.70–15.77). Significantly elevated risks were also noted for smoking-related cancers, anogenital cancers, cervix in situ, colon, rectum, lung, kidney, and prostate cancers. Most cancers developed within 10 years after the diagnosis of GW. Conclusions Patients with GW have an increased risk of HPV-related cancers, especially anogenital malignancies in Taiwan. The elevated risk of other cancers highlights differences in exposure and risk factors among patients with GW compared to the general population. Cancer screening and HPV vaccination programs should be emphasized for at-risk patients.
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Affiliation(s)
- Ching-Yi Cho
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Yu-Cheng Lo
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Miao-Chiu Hung
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Chou-Cheng Lai
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Chun-Jen Chen
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Keh-Gong Wu
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Lai CY, Wu WW, Tsai SY, Cheng SF, Lin KC, Liang SY. The Effectiveness of a Facebook-Assisted Teaching Method on Knowledge and Attitudes About Cervical Cancer Prevention and HPV Vaccination Intention Among Female Adolescent Students in Taiwan. HEALTH EDUCATION & BEHAVIOR 2015. [DOI: 10.1177/1090198114558591 10.1177/1090198114558591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Lack of education is a known barrier to vaccination, but data on the design and effectiveness of interventions remain limited. Objective. This study aims to identify the effectiveness of a Facebook-assisted teaching method on female adolescents’ knowledge and attitudes about cervical cancer prevention and on their human papillomavirus vaccination intention. Method. A quasi-experimental time series research design was used. Two hundred female adolescents at a senior high school in Taipei were recruited into two groups. Following a classroom lecture, one group was provided a Facebook-assisted online discussion, and the other group was provided an in-person discussion forum. A demographic questionnaire and cervical cancer prevention questionnaire were distributed. Data were analyzed for descriptive statistics and generalized estimation equations. Results. Improvement from T0 to T2 in knowledge and attitude scores was 4.204 and 4.496 points, respectively. The Facebook group’s improvement in vaccination intention from T0 to T2 was 2.310 times greater than the control group’s improvement under conditions of out-of-pocket expenses and 2.368 times greater under conditions of free vaccination. Conclusions. School-based cervical cancer prevention education can be effective. The Facebook-assisted discussion method was more effective than the in-person discussion. Providing the human papillomavirus vaccine free of charge would increase female adolescents’ intention to be vaccinated.
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Affiliation(s)
- Ching-Yi Lai
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wei-Wen Wu
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Su-Fen Cheng
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kuan-Chia Lin
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Yuan Liang
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Lai CY, Wu WW, Tsai SY, Cheng SF, Lin KC, Liang SY. The Effectiveness of a Facebook-Assisted Teaching Method on Knowledge and Attitudes About Cervical Cancer Prevention and HPV Vaccination Intention Among Female Adolescent Students in Taiwan. HEALTH EDUCATION & BEHAVIOR 2014; 42:352-60. [PMID: 25512072 DOI: 10.1177/1090198114558591] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lack of education is a known barrier to vaccination, but data on the design and effectiveness of interventions remain limited. OBJECTIVE This study aims to identify the effectiveness of a Facebook-assisted teaching method on female adolescents' knowledge and attitudes about cervical cancer prevention and on their human papillomavirus vaccination intention. METHOD A quasi-experimental time series research design was used. Two hundred female adolescents at a senior high school in Taipei were recruited into two groups. Following a classroom lecture, one group was provided a Facebook-assisted online discussion, and the other group was provided an in-person discussion forum. A demographic questionnaire and cervical cancer prevention questionnaire were distributed. Data were analyzed for descriptive statistics and generalized estimation equations. RESULTS Improvement from T0 to T2 in knowledge and attitude scores was 4.204 and 4.496 points, respectively. The Facebook group's improvement in vaccination intention from T0 to T2 was 2.310 times greater than the control group's improvement under conditions of out-of-pocket expenses and 2.368 times greater under conditions of free vaccination. CONCLUSIONS School-based cervical cancer prevention education can be effective. The Facebook-assisted discussion method was more effective than the in-person discussion. Providing the human papillomavirus vaccine free of charge would increase female adolescents' intention to be vaccinated.
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Affiliation(s)
- Ching-Yi Lai
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wei-Wen Wu
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Su-Fen Cheng
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kuan-Chia Lin
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Yuan Liang
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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