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Eva FN, Khan MAS, Islam T, Monisha UK, Meem NES, Hossain MA, Goutam A, Zerin T, Alam N, Nath R, Sifat S, Sultana S, Sultana MS, Saha SK, Sarker NE, Rahman ML, Nabi MH, Hawlader MDH. Awareness of HPV vaccine and its socio-demographic determinants among the parents of eligible daughters in Bangladesh: A nationwide study. Heliyon 2024; 10:e30897. [PMID: 38778954 PMCID: PMC11109798 DOI: 10.1016/j.heliyon.2024.e30897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Background Vaccination against Human papillomavirus (HPV) is recommended to avoid HPV infections and its associated diseases, including cervical cancer. However, there is no awareness study among Bangladeshi population. Hence, this nationwide study was conducted to explore HPV vaccine awareness and its determinants among parents of eligible adolescent girls. Methods This study was conducted among the parents of daughters aged 9-15 years from 42 out of 64 randomly selected districts of Bangladesh between June 28 to August 2, 2023. A multistage sampling method was used to enroll 2151 study participants from all eight divisions of Bangladesh. A semi-structured questionnaire was used for face-to-face interviews in this study. The statistical software Stata (Version 17) was used for statistical analyses. Results The average age of the participants was 38.18 (±5.86) years. Only 22.32 % of the participants were aware of the HPV vaccine. Every additional year of age increased the likelihood of being aware of the HPV vaccine by 3 % (AOR: 1.03; 95%CI: 1.00-1.06). Participants residing in the urban area had 3.56 times higher odds of awareness than rural and semi-urban people. Businessmen and housewives had 60 % (AOR: 0.40; 95 % CI: 0.22-0.69) and 77 % (AOR: 0.23; 95 % CI: 0.16-0.33) lower odds in comparison to job holders. The lower-income group exhibited significantly higher odds of awareness (AOR: 0.25, 95%CI: 0.16-0.39) compared to the middle and the higher-income group. Participants who never went through routine health check-ups had 77 % lower odds of being aware than those who availed of regular routine check-ups (AOR: 0.23; 95%CI: 0.16-0.34). Conclusion Awareness of the HPV vaccine among the general population of Bangladesh is very low. Age, residence, occupation, monthly income, and routine medical check-ups were associated with HPV vaccine awareness. A nationwide awareness campaign would increase this awareness level among the Bangladeshi population, especially among the parents of daughters.
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Affiliation(s)
- Fahima Nasrin Eva
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Md Abdullah Saeed Khan
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212, Bangladesh
| | - Tariful Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Umme Kulsum Monisha
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- Mandy Dental College & Hospital, Dhaka, 1209, Bangladesh
| | - Nur-E-Safa Meem
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mohammad Ali Hossain
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, 1216, Bangladesh
| | - Arpita Goutam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Tahmina Zerin
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Nishat Alam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Rima Nath
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Shamma Sifat
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Sayla Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mosammat Sadeka Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Sumit Kumar Saha
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Naifa Enam Sarker
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mohammad Lutfor Rahman
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh
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Ray S, Mulchandani R, Patel P. Demand and willingness to pay for human papilloma virus vaccine for their daughters among mothers in Haryana, India: A contingent valuation study. J Health Serv Res Policy 2024; 29:76-83. [PMID: 37994804 DOI: 10.1177/13558196231215969] [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] [Indexed: 11/24/2023]
Abstract
OBJECTIVES Cervical cancer accounts for 10 percent of cancer deaths among women in India. The human papillomavirus (HPV) vaccine can protect against infection but it is not included in India's universal immunisation programme. This study aimed to assess the demand and willingness to pay for the HPV vaccine among mothers of adolescent daughters. METHODS We conducted a contingent valuation exercise involving a hospital-based cross-sectional study to assess the demand for an HPV vaccine among mothers of adolescent daughters, their willingness to pay and its determinants. Participants were recruited at a tertiary care civil hospital in the city of Gurgaon in North India, and data was collected from December 2018 to February 2019. A questionnaire was administered to obtain demographic and awareness indicators. Payment cards were used to elicit the willingness to pay amount. RESULTS Out of 319 respondents, 79% were willing to pay for the vaccine. The mean maximum willingness to pay was INR 629 (USD 35), which was less than the vaccine market price of INR 2000-3000 (USD 117-175) per dose. Participant age and number of children significantly influenced demand, while family income and awareness of cervical cancer influenced willingness to pay for the HPV vaccine. Participants were willing to spend between 3% and 34% of their monthly income on the vaccine. CONCLUSIONS High demand and low willingness to pay for the HPV vaccine indicate low value perception of the health outcome among mothers of adolescent children in India. A strategy aimed at a price reduction of the vaccine and increasing its demand through improved awareness is important. At the same time, subsidising the vaccine in the short run is needed.
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Affiliation(s)
- Shomik Ray
- Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, India
| | - Rubina Mulchandani
- Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, India
| | - Pankaj Patel
- Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, India
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Zhetpisbayeva I, Kassymbekova F, Sarmuldayeva S, Semenova Y, Glushkova N. Cervical Cancer Prevention in Rural Areas. Ann Glob Health 2023; 89:75. [PMID: 37928103 PMCID: PMC10624144 DOI: 10.5334/aogh.4133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Globally, cervical cancer (CC) incidence is higher in rural areas than in urban areas that could be explained by the influence of many factors, including inequity in accessibility of the CC prevention measures. This review aimed to identify and analyze factors associated with a lack of cervical cancer screening and HPV vaccination programs in people living in rural areas and to outline strategies to mitigate these factors. Methods The literature search encompassed two focal domains: cervical cancer screening and HPV vaccination among populations residing in rural areas, covering publications between January 1, 2004 to December 31, 2021 in the PubMed, Google Scholar, Scopus, and Cyberleninka databases, available in both English and Russian languages. Result A literature review identified 22 sources on cervical cancer screening and HPV vaccination in rural and remote areas. These sources revealed similar obstacles to screening and vaccination in both high and low-income countries, such as low awareness and knowledge about CC, screening, and HPV vaccination among rural residents; limited accessibility due to remoteness and dearth of medical facilities and practitioners, associated with a decrease in recommendations from them, and financial constraints, necessitating out-of-pocket expenses. The reviewed sources analyzed strategies to mitigate the outlined challenges. Possible solutions include the introduction of tailored screening and vaccination campaigns designed for residents of rural and remote locations. New screening and vaccination sites have been proposed to overcome geographic barriers. Integrating HPV testing-based CC screening is suggested to counter the lack of healthcare personnel. HPV vaccination is essential for primary cervical cancer prevention, especially in rural and remote areas, as it requires less medical infrastructure. Conclusion Certain measures can be proposed to improve the uptake of CC screening and HPV vaccination programs among rural residents, which are needed to address the higher prevalence of CC in rural areas. Further investigation into cervical cancer prevention in rural and remote contexts is necessary to ascertain the optimal strategies that promote health equity.
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Affiliation(s)
- Indira Zhetpisbayeva
- Department of Public Health and Social Sciences, Kazakhstan Medical University “KSPH”, Almaty, Kazakhstan
| | - Fatima Kassymbekova
- Department of Public Health and Social Sciences, Kazakhstan Medical University “KSPH”, Almaty, Kazakhstan
| | - Sholpan Sarmuldayeva
- Department of Clinical Specialties, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan
| | - Yuliya Semenova
- Nazarbayev University School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
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Simion L, Rotaru V, Cirimbei C, Gales L, Stefan DC, Ionescu SO, Luca D, Doran H, Chitoran E. Inequities in Screening and HPV Vaccination Programs and Their Impact on Cervical Cancer Statistics in Romania. Diagnostics (Basel) 2023; 13:2776. [PMID: 37685314 PMCID: PMC10486539 DOI: 10.3390/diagnostics13172776] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Introduction: A Romanian woman is diagnosed with cervical cancer every two hours; the country ranks second in Europe in terms of the mortality and incidence rate of this disease. This paper aims to identify the main reasons that have led to this situation, focusing on the measures taken by the Romanian Ministry of Health for the prevention of this type of cancer-national programs for cervical cancer screening and HPV vaccination. (2) Materials and methods: We performed a study based on the available secondary data from the National Statistics Institute, World Health Organization and Bucharest Institute of Oncology in order to assess the burden associated with cervical cancer and place it in the context of known global and European incidence and mortality rates, thus evaluating the importance of this health issue in Romania. The second component of our study was a cross-sectional study. Here, we used a 14-question questionnaire applied to the women participating in the National Screening Program for Cervical Cancer and aimed to evaluate the women's level of knowledge about screening and HPV vaccination and their access cervical-cancer-specific healthcare services. (3) Results: The results of this research show that a high percentage of women postpone routine checks due to a lack of time and financial resources and indicate that a low level of knowledge about the disease and the specific preventive methods determines the low participation in screening and HPV vaccination programs implemented in Romania, contributing to the country's cervical cancer situation. (4) Conclusions: The national programs have complicated procedures, are underfunded and do not motivate healthcare workers enough. This, combined with the lack of information for the eligible population, adds up to an extremely low number of women screened and vaccinated. Our conclusion is that the Romanian Ministry of Health must take immediate action by conducting major awareness campaigns, implementing measures to make the programs functional and ensuring coherent funding.
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Affiliation(s)
- Laurentiu Simion
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Vlad Rotaru
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Ciprian Cirimbei
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Laurentia Gales
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- Medical Oncology Department, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Daniela-Cristina Stefan
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
| | - Sinziana-Octavia Ionescu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Dan Luca
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Horia Doran
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- Surgical Clinic I, Clinical Hospital Dr. I. Cantacuzino Bucharest, 030167 Bucharest, Romania
| | - Elena Chitoran
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
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Kaur R, Callaghan T, Regan AK. Disparities in Prenatal Immunization Rates in Rural and Urban US Areas by Indicators of Access to Care. J Rural Health 2023; 39:142-152. [PMID: 35165924 DOI: 10.1111/jrh.12647] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE To evaluate disparities in urban-rural immunization rates among pregnant women by indicators of access to health care. METHODS We analyzed Phase 8 (2016-2018) Pregnant Risk Assessment Monitoring System data for 82,603 respondents who recently gave birth to a live infant. Uptake of influenza (33 states) or Tdap (19 states) vaccines was compared for rural versus urban areas of participating states. We compared the prevalence of immunization for rural versus urban areas by indicators of health care access using average marginal predictive values from multivariable regression models. FINDINGS Although nearly half (48.2%) of pregnant women in rural areas relied on Medicaid to fund prenatal care, rural-residing women were less likely to live in a state offering full coverage under Medicaid to pregnant women than urban-residing women (93.9% vs 98.0%, respectively). Among states with Medicaid programs not offering full access for pregnant women, influenza immunization coverage was 12% lower (aPR 0.88; 95% CI 0.82, 0.94) and Tdap immunization coverage was 20% lower (aPR 0.80; 95% CI 0.68, 0.95) for rural versus urban areas. Uninsured women in rural areas were less likely to receive influenza or Tdap vaccine compared to uninsured women in urban areas (aPR 0.65; 95% CI 0.50, 0.85 and aPR 0.73; 95% CI 0.57, 0.95, respectively). CONCLUSIONS Pregnant women residing in rural areas more commonly rely on Medicaid to financially support prenatal care but are less likely to have expanded or full access to Medicaid coverage, potentially contributing to disparities vaccine uptake during pregnancy and increased rates of vaccine-preventable disease.
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Affiliation(s)
- Ravneet Kaur
- Southwest Rural Health Research Center, Texas A&M University, College Station, Texas, USA.,School of Public Health, Texas A&M University, College Station, Texas, USA.,Missouri Institute of Mental Health, University of Missouri, St Louis, Missouri, USA
| | - Timothy Callaghan
- Southwest Rural Health Research Center, Texas A&M University, College Station, Texas, USA.,School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Annette K Regan
- Southwest Rural Health Research Center, Texas A&M University, College Station, Texas, USA.,School of Public Health, Texas A&M University, College Station, Texas, USA.,School of Nursing and Health Professions, University of San Francisco, San Francisco, California, USA.,Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
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Kraaijeveld SR, Mulder BC. Altruistic Vaccination: Insights from Two Focus Group Studies. HEALTH CARE ANALYSIS 2022; 30:275-295. [PMID: 36454320 PMCID: PMC9713734 DOI: 10.1007/s10728-022-00453-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
Vaccination can protect vaccinated individuals and often also prevent them from spreading disease to other people. This opens up the possibility of getting vaccinated for the sake of others. In fact, altruistic vaccination has recently been conceptualized as a kind of vaccination that is undertaken primary for the benefit of others. In order to better understand the potential role of altruistic motives in people's vaccination decisions, we conducted two focus group studies with a total of 37 participants. Study 1 included three focus groups on the subject of HPV vaccination for boys. Study 2 included three focus groups on the subject of pertussis and measles vaccination for childcare workers. We found substantial evidence of other-regarding motives across all focus groups, which suggests that altruistic motives could be an important factor when it comes to people's vaccination decisions. We address the significance of these findings for vaccination policy surrounding HPV vaccination for boys and vaccination for childcare workers. We also extend the findings to normative work on vaccination for the sake of others more generally.
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Affiliation(s)
| | - Bob C. Mulder
- Strategic Communication Group, Wageningen University & Research, Wageningen, The Netherlands
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Structural equation modeling to detect correlates of childhood vaccination: A moderated mediation analysis. PLoS One 2020; 15:e0240749. [PMID: 33057426 PMCID: PMC7561155 DOI: 10.1371/journal.pone.0240749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/01/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination. Methods A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7th through 10th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one dose of Bacillus Calmette–Guérin; three doses of Diphtheria, Pertussis, Tetanus; three doses of oral Polio vaccine; and one dose of Measles vaccine. In addition, parents were asked about their attitudes towards childhood vaccination. Results Out of the 1599 parents, 52.2% reported that their children had received all the routine vaccines (fully vaccinated); 42.7% reported their children had missed at least one routine vaccine, and 5.2% reported that their children had missed all routine vaccinations. Perceptions about the benefits/facilitators to childhood vaccination significantly predicted the full vaccination rate (standardized regression coefficient (β) = 0.29) directly and mediated the effect of parental education (β = 0.11) and employment (β = -0.06) on the rate of full vaccination. Parental education was significantly associated indirectly with higher rates of full vaccination (β = 0.11). Parental employment was significantly associated indirectly with decreasing rates of full vaccination (β = -0.05). Area of residence moderated the role of religion (β = 0.24) and the ‘number of children’ in a family (β = 0.33) on parental perceptions about barriers to childhood vaccination. The model to data fit was acceptable (Root Mean Square Error of Approximation = 0.02, 95% CI 0.018 to 0.023; Comparative Fit Index = 0.92; Tucker–Lewis Index = 0.91). Conclusions Full vaccination rate was relatively low among children in Mysore, especially among parents who were unsure about the benefits of routine vaccination and those with low educational levels. Interventions increasing awareness of the benefits of childhood vaccination that target rural parents with lower levels of education may help increase the rate of full childhood vaccination in India.
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Fokom Domgue J, Chido-Amajuoyi OG, Yu RK, Shete S. Beliefs About HPV Vaccine's Success at Cervical Cancer Prevention Among Adult US Women. JNCI Cancer Spectr 2019; 3:pkz064. [PMID: 32280919 PMCID: PMC6901081 DOI: 10.1093/jncics/pkz064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/30/2019] [Accepted: 08/08/2019] [Indexed: 01/01/2023] Open
Abstract
Background Beliefs are known to be a key determinant in vaccines’ uptake. However, little is known about beliefs surrounding the success of the human papillomavirus (HPV) vaccine in preventing cervical cancer in the United States. Methods Data from the Health Information National Trends Survey 5 Cycle 1 (2017) were analyzed for 1851 female respondents aged 18 years and older. Weighted multinomial logistic regression was employed to determine predictors of beliefs in the success of the HPV vaccine in preventing cervical cancer. Results Overall, 29.8% of women believed that HPV vaccine is successful in preventing cervical cancer, 6.6% believed it is not successful, and 63.6% did not know if the HPV vaccine is successful. Non-Hispanic blacks (adjusted odds ratio [aOR] = 1.80, 95% confidence interval [CI] = 1.16 to 2.79), women with no more than 12 years of education (aOR = 2.05, 95% CI = 1.17 to 3.60), those who did not know if they were advised by a health-care provider to get an HPV shot within the last 12 months (aOR = 4.19, 95% CI = 1.39 to 12.60), and those unaware of a family cancer history (aOR = 5.17, 95% CI = 1.48 to 18.21) were more likely to not know whether the HPV vaccine prevents cervical cancer. Women younger than 65 years were more likely than elderly to believe that the HPV vaccine is not successful at preventing cervical cancer. Conclusions A substantial proportion of US women are uninformed about the HPV vaccine. To accelerate progress in the HPV vaccine’s uptake, future interventions should incorporate educational programs, particularly targeting Non-Hispanic blacks, women with a lower level of education, and those younger than 65 years. Health-care providers’ participation in promotion of patient education about HPV vaccination should also be increased.
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Affiliation(s)
| | | | - Robert K Yu
- See the Notes section for the full list of authors' affiliations
| | - Sanjay Shete
- See the Notes section for the full list of authors' affiliations
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Knowledge, awareness and attitude towards human papilloma virus vaccine in a resource-constrained setting: a comparison between an urban and rural population in South Africa. SOUTHERN AFRICAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 2019. [DOI: 10.1080/20742835.2019.1589183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Degarege A, Krupp K, Fennie K, Srinivas V, Li T, Stephens DP, Madhivanan P. An integrative behavior theory derived model to assess factors affecting HPV vaccine acceptance using structural equation modeling. Vaccine 2019; 37:945-955. [PMID: 30655176 DOI: 10.1016/j.vaccine.2019.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/13/2018] [Accepted: 01/02/2019] [Indexed: 01/20/2023]
Abstract
The study examined factors that affect parental intention-to-vaccinate adolescent daughters with HPV vaccine in Mysore district, India. A cross-sectional study was conducted among 1609 parents of adolescent girls attending schools in Mysore District between February 2010 and October 2011. A validated questionnaire was used to assess parental attitudes, beliefs related with HPV infection, cervical cancer, HPV vaccine and vaccination in general. Structural equation modeling was used to estimate parameters and assess whether a model based on the integrative behavior theory would fit the current data. More than two-thirds (78.0%) of parents would accept vaccinating their daughters with HPV vaccine. Intention to HPV vaccination significantly increased with increase in the perception of parents about the benefits (standardized regression coefficient (β) = 0.39) or sources of information about HPV vaccine (β = 0.24), but intention decreased significantly with an increase in the perception about barriers to HPV vaccination β = -0.44). The effect of beliefs about severity of HPV infection or cervical cancer (β = 0.20), and beliefs about benefits (β = 0.20) or barriers (β = -0.25) to vaccination in general on intention to HPV vaccination were significantly mediated by parental attitudes and source of information about the vaccine. Geographical location significantly moderated the awareness about HPV on beliefs about severity of HPV infection or cervical cancer (β = 0.33), and the effect of religion on norms related to HPV vaccination (β = 0.19). Fit of the model to the data was acceptable. This study identified modifiable parental attitudes about HPV vaccine and beliefs related with HPV infection, cervical cancer and vaccination, which predicted parental intention-to-vaccinate their daughters with HPV vaccine in India. Health education interventions tailored to counter parental negative attitudes and beliefs about HPV vaccine and vaccination in general would be important for the community to promote HPV vaccination.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA; Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Karl Krupp
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA; Public Health Research Institute of India, Mysore, India
| | - Kristopher Fennie
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA
| | | | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA
| | - Dionne P Stephens
- Department of Psychology, College of Arts, Sciences & Education, Florida International University, Miami, USA
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA; Public Health Research Institute of India, Mysore, India.
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