Culture and sexuality-related communication as sociocultural precursors of HPV vaccination among mother-daughter dyads of Mexican descent

Understanding HPV Vaccine Initiation and Intention Among Central American Immigrant Parents in the United States: The Role of Vaccine Literacy and Healthcare Provider Recommendations

Background/Objectives: The HPV vaccine is key to preventing HPV-related cancers, yet vaccination rates are low, particularly among immigrant and ethnic minority groups. This study explored factors influencing HPV vaccine initiation and intention among Central American immigrant parents in the U.S. Methods: A cross-sectional study with parents of children aged 11 to 17 years. Results: Among the 168 parents (53.8% mothers, 46.2% fathers) in this study, 20% reported that their children had initiated the HPV vaccine and 23% of parents of unvaccinated children intended to vaccinate within the next 12 months. Sociodemographic factors, including the parent's gender and length of U.S. residence, were significant predictors of HPV vaccine initiation and intention. Higher vaccine literacy was also a key factor, with parents with higher vaccine literacy scores being more likely to initiate vaccination and express intent to vaccinate their children. HCP communication strongly predicted both vaccine initiation and intention, yet fewer than 30% of parents received HPV vaccine information from a HCP, and less than 28% received a vaccine recommendation. In the multiple logistic regression analysis, receiving HPV vaccine information from a HCP was the strongest predictor of vaccine initiation (AOR = 93.23, 95% CI = 14.50-599.63, p < 0.001), adjusting for other variables. For vaccination intention, significant predictors included the length of U.S. residence (AOR = 0.84, 95% CI = 0.75-0.95, p < 0.01), having a U.S.-born child (AOR = 10.47, 95% CI = 1.51-72.68, p < 0.05), and receiving vaccine recommendation from a HCP (AOR = 14.73, 95% CI = 1.77-122.32, p < 0.05). Conclusions: To improve vaccination rates, interventions should enhance HCP training, strengthen provider-patient communication, and address vaccine literacy through culturally tailored strategies and community engagement.

Healthcare Professionals' Perspectives on HPV Recommendations: Themes of Interest to Different Population Groups and Strategies for Approaching Them

As a flagship of the Europe's Beating Cancer Plan, the European Commission supports EU member states' efforts to strengthen and expand the routine vaccination of girls and boys against human papillomavirus (HPV). Populations across Europe have grown in diversity, and health systems must adapt to meet the specific needs of increasing diversity. Healthcare professionals (HCPs) must strive to communicate HPV vaccine information in a culturally sensitive manner and address specific concerns related to cultural beliefs, trust in health systems and perceived risks. The objectives of this exploratory study are to identify which themes are most frequently raised during the recommendation of vaccination to minors based on the characteristics of the population (religion, region of origin, gender, level of education and language proficiency) and to collect strategies to improve communication with a diverse population. A survey was distributed through various European public health institutions to HCPs in the region and their networks. The survey included multi-response questions (themes addressed during vaccination recommendation based on population characteristics) and open-ended questions (own qualitative comments and strategies). The most common issues that arise during vaccine recommendation are a lack of knowledge, followed by misinformation. Differences were detected according to the population characteristics. Suggested strategies to improve HPV vaccine recommendation focused on the following aspects: affordability; sexuality and gender; communication platforms; multilingualism; quality of care; school collaboration. HCPs report differences according to the characteristics of the population receiving the recommendation. Personalisation of the recommendations would help to optimise the decision-making process for some groups.

HPV Vaccine Misperceptions Among Hispanics/Latinos in Southern California

BACKGROUND

Cervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites.

METHODS

HPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score.

RESULTS

Among the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p < 0.01).

DISCUSSION

Culturally relevant interventions are needed to address HPV vaccine misperceptions among Hispanics/Latinos as part of efforts toward HPV-associated cancer health equity.

Factors affecting HPV vaccine uptake among ethnic minority adolescent girls: A systematic review and meta-analysis

Objective

Human papillomavirus (HPV) vaccination rates remain low among adolescent girls across ethnic minority groups that experience high incidences of HPV-related cervical cancer with poor outcomes. This systematic review aimed to synthesize the available evidence on the factors affecting HPV vaccination among ethnic minority adolescent girls.

Methods

Six databases (PubMed, OVID MEDLINE, EMBASE, CINAHL, PsycINFO, and Scopus) were searched from inception to October 17, 2022. Guided by the conceptual model of vaccine hesitancy, the factors affecting HPV vaccine uptake were descriptively synthesized and analyzed using meta-analyses.

Results

This review included 14 studies. The pooled uptake rate of at least one dose of HPV vaccine among ethnic minority adolescent girls was only 38% (95% confidence interval ​= ​0.22, 0.39). At individual level, age of adolescent girls, knowledge of HPV, perceived importance of HPV vaccination, and perceived risk of HPV infection promoted the vaccine uptake. Beliefs in conspiracy theories and lack of trust in the government and HPV vaccine discouraged the utilization. At social and policy levels, health professionals' recommendations, subjective norms, sexuality-related communication, and vaccine policies such as insurance coverage facilitated HPV vaccination. The religious and moral convictions regarding abstinence from sex until marriage negatively influenced the vaccine acceptance.

Conclusions

HPV vaccination among ethnic minority adolescent girls was influenced by multi-level factors that highlighted a combined effort, including culturally sensitive health education programmes, sexuality-related communication skills training, collaboration with religious organizations, debunking conspiracy theories in HPV vaccine, and promoting school-based vaccination programs, to increase the coverage.

Systematic review registration

PROSPERO, CRD42022366805.

Professionally Created Content Related to HPV Vaccination on TikTok

Despite the protective abilities of the HPV vaccine, roughly half of adolescents in the United States have not completed the recommended HPV vaccine series. Professionals have taken to using social media platforms to encourage health behaviors such as receipt of the HPV vaccine. As such, the purpose of this study was to identify content created by professionals related to HPV on TikTok. This descriptive, cross-sectional study was conducted in January 2022 using the hashtag #HPV Vaccine to examine the 100 English language videos created by people who claimed to be health professionals. In addition to capturing metadata, each videos' content and subsequent comments were coded. Overall, 75.0% of the videos mentioned HPV-related cancer but few discussed vaccination as a cancer preventive measure (40.0%). More than half (52.0%) of the comments were neutral in tone and most focused on cancer (54.0%), alternative medicine (58.0%), and general questions about vaccination (62.0%). Comments about videos with greater numbers of “likes” more often mentioned cancer (85.0% vs. 46.3%, p = 0.002), the age at which to get vaccinated (70.0% vs. 41.3%, p = 0.02) and more frequently posed questions about vaccination (80.0% vs. 41.3%, p = 0.002) and cost and insurance coverage of vaccination (35.0% vs. 11.3%, p = 0.02) compared to videos with fewer “likes.” The power of provider information is paramount with HPV vaccine uptake. As providers increasingly create health messages on platforms such as TikTok, it is important that they remain aware of the potential for opposing or non-factual discourse.