1
|
Heyde S, Osmani V, Schauberger G, Cooney C, Klug SJ. Global parental acceptance, attitudes, and knowledge regarding human papillomavirus vaccinations for their children: a systematic literature review and meta-analysis. BMC Womens Health 2024; 24:537. [PMID: 39334328 PMCID: PMC11428909 DOI: 10.1186/s12905-024-03377-5] [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: 01/14/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND This systematic literature review aims to summarize global research on parental acceptance, attitudes, and knowledge regarding human papillomavirus vaccinations. METHODS The literature search was conducted in PubMed, Web of Science and Scopus, and included publications from 2006 to 2023. Study quality was assessed using the Newcastle-Ottawa Scale. The Grading of Recommendations Assessment, Development, and Evaluation guidelines were used to assess the strength of evidence for the primary outcome. Meta-analyses were performed using random-effects models to estimate pooled parental acceptance of HPV vaccinations. Studies were stratified by study years, and a subgroup analysis was conducted to estimate vaccine acceptance rates by world regions. Additionally, sensitivity analyses examined the role of parents in accepting HPV vaccinations for children of different sexes. RESULTS Based on 86 studies, we found that parents generally supported HPV vaccinations for their children, yet HPV vaccine acceptance rates showed high variation (12.0 to 97.5%). The subgroup analysis revealed geographical variations in pooled parental HPV vaccine acceptance rates, with the highest rate observed in Africa (79.6%; 95% CI: 73.5-85.2; I² = 98.3%; p < 0.01) and the lowest in North America (56.7%; 95% CI: 49.3-64.0; I² = 99.4%; p < 0.01). Sensitivity analyses showed that acceptance was higher for daughters than for sons, with mothers more willing to get their daughters vaccinated. The proportion of parents reporting barriers or benefits regarding HPV vaccinations varied widely (0.3-95.8%) between study regions. Across all world regions, fear of adverse effects and concerns about vaccine safety were the main barriers, whereas the desire to protect their children from cancer was a significant predictor of vaccine acceptance. Knowledge levels varied widely (6.5 to 100%) between world regions and according to the questions asked. In most studies, knowledge e.g., that HPV is sexually transmitted, and that HPV vaccination provides protection against cervical cancer, ranged from moderate to high. CONCLUSIONS The results indicated moderate parental acceptance of HPV vaccines. Public knowledge of HPV infection should be promoted, and special efforts should be made to minimize the existing barriers and increase vaccination accessibility and uptake.
Collapse
Affiliation(s)
- Sophia Heyde
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany.
| | - Vanesa Osmani
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany
| | - Gunther Schauberger
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany
| | - Claire Cooney
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany
| | - Stefanie J Klug
- TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Germany
| |
Collapse
|
2
|
Kohler RE, Wagner RB, Vega J, Rivera YM, Kantor L, Greene K. HPV Vaccination Information Access, Needs, and Preferences Among Black and Hispanic Mothers. JOURNAL OF HEALTH COMMUNICATION 2024; 29:566-579. [PMID: 39129253 PMCID: PMC11384291 DOI: 10.1080/10810730.2024.2386594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
HPV-associated cancer disparities disproportionately affect Black/African American and Hispanic individuals in the U.S. HPV vaccination, which can prevent many HPV-associated cancers, should be clearly recommended by pediatricians to parents of adolescents aged 9-12, yet uptake and completion remain lower than other adolescent vaccinations. We used the Structural Influence Model of Health Communication to explore communication inequalities from interviews with 19 Black and Hispanic mothers of adolescents. We identified HPV vaccination information seeking behaviors, media use, and preferred channels to address information needs. This study provides insights into how mothers' nativity and ethno-racial identity influenced how they accessed and processed information from various sources. Preferences for digital and community-based strategies to address information gaps and hesitancy concerns are also presented. Findings suggest future prevention strategies must increase access to accurate information that resonates with NH-Black and Hispanic communities' needs and is disseminated via preferred communication channels to maximize the effects of multi-level interventions promoting HPV vaccination among communities experiencing disparities.
Collapse
Affiliation(s)
- Racquel E Kohler
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Rachel B Wagner
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Jacqueline Vega
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Yonaira M Rivera
- School of Communication & Information, Rutgers University, New Brunswick, New Jersey, USA
| | - Leslie Kantor
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Kathryn Greene
- School of Communication & Information, Rutgers University, New Brunswick, New Jersey, USA
| |
Collapse
|
3
|
Finch LA, Levy MS, Thiele A, Jeudin P, Huang M. Barriers to cervical cancer prevention in a safety net clinic: gaps in HPV vaccine provider recommendation and series completion among Ob/Gyn patients. Front Oncol 2024; 14:1359160. [PMID: 38606100 PMCID: PMC11007179 DOI: 10.3389/fonc.2024.1359160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
Objective The primary objective of this study was to evaluate patients' knowledge regarding HPV vaccination and vaccine uptake in a diverse patient population. The secondary objective was to evaluate factors influencing the decision to vaccinate, potential barriers to vaccination, and to assess whether HPV vaccines were offered to or discussed with eligible patients in a safety net Obstetrics and Gynecology (Ob/Gyn) clinic. Methods A 28-item survey was developed using Likert scale survey questions to assess patient agreement with statements regarding HPV and the vaccine. The surveys were administered to patients in the Ob/Gyn outpatient clinics from May 2021 through September 2022. Additionally, pharmacy data were reviewed and chart review was performed as a quality improvement initiative to assess the impact of expanded HPV vaccine eligibility to patients with private insurance on vaccine uptake. Descriptive statistics were performed. Results 304 patients completed surveys from May 2021 through September 2022. The median age of respondents was 32 (range 18-80). 16 (5%) were Non-Hispanic White, 124 (41%) were Hispanic White, 58 (19%) were Non-Hispanic Black, 6 (2%) were Hispanic Black, 29 (9.5%) were Haitian, 44 (14%) were Hispanic Other, 7 (2%) were Non-Hispanic Other, 20 (6.6%) did not respond. 45 (14%) patients were uninsured. Many patients (62%) reported that a physician had never discussed HPV vaccination with them. Seventy nine percent of patients reported they had never received the HPV vaccine, and 69% of patients reported that lack of a medical provider recommendation was a major barrier. Among patients to whom HPV vaccination had been recommended, 57% reported that the vaccine was not available the same day in clinic. Conclusion Our study demonstrated that many patients never had a provider discuss HPV vaccination with them and never received the HPV vaccine. Additionally, amongst those who did initiate HPV vaccination, completion of the series remains a key barrier. Ensuring that providers discuss HPV vaccination and that patients receive HPV vaccines, along with expanding access to and convenience of HPV vaccination are critical aspects of preventing cervical cancer.
Collapse
Affiliation(s)
- Lindsey A. Finch
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Jackson Memorial Hospital, Miami, FL, United States
| | - Morgan S. Levy
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Amanda Thiele
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Patricia Jeudin
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Miami, FL, United States
| | - Marilyn Huang
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Miami, FL, United States
| |
Collapse
|
4
|
Coleman DC, Markham C, Guilamo-Ramos V, Santa Maria D. Relationship between religiosity and HPV vaccine initiation and intention in urban black and hispanic parents. BMC Public Health 2024; 24:265. [PMID: 38263012 PMCID: PMC10804600 DOI: 10.1186/s12889-024-17653-4] [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: 12/21/2022] [Accepted: 01/03/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE Religion is believed to be an important sociocultural influence in the U.S., but little is known about how religiosity shapes the human papillomavirus (HPV) vaccine decision in racial/ethnic minorities. The purpose of this study was to examine the relationship between religiosity and HPV vaccine initiation and intention among urban, racial/ethnic minority parents of adolescents 11-14 years old. DESIGN This study employed a descriptive, cross-sectional design using baseline data from Black and Hispanic parents (N = 175 and 285, respectively) recruited from medically underserved communities. Chi-square tests for independence and independent-samples t-tests were run to assess sociodemographic differences in vaccine initiation and vaccine intention. Binary logistic regression analyses were conducted to determine whether religious attendance and religious salience were associated with parents' HPV vaccine decisions for their children. RESULTS Approximately 47% of Black parents had vaccinated their youth against HPV. Of those who had not initiated the vaccine for their child, 54% did not intend to do so. 54% of Hispanic parents had initiated the HPV vaccine for their youth. Of those who had not initiated the vaccine for their child, 51% did not intend to do so. Frequency of attendance at religious services and the importance of religion in one's life was not significantly correlated with HPV vaccine decision-making for Black nor Hispanic parents. CONCLUSION This study suggests that religiosity does not influence the HPV vaccine decision for urban, Black and Hispanic parents. Future studies using measures that capture the complexity of religion as a social construct are needed to confirm the findings. In addition, studies with representative sampling will enable us to make generalizations about the influence of religion on HPV vaccine decision-making for urban, racial/ethnic minority parents.
Collapse
Affiliation(s)
- Deidra Carroll Coleman
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit. 1440, 77030, Houston, TX, USA.
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, 77030, Houston, TX, USA
| | - Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, 27710, Durham, MC, USA
| | - Diane Santa Maria
- Department of Research, The University of Texas Health Science Center at Houston, Cizik School of Nursing, 77030, Houston, TX, USA
| |
Collapse
|
5
|
Sacre A, Bambra C, Wildman JM, Thomson K, Bennett N, Sowden S, Todd A. Socioeconomic inequalities in vaccine uptake: A global umbrella review. PLoS One 2023; 18:e0294688. [PMID: 38091273 PMCID: PMC10718431 DOI: 10.1371/journal.pone.0294688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
This global umbrella review aimed to synthesise evidence of socioeconomic inequalities in the uptake of routine vaccinations and identify the mechanisms that may contribute to the association. To our knowledge, no attempt has been made to synthesise the global body of systematic reviews across a variety of vaccines, geographical locations, and measures of SES. The inclusion criteria were as follows: studies assessing vaccination uptake according to education, income, occupation/employment, and/or area-level deprivation; any country or universally recommended routine vaccination (according to the WHO); qualitative or quantitative reviews, published 2011-present. The searches were performed in eight databases. The screening process followed PRISMA-E guidelines, each stage was performed by one reviewer, and a 10% sample checked by a second for consistency. Included reviews underwent data extraction, quality appraisal (AMSTAR-2), and narrative synthesis according to country-context. After deduplication, 9,163 reports underwent title and abstract screening, leaving 119 full texts to be assessed for eligibility. Overall, 26 studies were included in the umbrella review. Evidence for lower uptake amongst disadvantaged SES individuals was found in all 26 reviews. However, 17 reviews showed mixed results, as inverse associations were also identified (lower uptake for advantaged SES, and/or higher uptake for disadvantaged SES). Those that explored high-income countries had a greater prevalence of mixed findings than those focusing on low/middle-income countries. The two most frequently cited mechanisms were vaccination knowledge, and confidence in vaccination or vaccination providers. These mechanisms were often understood by review authors as varying by level of education. We find socioeconomic differences in routine vaccination uptake, but the association did not always follow a gradient. Whilst education may be associated with uptake globally, our study indicates that its role varies by country-context. A limitation is the overlap of some primary studies across the included systematic reviews.
Collapse
Affiliation(s)
- Amber Sacre
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC), Newcastle, United Kingdom
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC), Newcastle, United Kingdom
| | | | - Katie Thomson
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Natalie Bennett
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC), Newcastle, United Kingdom
| | - Sarah Sowden
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Adam Todd
- School of Pharmacy, Newcastle University, Newcastle, United Kingdom
| |
Collapse
|
6
|
Chan DN, Li C, Law BM, Choi K, Lee PP, So WK. Factors affecting HPV vaccine uptake among ethnic minority adolescent girls: A systematic review and meta-analysis. Asia Pac J Oncol Nurs 2023; 10:100279. [PMID: 37661962 PMCID: PMC10471936 DOI: 10.1016/j.apjon.2023.100279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Dorothy N.S. Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Caixia Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Bernard M.H. Law
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K.C. Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Pinky P.K. Lee
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Winnie K.W. So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
7
|
Cunningham-Erves J, Smalls M, Stewart EC, Edwards K, Hull PC, Dempsey AF, Wilkins CH. Communication Interactions, Needs, and Preferences During Clinical Encounters of African American Parent-Child Dyads. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01754-8. [PMID: 37603225 DOI: 10.1007/s40615-023-01754-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/29/2023] [Accepted: 08/06/2023] [Indexed: 08/22/2023]
Abstract
Human papillomavirus (HPV) vaccination rates remain suboptimal among African American adolescents. Although provider recommendations during clinical encounters are believed to be highly effective in increasing uptake and series completion, little has been reported about parent-child perspectives on the counseling received during these encounters. Among African American parent-child dyads, we sought to explore and compare interactions, needs, and preferences during clinical encounters by child's HPV vaccination status. We applied a qualitative, phenomenological study design to conduct semi-structured interviews with African American parent-child dyads representing children who were unvaccinated (n = 10), had initiated but not completed (n = 11), or had completed the HPV vaccine series (n = 9). Using iterative, inductive-deductive thematic analysis, five themes were generated: (1) parents' attitudes varied about the HPV vaccine but were mostly positive for vaccines in general; (2) patient-parent-provider clinical encounters from the parent perspective; (3) patient-parent-provider clinical encounters from the child perspective; (4) methods of distribution of supplemental HPV information; and (5) communication desired on HPV vaccination by parents and children. Parents stating they received a provider's recommendation increased by vaccination status (unvaccinated: 6 out of 10; initiated: 7 out of 11; completed: 9 out of 9). Most parents and children were not satisfied with provider communication on the HPV vaccine and used supplemental materials to inform decision-making. Ongoing communication on the HPV vaccine was requested even post-vaccination of the child. During clinical encounters, children and parental messaging needs are similar yet dissimilar. We offer communication strategies and messaging that can be used for African American parent-child dyads by child HPV vaccination status during a clinical encounter.
Collapse
Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN, 37208-3599, USA.
| | - Meredith Smalls
- Meharry Vanderbilt Alliance, 1005 Dr. D.B. Todd Jr. Blvd., Biomedical Building, Nashville, TN, 37208, USA
| | - Elizabeth C Stewart
- Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN, 37208-3599, USA
| | - Kathryn Edwards
- Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, 2200 Children's Way, Suite 2404, Nashville, TN, 37232, USA
| | - Pamela C Hull
- Department of Behavioral Science, College of Medicine, Markey Cancer Center, University of Kentucky, Lexington, KY, 40506, USA
| | - Amanda F Dempsey
- Adult & Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, 80045, USA
- Merck and Company, Wales, PA, 19454, USA
| | - Consuelo H Wilkins
- Office of Health Equity, Vanderbilt University Medical Center, 1121 Medical Center Drive, Nashville, TN, 37232, USA
| |
Collapse
|
8
|
Zhu X, Jacobson RM, MacLaughlin KL, Sauver JS, Griffin JM, Finney Rutten LJ. Parent-reported Barriers and Parental Beliefs Associated with Intentions to Obtain HPV Vaccination for Children in a Primary care Patient Population in Minnesota, USA. J Community Health 2023; 48:678-686. [PMID: 36920709 PMCID: PMC10015522 DOI: 10.1007/s10900-023-01205-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 03/16/2023]
Abstract
Human papillomavirus (HPV) vaccine uptake among adolescents remains suboptimal in the US. The COVID-19 pandemic posed new challenges to increase HPV vaccination rates. To characterize parent-reported barriers to obtain HPV vaccination for their children and to identify psychosocial factors associated with parents' intention to vaccinate their children for HPV, we administered parent surveys between April 2020 and January 2022 during a randomized pragmatic trial assessing the impact of evidence-based implementation strategies on HPV vaccination rates for adolescent patients at six Mayo Clinic primary care practices in Southeast Minnesota. A total of 342 surveys were completed (response rate 34.1%). Analyses were focused on parents of unvaccinated children (n = 133). The survey assessed the main reason the child did not receive the HPV vaccine, parental beliefs about the vaccine, and the parent's intention to vaccinate the child for HPV in the next 12 months. Frequently reported awareness and access barriers to HPV vaccination included not knowing the child was due (17.8%) and COVID-19 related delay (11.6%). Frequently reported attitudinal barriers include the belief that the child was too young for the vaccine (17.8%) and that the vaccine is not proven to be safe (16.3%). Injunctive social norm (Adjusted-OR = 3.15, 95%CI: 1.94, 5.41) and perceived harm beliefs (Adjusted-OR = 0.58, 95%CI: 0.35, 0.94) about the HPV vaccine were positively and negatively associated with HPV vaccination intention, respectively. Our findings suggest that continued efforts to overcome parental awareness, access, and attitudinal barriers to HPV vaccination are needed and underscore the importance of utilizing evidence-based health system-level interventions.
Collapse
Affiliation(s)
- Xuan Zhu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA.
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| | - Kathy L MacLaughlin
- Department of Family Medicine, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| | - Jennifer St Sauver
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| | - Joan M Griffin
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| | - Lila J Finney Rutten
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| |
Collapse
|
9
|
Xu MA, Choi J, Capasso A, DiClemente R. Patient-Provider Health Communication Strategies: Enhancing HPV Vaccine Uptake among Adolescents of Color. Healthcare (Basel) 2023; 11:1702. [PMID: 37372820 DOI: 10.3390/healthcare11121702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Cervical cancer remains a public health issue in the United States, particularly among stigmatized racial and ethnic populations. The human papillomavirus (HPV) vaccine has been clinically proven to prevent cervical cancers, and other HPV-associated cancers, among men and women. However, HPV vaccine uptake is suboptimal; only 55% of adolescents complete the two-dose series by age 15. Past research has shown that provider HPV vaccine communication for people of marginalized races/ethnicities is subpar. This article focuses on provider communication strategies to promote HPV vaccine uptake effectively and equitably. The authors reviewed the literature on evidence-based patient-provider HPV vaccine communication techniques to create a set of communication language providers could use and avoid using to enhance HPV vaccine acceptance and uptake among adolescents of marginalized racial and ethnic groups. Evidence has shown that information and the manner of dissemination are critical for influencing HPV vaccine uptake. These communication strategies must be suited to the context of the targeted population, and the message content can be broadly categorized into source, content, and modality. Strategies to improve patient-provider communication among adolescents of color using source, modality, and content include the following: (1) Source: increase provider self-efficacy to provide the recommendation, building rapport between providers and parents; (2) Content: persistent, forceful language with minimal acquiescence should be employed, reframing the conversation focus from sex to cancer; and (3) Modality: use multiple vaccine reminder modalities, and work with the community to culturally adapt the vaccination language. Utilizing effective behavior-change communication adapted for adolescents of color can reduce missed opportunities for HPV prevention, potentially decreasing racial and ethnic disparities in HPV-related morbidity and mortality.
Collapse
Affiliation(s)
- Mia Ann Xu
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA
| | - Jasmin Choi
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA
| | | | - Ralph DiClemente
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA
| |
Collapse
|
10
|
Jin SW, Lattimore DC, Harlin E, Davis L, Erholtz V, Brandt HM. Medical and public health professionals' perceived facilitators and barriers of human papillomavirus (HPV) vaccination among African American adolescents in Shelby County, Tennessee. BMC Health Serv Res 2023; 23:469. [PMID: 37165427 PMCID: PMC10173571 DOI: 10.1186/s12913-023-09415-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/18/2023] [Indexed: 05/12/2023] Open
Abstract
Human papillomavirus (HPV) infects nearly 85% of sexually active Americans during their lifetime, causing most cervical and five other cancers. Routine HPV vaccination is recommended for adolescents to prevent HPV-attributable cancers, but HPV vaccination coverage remains low, especially in Tennessee. In 2021, 54.6% of the population in Shelby County, Tennessee was Black or African American, reporting higher rates of new cervical cancer cases than other counties in Tennessee. While medical and public health professionals (HPs) play a critical role in promoting vaccination coverage, little is known about the factors HPs perceive to influence HPV vaccination for this population. This study sought to explore HPs' perceived facilitators and barriers of HPV vaccination among African American adolescents. Qualitative individual interviews with 26 HPs in Shelby County were conducted between October 2019 and February 2020. Interpretive content analysis of the interview data guided by the socio-ecological model revealed several important themes regarding the facilitators and barriers across the individual, interpersonal, and community levels. At the individual level, parental vaccine hesitancy emerged as a leading barrier to HPV vaccination, while appropriate education facilitated the vaccination. At the interpersonal level, a lack of strong provider recommendations impeded HPV vaccination, whereas improved communication skills with patients facilitated the vaccination. Finally, the community-level barriers included a lack of education and social/religious norms; the community-level facilitators included community outreach efforts. HPs should consider development of comprehensive community-based approaches that leverage the facilitators and barriers at multiple levels to increase HPV vaccination among African American adolescents in this region.
Collapse
Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 119 McCord Hall, Memphis, TN, 38152, USA.
- Department of Medical Humanities and Social Science, College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute of Media Arts , Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | | | - Eric Harlin
- School of Social Work, The University of Memphis, 119 McCord Hall, Memphis, TN, 38152, USA
| | - Levonna Davis
- School of Social Work, The University of Memphis, 119 McCord Hall, Memphis, TN, 38152, USA
| | - Virginia Erholtz
- The University of Memphis, 226 McCord Hall, Memphis, TN, 38152, USA
| | - Heather M Brandt
- HPV Cancer Prevention Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| |
Collapse
|
11
|
Calderón-Mora J, Lara H, Hernandez B, Molokwu J. Factors Affecting Completion of Human Papillomavirus Vaccination Series by Gender in a Predominantly Hispanic Border Town Community. J Low Genit Tract Dis 2023; 27:161-167. [PMID: 36951986 DOI: 10.1097/lgt.0000000000000728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVES The human papillomavirus (HPV) vaccine is recommended for females and males aged 9 to 45. Nationally, the HPV vaccination rates are lower for males than females; however, this has not been studied in a US-Mexico border community. Our study aims to report the HPV vaccination completion by gender and determine which sociodemographic factors influence vaccination. METHODS This cross-sectional study was conducted among uninsured and underinsured individuals aged between 9 and 26 years served through a community-based HPV vaccine program in El Paso, TX. Data collected included demographic information, psychosocial variables, and vaccine administration data. Descriptive statistics were used to summarize demographic data. Unadjusted t test/Fisher exact test and multivariable relative risk regression were run on significant variables to determine the association with vaccine completion by gender. RESULTS Most participants were female (63.4%), and an overall vaccine series completion was 30.67%. We found no significant difference in HPV vaccine completion rates by gender. Males who resided in the United States for more than a decade were 31% more likely to complete the vaccine series, and females who had 9 to 13 years of education had lower odds of vaccine completion. Knowledge significantly increased after the intervention for both genders (p = .002). There was no significant change in psychosocial variables from the preintervention to the immediate postintervention survey. CONCLUSIONS Our multicomponent, culturally tailored intervention may equally impact male and female participants and encourages all genders to complete their HPV vaccine series. Additional studies with a larger male sample are needed.
Collapse
Affiliation(s)
- Jessica Calderón-Mora
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX
| | - Hatty Lara
- Department of Psychology, University of Arizona College of Science, Tucson, AZ
| | - Blanca Hernandez
- Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, TX
| | - Jennifer Molokwu
- Department of Family and Community Medicine, Cancer Prevention and Control, Department of Molecular and Translational Medicine, Center of Emphasis for Cancer, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, TX
| |
Collapse
|
12
|
Shin MB, Sloan KE, Martinez B, Soto C, Baezconde-Garbanati L, Unger JB, Kast WM, Cockburn M, Tsui J. Examining multilevel influences on parental HPV vaccine hesitancy among multiethnic communities in Los Angeles: a qualitative analysis. BMC Public Health 2023; 23:545. [PMID: 36949438 PMCID: PMC10031192 DOI: 10.1186/s12889-023-15318-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/24/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccine hesitancy is a growing concern in the United States, yet understudied among racial/ethnic minority parents. We conducted qualitative research to understand parental HPV vaccine hesitancy and inform community-specific, multilevel approaches to improve HPV vaccination among diverse populations in Los Angeles. METHODS We recruited American Indian/Alaska Native (AI/AN), Hispanic/Latino/a (HL) and Chinese parents of unvaccinated children (9-17 years) from low-HPV vaccine uptake regions in Los Angeles for virtual focus groups (FGs). FGs were conducted in English (2), Mandarin (1), and Spanish (1) between June-August 2021. One English FG was with AI/AN-identifying parents. FGs prompted discussions about vaccine knowledge, sources of information/hesitancy, logistical barriers and interpersonal, healthcare and community interactions regarding HPV vaccination. Guided by the social-ecological model, we identified multilevel emergent themes related to HPV vaccination. RESULTS Parents (n = 20) in all FGs reported exposure to HPV vaccine information from the internet and other sources, including in-language media (Mandarin) and health care providers (Spanish). All FGs expressed confusion around the vaccine and had encountered HPV vaccine misinformation. FGs experienced challenges navigating relationships with children, providers, and friends/family for HPV vaccine decision-making. At the community-level, historical events contributed to mistrust (e.g., forced community displacement [AI/AN]). At the societal-level, transportation, and work schedules (Spanish, AI/AN) were barriers to vaccination. Medical mistrust contributed to HPV vaccine hesitancy across the analysis levels. CONCLUSION Our findings highlight the importance of multilevel influences on parental HPV vaccine hesitancy and decision-making and the need for community-specific messaging to combat medical mistrust and other barriers to HPV vaccination among racial/ethnic minority communities.
Collapse
Affiliation(s)
- Michelle B Shin
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, United States
| | - Kylie E Sloan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Bibiana Martinez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claradina Soto
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - W Martin Kast
- Department of Molecular Microbiology & Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| |
Collapse
|
13
|
Robinson MS, England M, Luthy KE, Peterson NE. HPV Infection and Vaccination: A Question and Answer Guide for School Nurses. NASN Sch Nurse 2023; 38:134-144. [PMID: 36757046 DOI: 10.1177/1942602x221146758] [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: 02/10/2023]
Abstract
School nurses frequently interact with school-age children and their parents/guardians regarding vaccinations. As a trusted source of information, the school nurse is in a unique position to share vaccine information with parents/guardians and school-age children that may dispel myths and, consequently, improve vaccination rates. Nevertheless, some parents/guardians are still reluctant to vaccinate their school-age children against Human Papilloma Virus (HPV) for a variety of reasons. Common barriers to HPV vaccination include a lack of understanding of the vaccine's purpose, concerns regarding the vaccine's safety, and insufficient recommendation from healthcare workers. However, school nurses have many duties in addition to ensuring vaccine compliance. School nurses may have difficulty remaining up-to-date on evidence-based answers to parents'/guardians' questions about HPV vaccine. Therefore, the purpose of this article is to provide school nurses with a quick reference question and answer guide to parents'/guardians' common HPV-related vaccination questions.
Collapse
|
14
|
Associations between Vaccination Behavior and Trust in Information Sources Regarding COVID-19 Vaccines under Emergency Approval in Japan: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:vaccines11020233. [PMID: 36851111 PMCID: PMC9965898 DOI: 10.3390/vaccines11020233] [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] [Received: 12/30/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
We examined the association between COVID-19 vaccination behavior and trust in COVID-19-related information sources during the initial period of COVID-19 vaccination in Japan. A cross-sectional survey was conducted in August 2021, 5 months after the start of COVID-19 vaccination for the general public under emergency approval. Participants were recruited using non-probability quota sampling from among Japanese residents who were under a declared state of emergency. Sociodemographic data, vaccination behavior, and levels of trust in eight media sources of information and three interpersonal information sources were assessed using an online survey form. A total of 784 participants completed the survey. The results of multiple logistic regression analysis showed that age, household income, underlying medical conditions, and living with family were significantly associated with COVID-19 vaccination behavior. Regarding COVID-19 vaccine information sources, trust in public health experts as a source of media information and primary care physicians as a source of interpersonal information showed significantly positive associations with COVID-19 vaccination behavior (odds ratio [OR] = 1.157, 95% confidence interval [CI] 1.017-1.31; OR = 1.076; 95% CI 1.006-1.150, respectively). Increasing trust in public health experts and primary care physicians and disseminating vaccine information from these sources will help promote vaccination under emergency approval.
Collapse
|
15
|
Ampofo AG, Mackenzie L, Boyes AW. HPV vaccination: Intention to participate among female senior high school students in Ghana. Vaccine 2023; 41:159-169. [PMID: 36411133 DOI: 10.1016/j.vaccine.2022.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cervical cancer is the second most common cancer and the second leading cause of cancer death among women in Ghana. HPV vaccination is expected to be added to the national vaccination schedule in 2023. This study aimed to: i) describe intentions to participate in HPV vaccination and ii) explore factors associated with vaccination intentions among female senior high school students in Ghana. METHODS Female students (aged 16-24) were recruited from 17 senior high schools in Ashanti Region. A cross-sectional anonymous self-report paper-and-pen survey assessed students' HPV vaccination intentions using three items, and a range of correlates (individual, parent/family, social networks, service provision). Descriptive statistics were calculated for vaccination intentions, and correlates of intention scores (where higher scores indicate stronger intentions) were explored with a linear mixed-effect model. RESULTS Of 2400 participants, 64% (95%CI: 62%, 67%) agreed with at least one vaccination intention item. Uncertainty and disagreement with at least one item were endorsed by 51% (95%CI: 49%, 53%) and 44% (95%CI: 42%, 46%) of students, respectively. One-quarter of the students (25%, 95%CI: 23%, 26%) agreed, 12% (95% 11%, 13%) disagreed, and 11% (95%CI: 10%,13%) indicated uncertainty, on all three vaccination intention items. Vaccination uptake was 4.5%. Students were likely to have higher vaccination intention scores if: they had stronger beliefs about vaccine effectiveness; vaccination was recommended by parents, religious leaders and service providers, and vaccinated peers; and it was free. Students were likely to have lower vaccination intention scores if they perceived barriers to vaccination (e.g., side effects). CONCLUSIONS While two-thirds of students had some intention to participate in HPV vaccination, vaccine hesitancy (i.e., uncertainty or disagreement) was apparent. Alongside the rollout of a free national vaccination programme, messaging about vaccination benefits and effectiveness targeting students, as well as parents, religious leaders, service providers and peers would be beneficial given their influential role in students' vaccination intentions.
Collapse
Affiliation(s)
- Ama Gyamfua Ampofo
- Health Behavior Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Lisa Mackenzie
- Health Behavior Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Allison W Boyes
- Health Behavior Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| |
Collapse
|
16
|
Atrooz F, Majd Z, Alrousan G, Zeidat S, Abuelezam NN, Abughosh S, Salim S. Acceptance of COVID-19 vaccination in a sample of Middle Eastern and North African (MENA) Houston residents. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001441. [PMID: 36962927 PMCID: PMC10021233 DOI: 10.1371/journal.pgph.0001441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/05/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND COVID-19 vaccination has averted a significant number of deaths in the United States, but vaccination hesitancy continues to be a problem. Therefore, examining vaccination acceptance and/or hesitancy in local communities is critical. METHODS A quantitative survey and a multivariable logistic regression model was utilized to determine predictors of COVID-19 vaccination in Middle Eastern and North African (MENA) origin Houston residents. The outcome of interest was COVID-19 vaccination status (vaccinated versus not vaccinated). Covariates included: demographics, health, and COVID-19 factors. Statistical analyses included SAS version 9.4 at a priori significance level of 0.05. RESULTS The overall vaccine acceptance rate was significantly high in this population subset (N = 366), with 77.60% vaccinated, and 22.40% not vaccinated. MENA individuals with some college degrees were less likely to report vaccination than those with a graduate degree [Odds Ratio (OR): 0.18; 95% Confidence Interval (CI): 0.04, 0.77]. Homeowners were more likely to get vaccinated than renters (OR: 2.58; 95%CI: 1.17, 5.68). Individuals practicing Islamic faith were more likely to get vaccinated than other religious affiliations (OR: 3.26; 95%CI: 1.15, 9.19). Individuals with hypertension were less likely to get vaccinated than those without it (OR: 0.34; 95%CI: 0.13, 0.92), and those with anxiety were more likely to get vaccinated than those without anxiety (OR: 4.23; 95%CI: 1.68, 10.64). CONCLUSIONS Health status, education level, financial stability, and religious affiliation are some of the determining factors that potentially influence vaccination acceptance/hesitancy among the MENA community.
Collapse
Affiliation(s)
- Fatin Atrooz
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, Texas, United States of America
| | - Zahra Majd
- Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, Texas, United States of America
| | - Ghalya Alrousan
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, Texas, United States of America
| | - Sarah Zeidat
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, Texas, United States of America
| | - Nadia N Abuelezam
- William F. Connell School of Nursing, Boston College, Boston, Massachusetts, United States of America
| | - Susan Abughosh
- Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, Texas, United States of America
| | - Samina Salim
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, Texas, United States of America
| |
Collapse
|
17
|
Nan X, Wang Y, Thier K, Adebamowo C, Quinn S, Ntiri S. Moral Foundations Predict COVID-19 Vaccine Hesitancy: Evidence from a National Survey of Black Americans. JOURNAL OF HEALTH COMMUNICATION 2022; 27:801-811. [PMID: 36576158 DOI: 10.1080/10810730.2022.2160526] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
In this study we examine the role of moral values in predicting COVID-19 vaccine hesitancy among Black Americans. Guided by moral foundations theory, we assess the associations between six moral foundations (care, fairness, loyalty, authority, purity, liberty) and attitudes and intentions toward COVID-19 vaccination. Results of a national survey of Black Americans (N = 1,497) indicate that the care and loyalty moral foundations consistently predicted less vaccine hesitancy with overall more favorable attitudes and intentions toward COVID-19 vaccination, whereas the purity and liberty moral foundations were consistently associated with greater vaccine hesitancy. Relationships between the foundations and vaccine hesitancy were mediated by perceived vaccine effectiveness and safety. Implications of the findings for COVID-19 vaccine communication are discussed.
Collapse
Affiliation(s)
- Xiaoli Nan
- Department of Communication, University of Maryland, College Park, Maryland, U.S.A
| | - Yuan Wang
- Department of Communication, University of Maryland, College Park, Maryland, U.S.A
| | - Kathryn Thier
- Department of Communication, University of Maryland, College Park, Maryland, U.S.A
| | - Clement Adebamowo
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
| | - Sandra Quinn
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, U.S.A
| | - Shana Ntiri
- Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
| |
Collapse
|
18
|
Lama Y, Qin Y, Nan X, Knott C, Adebamowo C, Ntiri SO, Wang MQ. Human Papillomavirus Vaccine Acceptability and Campaign Message Preferences Among African American Parents: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1691-1701. [PMID: 33934287 PMCID: PMC8088401 DOI: 10.1007/s13187-021-02014-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 05/08/2023]
Abstract
Human papillomavirus (HPV) vaccination can prevent numerous cancers, yet uptake remains low for adolescents. Given disproportionate burden of cancers among African Americans, it is important to identify factors that influence HPV vaccination decisions among African American parents, specifically the role and preferences of vaccine campaign messages. The objectives of this study were to (1) identify the predictors of parents' decisions to get their children vaccinated against HPV, (2) assess parents' evaluation of current HPV vaccination campaign messages, and (3) uncover message strategies or themes parents consider to be effective and motivating to vaccinate their children against HPV. Focus groups were conducted with African American mothers and fathers (n = 18) in person. Several themes emerged regarding HPV vaccine acceptability including the desire to be informed, the unfamiliarity of vaccination, and mistrust toward government, pharmaceutical companies, and healthcare providers. Parental review of existing campaign messages highlighted the importance of clarifying risks and benefits of vaccination, including cancer prevention, and the preference for straightforward language. When brainstorming strategies to craft effective messages, parents highlighted need for the inclusion of diverse groups across race, gender, and age. Additionally, parents recommended clear language on side effects, eligibility, and additional resources for further information. Our findings highlight concerns and potential strategies to promote HPV vaccination tailored to African American parents and their children. Targeted interventions to increase vaccination need to consider the importance of building trust and representation in health promotional materials. Considerations for how messages were shared were also discussed such as physical locations, word of mouth, and social media.
Collapse
Affiliation(s)
- Yuki Lama
- Department of Family Science, University of Maryland School of Public Health, 4200 Valley Drive, Bldg. 225, College Park, MD, 20742, USA.
| | - Yan Qin
- Department of Communication, University of Maryland, College Park, MD, USA
| | - Xiaoli Nan
- Department of Communication, University of Maryland, College Park, MD, USA
| | - Cheryl Knott
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Clement Adebamowo
- Institute of Human Virology, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shana O Ntiri
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
| |
Collapse
|
19
|
Aragones A, Gany F, Kaplan A, Bruno D. An opportunity to increase human papillomavirus vaccination rates: Change the guidelines. Hum Vaccin Immunother 2022; 18:2136444. [PMID: 36282533 PMCID: PMC9746429 DOI: 10.1080/21645515.2022.2136444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 02/09/2023] Open
Abstract
Given the low rates of Human Papillomavirus (HPV) vaccination initiation and timely series completion in 11- and 12-year old children, we sought to assess potential opportunities for initiating routine vaccination at a younger age. A cross-sectional study of Latino parents of HPV vaccine-eligible 9- or 10-year-old children in New York City assessed whether there were opportunities to discuss the HPV vaccine during their most recent primary care provider (PCP) visit. Parents were approached between November, 2016 and January, 2018. Of 86 parents who participated, 97% reported having visited the child's PCP in the previous year for an annual checkup and 85% reported that they had neither discussed the HPV vaccine nor received a recommendation for the vaccine during that visit. In a population of Latino parents, predominantly Mexican immigrants with less than a high school education and limited English proficiency, most 9- to 10-year-old children followed the recommendation for an annual PCP visit. Lowering the recommended age for routine vaccination with the HPV vaccine to 9 - 10 years of age should be considered as an important strategy to increase HPV vaccination rates in this and other populations.
Collapse
Affiliation(s)
- Abraham Aragones
- Immigrant Health & Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- School of Public Health, Downstate Health Sciences University, State University of New York, Brooklyn, NY, USA
| | - Francesca Gany
- Immigrant Health & Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Denise Bruno
- School of Public Health, Downstate Health Sciences University, State University of New York, Brooklyn, NY, USA
| |
Collapse
|
20
|
Reiter PL, Gower AL, Kiss DE, Shoben AB, Katz ML, Bauermeister JA, Paskett ED, McRee AL. Effects of a web-based HPV vaccination intervention on cognitive outcomes among young gay, bisexual, and other men who have sex with men. Hum Vaccin Immunother 2022; 18:2114261. [PMID: 36069662 DOI: 10.1080/21645515.2022.2114261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Knowledge, attitudes, and beliefs are important antecedents to HPV vaccination, yet remain suboptimal among young gay, bisexual, and other men who have sex with men (YGBMSM). We report the effects of a theoretically-informed, web-based HPV vaccination intervention on these cognitive outcomes. From 2019-2021, we recruited a national sample of YGBMSM ages 18-25 in the United States who were unvaccinated against HPV (n = 1,227). Participants received either standard HPV vaccination information online (control) or population-targeted, individually-tailored content online (Outsmart HPV intervention). Mixed effects models determined if pre-post changes in cognitive outcomes differed between study groups. For five of seven knowledge items about HPV, there were larger pre-post increases among the intervention group than the control group in the percentage of participants who provided correct responses (all statistically significant at p = .05 after Holm's correction). There were also larger pre-post improvements among the intervention group than the control group for most attitudes and beliefs examined, including response efficacy of HPV vaccine (pre-post increases in means: 0.57 vs. 0.38); self-efficacy for the HPV vaccination process (pre-post increases in means: 0.23 vs. 0.10); and intention to get HPV vaccine (pre-post increases in means: 0.70 vs. 0.28) (all statistically significant at p = .05 after Holm's correction). Outsmart HPV is a promising tool for improving key cognitive antecedents to HPV vaccination among YGBMSM, supporting the use of theoretically-informed interventions to affect such outcomes. If efficacious in increasing HPV vaccine uptake in future analyses, this intervention could be utilized in clinical and other healthcare settings that provide services to YGBMSM.
Collapse
Affiliation(s)
- Paul L Reiter
- College of Public Health, The Ohio State University, Columbus, OH, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Amy L Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Dale E Kiss
- College of Public Health, The Ohio State University, Columbus, OH, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Abigail B Shoben
- College of Public Health, The Ohio State University, Columbus, OH, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Mira L Katz
- College of Public Health, The Ohio State University, Columbus, OH, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - José A Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Electra D Paskett
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.,Center for Scientific Review, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
21
|
Lindsay AC, Delgado D, Valdez MJ, Granberry P. Latinx fathers report low awareness and knowledge of the human papillomavirus vaccine, but high willingness to vaccinate their children if recommended by a healthcare provider: A qualitative study. Glob Public Health 2022; 17:2883-2897. [PMID: 34605379 PMCID: PMC8976858 DOI: 10.1080/17441692.2021.1985580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022]
Abstract
This descriptive qualitative study explored Latinx fathers' awareness, knowledge, and acceptability of the human papillomavirus (HPV) vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analysed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Nineteen, majority foreign-born Latinx fathers participated. Four main themes and two subthemes emerged from the analyses. Results found fathers' low awareness and knowledge of HPV and the HPV vaccine. Results also identified fathers' positive attitudes toward vaccines in general. Moreover, results revealed fathers trust in healthcare providers and high willingness to vaccinate their children against HPV if recommended by their child's primary healthcare provider. Findings indicate the need for increased efforts to raise awareness and knowledge among Latinx fathers of HPV and the HPV vaccine. Given the limited research focused on Latinx fathers, the study's findings are valuable in building a knowledge foundation for developing future studies and interventions to promote the HPV vaccine targeting Latinx fathers living in the United States. Future research should quantify Latinx fathers' awareness, knowledge, and acceptability of the HPV vaccine for their sons and daughters and assess fathers' role in the decision-making process to vaccinate their children against HPV.
Collapse
Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Denisse Delgado
- Department of Public Policy and Public Affairs, McCormack Graduate School of Policy and Global Studies, University of Massachusetts—Boston, Massachusetts, USA
| | - Madelyne J. Valdez
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Phillip Granberry
- College of Liberal Arts and The Mauricio Gastón Institute for Latino Community Development and Public Policy, University of Massachusetts—Boston, Massachusetts, USA
| |
Collapse
|
22
|
Parent Attitudes regarding Orthodontists’ Role as Potential Administrators of Human Papilloma Virus (HPV) Vaccines. Int J Dent 2022; 2022:6541532. [PMID: 35706457 PMCID: PMC9192217 DOI: 10.1155/2022/6541532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/03/2022] [Accepted: 05/12/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To assess parent attitudes regarding orthodontists' role as potential administrators of human papilloma virus (HPV) vaccines. Materials and Methods 275 parents of adolescents, aged 11–17, who attended the orthodontic clinic at an American university for orthodontic adjustment visits and met inclusion criteria were given information about HPV and HPV vaccines. A paper questionnaire was administered to assess comfort level with orthodontists as HPV vaccinators. Demographic and other potential explanatory characteristics were collected. Descriptive, bivariate, and multivariate ordinal logistic regression analyses were performed with SPSS statistical software v25. Results The majority of participants were between 31 and 40 years old, with 79.6% identifying as female. 54.3% of the subjects' children identified as female. Although 71.3% of participants identified as Hispanic, 55.3% of the total participants chose to respond to the questionnaire in Spanish. 66.7% of the participants reported education level as high school degree or less. Overall, 52.4% of parents responded that they would be comfortable with orthodontists administering HPV vaccines to their children. Bivariate analysis suggested a significant association (p < 0.05) of parents taking the survey in Spanish and parents' educational attainment with HPV vaccine administration comfort level. Multivariate ordinal logistic regression indicates that parents taking survey in Spanish (adjusted OR: 2.42, 95% CI: 1.24–4.72; p < .01) and parents of male children (adjusted OR: 1.66, 95% CI: 1.01–2.73; p < 047) were comfortable with orthodontists administering the HPV vaccine. Conclusions The language of the survey influenced parents' comfort level with orthodontists as HPV vaccinators, with Spanish having a positive correlation to comfort level. Parents of male children were more comfortable with orthodontists as HPV vaccinator.
Collapse
|
23
|
Chervenak FA, McCullough LB, Grünebaum A. Reversing physician hesitancy to recommend COVID-19 vaccination for pregnant patients. Am J Obstet Gynecol 2022; 226:805-812. [PMID: 34762864 PMCID: PMC8572733 DOI: 10.1016/j.ajog.2021.11.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/18/2022]
Abstract
Physician hesitancy is said to occur when physicians do not recommend COVID-19 vaccination, and it is a contributing factor for the low vaccination rate for COVID-19 in pregnant women. Physician hesitancy has become a major, unaddressed problem with regard to the quality and safety of obstetrical care. We identify 3 root causes of physician hesitancy and describe how professional ethics in obstetrics should guide in reversing these root causes. They are clinical misapplications of key components of professionally responsible obstetrical practice: therapeutic nihilism, shared decision-making, and respect for patient autonomy. Therapeutic nihilism directs the obstetrician to avoid any clinical interventions during pregnancy to prevent teratogenic effects that might be unknown. Therapeutic nihilism is misapplied when there is a documented net clinical benefit with no evidence of clinical harm. Shared decision directs the obstetrician to only offer but not recommend clinical management. Shared decision-making plays a major role when there is uncertainty in clinical judgment but is misapplied when it becomes a universal model. It does not apply when there is a net clinical benefit. When there is a net clinical benefit, clinical management should be recommended, not simply offered. The ethical principle of respect for patient autonomy plays an indispensable role in decision-making with patients. It is misapplied when it is assumed that respect for autonomy requires physicians not to make recommendations and to defer to and implement patients' decisions without exception. There is evidence that the obstetrician's recommendations about the management of pregnancy are the most important factor in a pregnant woman's decision-making. Simply deferring to the patient's decisions makes for misapplied respect for patient autonomy. Obstetricians must end physician hesitancy about COVID-19 vaccination of pregnant women by reversing these 3 root causes of physician hesitancy. Reversing the root causes of physician hesitancy is an urgent matter of patient safety. The longer physician hesitancy continues and the longer the low vaccine acceptance rate of pregnant women lasts, preventable serious diseases, deaths of pregnant women, intensive care unit admissions, stillbirths, and other maternal and fetal complications of unvaccinated women will continue to occur. Physician hesitancy should not be permitted to influence the response to future pandemics.
Collapse
Affiliation(s)
- Frank A Chervenak
- Department of Obstetrics and Gynecology, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY
| | - Laurence B McCullough
- Department of Obstetrics and Gynecology, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY
| | - Amos Grünebaum
- Department of Obstetrics and Gynecology, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY.
| |
Collapse
|
24
|
Gopalani SV, Sedani AE, Janitz AE, Clifton SC, Peck JD, Comiford A, Campbell JE. Barriers and Factors Associated with HPV Vaccination Among American Indians and Alaska Natives: A Systematic Review. J Community Health 2022; 47:563-575. [PMID: 35201544 PMCID: PMC9167249 DOI: 10.1007/s10900-022-01079-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 11/26/2022]
Abstract
American Indian and Alaska Native (AI/AN) persons bear a disproportionate burden of human papillomavirus (HPV)-associated cancers and face unique challenges to HPV vaccination. We undertook a systematic review to synthesize the available evidence on HPV vaccination barriers and factors among AI/AN persons in the United States. We searched fourteen bibliographic databases, four citation indexes, and six gray literature sources from July 2006 to January 2021. We did not restrict our search by study design, setting, or publication type. Two reviewers independently screened the titles and abstracts (stage 1) and full-text (stage 2) of studies for selection. Both reviewers then independently extracted data using a data extraction form and undertook quality appraisal and bias assessment using the modified Mixed Methods Appraisal Tool. We conducted thematic synthesis to generate descriptive themes. We included a total of 15 records after identifying 3017, screening 1415, retrieving 203, and assessing 41 records. A total of 21 unique barriers to HPV vaccination were reported across 15 themes at the individual (n = 12) and clinic or provider (n = 3) levels. At the individual level, the most common barriers to vaccination-safety and lack of knowledge about the HPV vaccine-were each reported in the highest number of studies (n = 9; 60%). The findings from this review signal the need to develop interventions that target AI/AN populations to increase the adoption and coverage of HPV vaccination. Failure to do so may widen disparities.
Collapse
Affiliation(s)
- Sameer V Gopalani
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK, 73104, USA.
| | - Ami E Sedani
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK, 73104, USA
| | - Amanda E Janitz
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK, 73104, USA
| | - Shari C Clifton
- Robert M. Bird Health Sciences Library, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Jennifer D Peck
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK, 73104, USA
| | - Ashley Comiford
- Cherokee Nation Public Health, Cherokee Nation, Tahlequah, OK, 74464, USA
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK, 73104, USA
| |
Collapse
|
25
|
Morales DX, Beltran TF, Morales SA. Gender, socioeconomic status, and COVID-19 vaccine hesitancy in the US: An intersectionality approach. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:953-971. [PMID: 35500003 PMCID: PMC9348198 DOI: 10.1111/1467-9566.13474] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 04/01/2022] [Indexed: 05/11/2023]
Abstract
Previous research on coronavirus disease 2019 (COVID-19) vaccine hesitancy lacks a gender perspective, and it is unclear whether gender intersects with socioeconomic status to co-produce inequalities in people's intent to take vaccines. The current study draws on intersectionality theory and uses data from the 2021 US Household Pulse Survey (n = 50,359). Both bivariate and multivariate statistical analyses were conducted. The results suggest that American women had a higher vaccine hesitancy rate than men. Gender interacts with socioeconomic status to shape people's vaccine hesitancy in a complex way. Specifically, women living in poverty or currently working were more vaccine-hesitant, while poverty and employment status did not affect men's vaccine hesitancy. However, not having a college education contributed to both women's and men's COVID-19 vaccine hesitancy. Moreover, women were more worried about the safety of the vaccine, but men's hesitancy tended to be driven by lower perceptions of COVID-19 dangers and belief in conspiratorial claims.
Collapse
Affiliation(s)
| | - Tyler Fox Beltran
- Department of Sociology and AnthropologyThe University of TexasEl PasoTexasUSA
| | | |
Collapse
|
26
|
Witus LS, Larson E. A randomized controlled trial of a video intervention shows evidence of increasing COVID-19 vaccination intention. PLoS One 2022; 17:e0267580. [PMID: 35587462 PMCID: PMC9119500 DOI: 10.1371/journal.pone.0267580] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 04/12/2022] [Indexed: 11/19/2022] Open
Abstract
Increasing acceptance of COVID-19 vaccines is imperative for public health. Previous research on educational interventions to overcome vaccine hesitancy have shown mixed effects in increasing vaccination intention, although much of this work has focused on parental attitudes toward childhood vaccination. In this study, we conducted a randomized controlled trial to investigate whether vaccination intention changes after viewing an animated YouTube video explaining how COVID-19 mRNA vaccines work. We exposed participants to one of four interventions–watching the video with a male narrator, watching the same video with a female narrator, reading the text of the transcript of the video, or receiving no information (control group). We found that participants who watched the version of the video with a male narrator expressed statistically significant increased vaccination intention compared to the control group. The video with a female narrator had more variation in results. As a whole, there was a non-significant increased vaccination intention when analyzing all participants who saw the video with a female narrator; however, for politically conservative participants there was decreased vaccination intention for this intervention compared to the control group at a threshold between being currently undecided and expressing probable interest. These results are encouraging for the ability of interventions as simple as YouTube videos to increase vaccination propensity, although the inconsistent response to the video with a female narrator demonstrates the potential for bias to affect how certain groups respond to different messengers.
Collapse
Affiliation(s)
- Leah S. Witus
- Department of Chemistry, Macalester College, Saint Paul, Minnesota, United States of America
- * E-mail: (LSW); (EL)
| | - Erik Larson
- Department of Sociology, Macalester College, Saint Paul, Minnesota, United States of America
- * E-mail: (LSW); (EL)
| |
Collapse
|
27
|
Guo F, Hirth JM, Fuchs EL, Cofie LE, Brown V, Kuo YF, Fernandez ME, Berenson AB. Knowledge, Attitudes, Willingness to Pay, and Patient Preferences About Genetic Testing and Subsequent Risk Management for Cancer Prevention. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:362-369. [PMID: 32642924 PMCID: PMC7794087 DOI: 10.1007/s13187-020-01823-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Knowledge, attitudes, and patient preferences about genetic testing and subsequent risk management for cancer prevention among average risk populations are understudied, especially among Hispanics. This study was to assess these items by conducting an in-person survey in this understudied population. We conducted in-person surveys using a self-administered, structured questionnaire among young women in 2017. Survey questions were adapted from other validated surveys. This study had 677 participants in the final analyses. Data were collected in 2017 and analyzed in 2018 and 2019. Participants had little knowledge about genes or breast cancer risk, but most felt that genetic testing for cancer prevention is "a good idea" (87.0%), "a reassuring idea" (84.0%), and that "everyone should get the test" (87.7%). Most (64.0%) of these women would pay up to $25 for the test, 29.3% would pay $25-$500, and < 10% would pay more than $500 for the test. When asked about a hypothetical scenario of high breast cancer risk, 34.2% Hispanics and 24.5% non-Hispanics would choose chemoprevention. Women would be less likely to choose risk reduction procedures, such as mastectomy (19.6% among Hispanics and 15.1% among non-Hispanics) and salpingo-oophorectomy (11.8% among Hispanics and 10.7% among non-Hispanics). In this low-income, mostly Hispanic population, knowledge about genetic testing and cancer risk is poor, but most have positive opinions about genetic testing for cancer prevention. However, their strong preference for chemoprevention and lesser preference for prophylactic surgeries in a hypothetical scenario underscore the importance of genetic counseling and education.
Collapse
Affiliation(s)
- Fangjian Guo
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA.
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA.
| | - Jacqueline M Hirth
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
| | - Erika L Fuchs
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
| | - Leslie E Cofie
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - Veronica Brown
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
| | - Yong-Fang Kuo
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
- Office of Biostatistics, Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX, USA
- Institute for Translational Science, The University of Texas Medical Branch, Galveston, TX, USA
| | - Maria E Fernandez
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Abbey B Berenson
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555-0587, USA
| |
Collapse
|
28
|
Lindsay AC, Delgado D, Valdez MJ, Restrepo E, Guzman YM. "I don't Think He Needs the HPV Vaccine Cause Boys Can't Have Cervical Cancer": a Qualitative Study of Latina Mothers' (Mis) Understandings About Human Papillomavirus Transmission, Associated Cancers, and the Vaccine. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:370-378. [PMID: 32654037 DOI: 10.1007/s13187-020-01824-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Genital human papillomavirus (HPV) is the most common sexually transmitted virus in the United States and etiologically linked to several types of cancers including the cervix, vulva, vagina, penis, anus, and oropharynges. Evidence indicates certain types of HPV-associated cancers disproportionally affect Latinos in the United States. This qualitative study sought to explore Latina mothers' perceptions and understanding of HPV infection, HPV-associated cancers, and the HPV vaccination for their adolescent sons and daughters. Twenty-two individual, face-to-face interviews were conducted in 2018-2019 with mothers who had at least one child between the ages of 11 and 19 years. Data were analyzed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Two major themes emerged from the analysis: (1) mothers' (mis) understanding about HPV infection transmission and HPV-associated cancer risk for girls and boys, and (2) mothers' (mis) understandings about the HPV vaccination for girls and boys. Results found that most mothers had inadequate understanding of HPV transmission, HPV-associated cancer risk for males, and need to vaccinate boys against the virus for their own personal health and prevention of HPV-associated cancers. Findings suggest that interventions should focus on improving Latina mothers' understanding of HPV transmission, addressing the lack or inadequate knowledge about HPV-associated cancer risk for males, as well as misconceptions about the importance of the HPV vaccination for males for their personal health and the prevention of HPV-associated cancers. Future research should quantify Latino parents' awareness, knowledge, and acceptability of the HPV vaccine for their sons and daughters.
Collapse
Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts-Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - Denisse Delgado
- College of Nursing and Health Sciences, University of Massachusetts-Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
| | - Madelyne J Valdez
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts-Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
| | - Emily Restrepo
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts-Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
| | - Yessica M Guzman
- Department of Public Policy and Public Affairs, McCormack Graduate School of Policy and Global Studies, University of Massachusetts-Boston, Boston, MA, USA
| |
Collapse
|
29
|
Upenieks L, Ford-Robertson J, Robertson JE. Trust in God and/or Science? Sociodemographic Differences in the Effects of Beliefs in an Engaged God and Mistrust of the COVID-19 Vaccine. JOURNAL OF RELIGION AND HEALTH 2022; 61:657-686. [PMID: 34843011 PMCID: PMC8628135 DOI: 10.1007/s10943-021-01466-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 05/26/2023]
Abstract
At present, COVID-19 vaccines are widely available in the USA, but large proportions of the American populace remain unvaccinated. One possible source of COVID-19 vaccine hesitancy is a lack of trust in science. In this study, drawing from the large literature at the intersection of science and religion, we ask whether beliefs in an engaged God (the belief that God is involved in daily human affairs) predict mistrust of the COVID-19 vaccine and whether any observed association differs across race, gender, and education. Using nationally representative data from Wave 6 of the Baylor Religion Survey (2021), our results suggest that beliefs in an engaged God were associated with greater mistrust in the COVID-19 vaccine. This association was amplified for Hispanic and lower educated Americans. We argue that beliefs in an engaged God may promote a distrust of science, reduce motivation to get vaccinated, and derive comfort and strength by placing control over one's life in the hands of a loving, involved deity. We also situate our findings within an emerging body of work on the "dark side" of religion and reflect on their implications for understanding the broader religion/health connection.
Collapse
Affiliation(s)
- Laura Upenieks
- Department of Sociology, Baylor University, One Bear Place, Waco, TX, 76798, USA.
| | | | | |
Collapse
|
30
|
Anuforo B, McGee-Avila JK, Toler L, Xu B, Kohler RE, Manne S, Tsui J. Disparities in HPV vaccine knowledge and adolescent HPV vaccine uptake by parental nativity among diverse multiethnic parents in New Jersey. BMC Public Health 2022; 22:195. [PMID: 35093050 PMCID: PMC8800253 DOI: 10.1186/s12889-022-12573-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022] Open
Abstract
Background Suboptimal human papillomavirus (HPV) vaccination rates persist among adolescents in the United States (U.S.). New Jersey (NJ), among the top, most racially/ethnically diverse states in the U.S., had among the lowest HPV vaccine initiation rates, prior to 2018. This study examined parental HPV vaccine knowledge and adolescent HPV vaccine initiation among multiethnic parents in NJ, where access to language concordant HPV vaccine information and vaccination services may differ, for immigrant parents. Methods We surveyed parents of adolescents (ages 11–18) at community events in NJ to examine parental HPV vaccine knowledge and adolescent HPV vaccine uptake. Vaccine knowledge was assessed using an 11-item question stem that covered vaccine efficacy, gender recommendation, vaccine protection, and myths. Multivariable models assessed the association of parent nativity on HPV vaccine knowledge scores and adolescent HPV vaccine initiation, controlling for sociodemographic factors. Results Of the 77 parents, most parents (84%) were aware of the HPV vaccine. However, knowledge scores were low and differed by parent nativity. Non-U.S. born parents had significantly lower knowledge scores − 1.7 [− 3.1, − 0.4] and lower odds of adolescent children initiating the HPV vaccine 0.3 [0.1, 0.9] compared to U.S.-born parents after adjusting demographic characteristics. Conclusions Our findings reveal that parental HPV vaccine knowledge remains low among suburban dwelling, immigrant parents, even though they have higher education and access to health care. Multilevel strategies to reduce missed opportunities for HPV vaccine education among parents and HPV vaccination for adolescents are needed, including for suburban, immigrant communities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12573-7.
Collapse
|
31
|
Lindsay AC, Delgado D, Valdez MJ, Restrepo E, Granberry P. "Everyone in our community should be informed about the HPV vaccine": Latinx mothers' suggested strategies to promote the human papillomavirus vaccine. Am J Health Promot 2022; 36:853-863. [PMID: 35081770 DOI: 10.1177/08901171211073960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Parents play a critical decision-making role in vaccinating their children against HPV, and mothers, in particular, are key stakeholders as they are often the parent taking their children to healthcare visits. Given the importance of the HPV vaccination as a cancer prevention strategy, this study was designed to explore Latinx mothers' suggested strategies to promote vaccine uptake among Latinx parents. SETTING AND PARTICIPANTS Community-based in Massachusetts, United States, and Latinx mothers. DESIGN AND METHODS Descriptive qualitative research employing individual semi-structured interviews. Data were analyzed using a hybrid method of thematic analysis incorporating deductive and inductive approaches. RESULTS Twenty-two, majority foreign-born (91%) Latinx mothers of adolescent girls (∼60%) and boys (∼40%) aged 11-19 years participated. Mothers suggested several strategies to promote uptake of the HPV vaccine among Latinx families including healthcare providers' increased communication and anticipatory guidance addressing factors influencing parents' HPV vaccination hesitancy, and improved community-wide dissemination of culturally and linguistically relevant information targeting not only parents of age-eligible participants but the broader community. Finally, mothers suggested the use of social media using personal narratives and an enhanced active role of schools in providing accurate information to raise awareness and educate adolescents and parents about the importance of HPV vaccination. CONCLUSION Findings are relevant to the development of tailored interventions to meet the needs of Latinx populations, and ultimately increase Latinx children's HPV vaccination rates.
Collapse
Affiliation(s)
| | | | | | - Emily Restrepo
- Exercise and Health Sciences14708University of Massachusetts Boston
| | | |
Collapse
|
32
|
Nan X, Iles IA, Yang B, Ma Z. Public Health Messaging during the COVID-19 Pandemic and Beyond: Lessons from Communication Science. HEALTH COMMUNICATION 2022; 37:1-19. [PMID: 34724838 DOI: 10.1080/10410236.2021.1994910] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The COVID-19 pandemic has made it clear that effective public health messaging is an indispensable component of a robust pandemic response system. In this article, we review decades of research from the interdisciplinary field of communication science and provide evidence-based recommendations for COVID-19 public health messaging. We take a principled approach by systematically examining the communication process, focusing on decisions about what to say in a message (i.e., message content) and how to say it (i.e., message executions), and how these decisions impact message persuasiveness. Following a synthesis of each major line of literature, we discuss how science-based principles of message design can be used in COVID-19 public health messaging. Additionally, we identify emerging challenges for public health messaging during the COVID-19 pandemic and discuss possible remedies. We conclude that communication science offers promising public health messaging strategies for combatting COVID-19 and future pandemics.
Collapse
Affiliation(s)
- Xiaoli Nan
- Department of Communication, University of Maryland-College Park
| | - Irina A Iles
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health
| | - Bo Yang
- Department of Communication, University of Arizona
| | - Zexin Ma
- Department of Communication, Journalism, and Public Relations, Oakland University
| |
Collapse
|
33
|
Chew KT, Kampan N, Shafiee MN. Perception and knowledge of human papillomavirus (HPV) vaccine for cervical cancer prevention among fully vaccinated female university students in the era of HPV vaccination: a cross-sectional study. BMJ Open 2021; 11:e047479. [PMID: 34876417 PMCID: PMC8655553 DOI: 10.1136/bmjopen-2020-047479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To assess the perception and knowledge of cervical cancer prevention among fully vaccinated female university students in the era of human papillomavirus (HPV) vaccination. DESIGN Cross-sectional using a validated questionnaire. SETTING Face-to-face interview at a public university in Malaysia. PARTICIPANTS 384 fully vaccinated female students were included in the study. RESULTS The total knowledge score in the questionnaire was 18 and was ranked according to score level into three groups: poor (score ≤5), moderate (score 6-10) and good (score ≥11). Mean score for knowledge of cervical cancer prevention was 8.24 (SD ±3.85), with 170 respondents (44.3%) scoring moderate knowledge level. The mean score for knowledge of HPV infection and its association with cervical cancer was 4.56±2.47, while the mean score for knowledge of HPV vaccination for cervical cancer prevention was 3.68 (SD ±1.98). A total of 186 (48.4%) respondents perceived that regular Pap smear was unnecessary after HPV vaccination. Respondents' perceived seriousness and susceptibility of HPV infection correlated well with knowledge of cervical cancer prevention. Two main reasons for their acceptance of HPV vaccine were self-health awareness and free vaccination. CONCLUSION The knowledge of HPV vaccination for cervical cancer prevention was average among vaccinated university students. Many of them had poor knowledge about Pap smear and did not consider regular Pap smear as an important cervical cancer screening tool following HPV vaccination. There is still a need for continued health education to improve the perception and knowledge about HPV infection and cervical cancer prevention among young adults in the community.
Collapse
Affiliation(s)
- Kah Teik Chew
- Obstetrics & Gynaecology, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Nirmala Kampan
- Obstetrics & Gynaecology, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Mohamad Nasir Shafiee
- Obstetrics & Gynaecology, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
| |
Collapse
|
34
|
Corcoran KE, Scheitle CP, DiGregorio BD. Christian nationalism and COVID-19 vaccine hesitancy and uptake. Vaccine 2021; 39:6614-6621. [PMID: 34629205 PMCID: PMC8489517 DOI: 10.1016/j.vaccine.2021.09.074] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/24/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022]
Abstract
Understanding COVID-19 vaccine hesitancy and uptake is vital for informing public health interventions. Prior U.S. research has found that religious conservatism is positively associated with anti-vaccine attitudes. One of the strongest predictors of anti-vaccine attitudes in the U.S. is Christian nationalism-a U.S. cultural ideology that wants civic life to be permeated by their particular form of nationalist Christianity. However, there are no studies examining the relationship between Christian nationalism and COVID-19 vaccine hesitancy and uptake. Using a new nationally representative sample of U.S. adults, we find that Christian nationalism is one of the strongest predictors of COVID-19 vaccine hesitancy and is negatively associated with having received or planning to receive a COVID-19 vaccine. Since Christian nationalists make up approximately 20 percent of the population, these findings could have important implications for achieving herd immunity.
Collapse
Affiliation(s)
- Katie E Corcoran
- West Virginia University, Department of Sociology & Anthropology, PO Box 6326, Morgantown, WV 26506-6326, United States.
| | - Christopher P Scheitle
- West Virginia University, Department of Sociology & Anthropology, PO Box 6326, Morgantown, WV 26506-6326, United States.
| | - Bernard D DiGregorio
- West Virginia University, Department of Sociology & Anthropology, PO Box 6326, Morgantown, WV 26506-6326, United States.
| |
Collapse
|
35
|
Ma J, Zhang X, Wang W, Zhang R, Du M, Shan L, Li Y, Wang X, Liu Y, Zhang W, Li X, Qiao Y, Wei M, Chen H, Zhou J, Li J. Knowledge of HPV, its vaccines, and attitudes toward HPV vaccines among obstetrician-gynecologists, pediatricians and immunization services providers in Western China. Hum Vaccin Immunother 2021; 18:1-7. [PMID: 34520323 PMCID: PMC8920158 DOI: 10.1080/21645515.2021.1962150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In mainland China, HPV vaccines have been available to the public. However, only a few related studies among health care providers, as the key information providers, were reported although public concerns on HPV vaccines still exist. In this study, we aim to assess the knowledge of HPV, its vaccines, and attitudes toward HPV vaccines among the three most important groups of health care providers in Western China. Method This was a cross-sectional questionnaire-based study. Health care providers including obstetrician-gynecologists (OB-GYNs), pediatricians, and immunization service providers in Western China were investigated regarding their knowledge of HPV and its vaccines and their attitudes toward HPV vaccines. Results Of 1079 health care providers completing the survey, 1015 (94.1%) knew HPV infection is the primary cause of cervical cancer. However, lower knowledge levels of other HPV-related diseases were also found (43.2%). About three-quarters (74.1%) of practitioners interviewed would be willing to recommend HPV vaccination, which was found to be lower among the OB-GYNs (69.6%) and the pediatricians (73.2%). “Lack of relevant knowledge,” “concerns on safety and efficacy” and price were the three most important concerns surrounding HPV vaccination. Conclusion The interviewed practitioners did not have adequate knowledge of HPV and its vaccines in depth. Education interventions are highly recommended to the health care providers, especially for OB-GYNs and pediatricians, to increase the coverage of HPV vaccination among the population. For the currently high price of vaccines, a future co-sharing mechanism between the government, the providers, and the individuals might be a solution.
Collapse
Affiliation(s)
- Jianqiao Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xi Zhang
- Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Wang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Rong Zhang
- Postdoctoral Research Station, Xinjiang Center for Disease Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Mei Du
- Department of Obstetrics & Gynaecology, Dali Maternal & Child Health Hospital/Dali Children's Hospital, Dali, China
| | - Li Shan
- Department of Gynaecology, Northwest Women's and Children's Hospital, Shannxi, China
| | - Yucong Li
- Department of Gynecological Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Xiaohui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital/Gansu Provincial Academic Institute for Medical Research, Lanzhou, China
| | - Yijun Liu
- School of Public Health, Zunyi Medical University, Zunyi, China
| | - Wen Zhang
- Department of Gynecology, Kunming Women and Children's Hospital, Kunming, China
| | - Xiaoling Li
- Obstetrics and Gynecology Department, Yuxi Hospital of Traditional Chinese Medicine, Yuxi, China
| | - Youlin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengna Wei
- Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jing Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
36
|
Shahbari NAE, Gesser-Edelsburg A, Davidovitch N, Brammli-Greenberg S, Grifat R, Mesch GS. Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel. Int J Equity Health 2021; 20:201. [PMID: 34493294 PMCID: PMC8423338 DOI: 10.1186/s12939-021-01523-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Parents in the Arab population of Israel are known to be “pro-vaccination” and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza. Objectives This study seeks to identify and compare variables associated with mothers’ uptake of two vaccinations, influenza and HPV, among different subgroups in Arab and Jewish society in Israel. Methods A cross-sectional study of the entire spectrum of the Israeli population was conducted using a stratified sample of Jewish mothers (n = 159) and Arab mothers (n = 534) from different subgroups: Muslim, Christian, Druse and Northern Bedouins. From March 30, 2019 through October 20, 2019, questionnaires were distributed manually to eighth grade pupils (13–14 years old) who had younger siblings in second (7–8 years old) or third (8–9 years old) grades. Results Arab mothers exhibited a higher rate of uptake for both vaccinations (p < .0001, HPV – 90%; influenza – 62%) than Jewish mothers (p = 0.0014, HPV – 46%; influenza – 34%). Furthermore, results showed that HPV vaccination uptake is significantly higher than seasonal influenza vaccination uptake in both populations. Examination of the different ethnic subgroups revealed differences in vaccination uptake. For both vaccinations, the Northern Bedouins exhibited the highest uptake rate of all the Arab subgroups (74%), followed by the Druse (74%) and Muslim groups (60%). The Christian Arab group exhibited the lowest uptake rate (46%). Moreover, the uptake rate among secular Jewish mothers was lower than in any of the Arab groups (38%), though higher than among religious/traditional Jewish mothers, who exhibited the lowest uptake rate (26%). A comparison of the variables associated with mothers’ vaccination uptake revealed differences between the ethnic subgroups. Moreover, the findings of the multiple logistic regression revealed the following to be the most significant factors in Arab mothers’ intake of both vaccinations: school-located vaccination and mothers’ perceived risk and perceived trust in the system and in the family physician. These variables are manifested differently in the different ethnic groups. Conclusions This research shows that all Arabs cannot be lumped together as one monolithic group in that they exhibit major differences according to religion, education and access to information. Ranking of variables associated with uptake of the two vaccines can provide decision-makers an empirical basis for tailoring appropriate and specific interventions to each subgroup to achieve the highest vaccine uptake rate possible. Media campaigns targeting the Arab population should be segmented to appeal to the various sub-groups according to their viewpoints, needs and health literacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01523-1.
Collapse
Affiliation(s)
- Nour Abed Elhadi Shahbari
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel.
| | - Anat Gesser-Edelsburg
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel.,School of Public Health, Founding Director of the Health and Risk Communication Research Center, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, Faculty of Health Sciences, Ben Gurion University of the Negev, 84105, Beer Sheva, Israel
| | - Shuli Brammli-Greenberg
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, P.O. Box 12272, 9112102, Jerusalem, Israel
| | - Rami Grifat
- Ziv Medical Center, 1 Derech HaRambam, 13100, Safed, Israel
| | - Gustavo S Mesch
- Department of Sociology, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel
| |
Collapse
|
37
|
Carson SL, Casillas A, Castellon-Lopez Y, Mansfield LN, Morris D, Barron J, Ntekume E, Landovitz R, Vassar SD, Norris KC, Dubinett SM, Garrison NA, Brown AF. COVID-19 Vaccine Decision-making Factors in Racial and Ethnic Minority Communities in Los Angeles, California. JAMA Netw Open 2021; 4:e2127582. [PMID: 34591103 PMCID: PMC8485164 DOI: 10.1001/jamanetworkopen.2021.27582] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/23/2021] [Indexed: 11/26/2022] Open
Abstract
Importance The COVID-19 pandemic has had disproportionate effects on racial and ethnic minority communities, where preexisting clinical and social conditions amplify health and social disparities. Many of these communities report lower vaccine confidence and lower receipt of the COVID-19 vaccine. Understanding factors that influence the multifaceted decision-making process for vaccine uptake is critical for narrowing COVID-19-related disparities. Objective To examine factors that members of multiethnic communities at high risk for COVID-19 infection and morbidity report as contributing to vaccine decision-making. Design, Setting, and Participants This qualitative study used community-engaged methods to conduct virtual focus groups from November 16, 2020, to January 28, 2021, with Los Angeles County residents. Potential participants were recruited through email, video, and telephone outreach to community partner networks. Focus groups were stratified by self-identified race and ethnicity as well as age. Transcripts were analyzed using reflexive thematic analysis. Main Outcomes and Measures Themes were categorized by contextual, individual, and vaccine-specific influences using the World Health Organization's Vaccine Hesitancy Matrix categories. Results A total of 13 focus groups were conducted with 70 participants (50 [71.4%] female) who self-identified as American Indian (n = 17 [24.3%]), Black/African American (n = 17 [24.3%]), Filipino/Filipina (n = 11 [15.7%]), Latino/Latina (n = 15 [21.4%]), or Pacific Islander (n = 10 [14.3%]). A total of 39 participants (55.7%) were residents from high-poverty zip codes, and 34 (48.6%) were essential workers. The resulting themes included policy implications for equitable vaccine distribution: contextual influences (unclear and unreliable information, concern for inequitable access or differential treatment, references to mistrust from unethical research studies, accessibility and accommodation barriers, eligibility uncertainty, and fears of politicization or pharmaceutical industry influence); social and group influences (inadequate exposure to trusted messengers or information, altruistic motivations, medical mistrust, and desire for autonomy); and vaccination-specific influences (need for vaccine evidence by subpopulation, misconceptions on vaccine development, allocation ambiguity, vaccination safety preferences, the importance of perceiving vaccine equity, burden of vaccine scheduling, cost uncertainty, and desire for practitioner recommendation). Conclusions and Relevance In this qualitative study, participants reported a number of factors that affected their vaccine decision-making, including concern for inequitable vaccine access. Participants endorsed policy recommendations and strategies to promote vaccine confidence. These results suggest that support of informed deliberation and attainment of vaccine equity will require multifaceted, multilevel policy approaches that improve COVID-19 vaccine knowledge, enhance trust, and address the complex interplay of sociocultural and structural barriers to vaccination.
Collapse
Affiliation(s)
- Savanna L. Carson
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Alejandra Casillas
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Yelba Castellon-Lopez
- Department of Family Medicine, UCLA David Geffen School of Medicine, University of California, Los Angeles
| | - Lisa N. Mansfield
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - D’Ann Morris
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Juan Barron
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Ejiro Ntekume
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Raphael Landovitz
- Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles
| | - Stefanie D. Vassar
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Olive View-UCLA Medical Center, Sylmar, California
| | - Keith C. Norris
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Steven M. Dubinett
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Nanibaa’ A. Garrison
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Institute for Society & Genetics, College of Letters and Science, University of California, Los Angeles
- Institute for Precision Health, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Arleen F. Brown
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Olive View-UCLA Medical Center, Sylmar, California
| |
Collapse
|
38
|
Richards AS, Qin Y, Daily K, Nan X. African American Parents' Perceived Vaccine Efficacy Moderates the Effect of Message Framing on Psychological Reactance to HPV Vaccine Advocacy. JOURNAL OF HEALTH COMMUNICATION 2021; 26:534-544. [PMID: 34427548 PMCID: PMC8994864 DOI: 10.1080/10810730.2021.1966688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This experiment assessed how the frame of promotional vaccine messages elicited psychological reactance differently for African American parents according to their level of perceived vaccine efficacy. We found that those with low perceived HPV vaccine efficacy experienced more psychological reactance in response to loss-framed messages compared to gain-framed messages, whereas message framing made little difference for those with high perceived HPV vaccine efficacy. In addition, the interaction between frame and perceived HPV vaccine efficacy indirectly affected parents' intentions to vaccinate their child for HPV via reactance. These results support current theorizing about framing effects under defensive message processing specifically as it applies to psychological reactance.
Collapse
Affiliation(s)
| | - Yan Qin
- Department of Communication, University of Maryland
| | - Kelly Daily
- Department of Communication, La Salle University
| | - Xiaoli Nan
- Department of Communication, University of Maryland
| |
Collapse
|
39
|
Kepka D, Bodson J, Lai D, Sanchez-Birkhead AC, Davis FA, Lee D, Tavake-Pasi F, Napia E, Villalta J, Mukundente V, Mooney R, Coulter H, Stark LA. Diverse caregivers' HPV vaccine-related awareness and knowledge. ETHNICITY & HEALTH 2021; 26:811-826. [PMID: 30589389 PMCID: PMC6597331 DOI: 10.1080/13557858.2018.1562052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
Objectives: To assess factors associated with HPV vaccine-related awareness and knowledge among caregivers of adolescents from five ethnic community groups in Utah.Design: For this community-based participatory research study, we surveyed N = 228 caregivers of teens aged 11-17 years from African American, African refugee, American Indian/Alaskan Native, Hispanic/Latino, and Native Hawaiian/Pacific Islander community groups in Utah about their HPV vaccine awareness and knowledge.Results: Participants exhibited high awareness of cervical cancer (71.05%), moderate awareness of HPV (53.95%), and low awareness of the HPV vaccine (46.49%). HPV vaccine-related knowledge was mostly worse, with fewer than half the participants reporting knowing that HPV can cause cervical cancer (46.93%), that most people are infected with HPV at some point in their lives (28.95%), that HPV is asymptomatic in females (36.40%) and males (37.28%), that the HPV vaccine is recommended for adolescent females (41.67%) and males (36.40%), and that the HPV vaccine requires more than one dose (27.19%). HPV vaccine-related awareness and knowledge were significantly associated with race/ethnicity, educational attainment, income, occupation, birthplace, parents' birthplace, English usage, health insurance coverage, type of health insurance, and child having a primary care provider (all p < 0.05). HPV vaccine-related knowledge (p < 0.05) and awareness (p < 0.05) of caregivers were associated with a child in the household receiving the HPV vaccine.Conclusion: Our findings indicate a need to develop educational interventions in collaboration with diverse communities in Utah. We underscore the importance of promoting knowledge about the existence of the HPV vaccine, as well as deeper HPV vaccine-related issues (e.g. HPV risks, treatment, and recommendations).
Collapse
Affiliation(s)
- Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Julia Bodson
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Djin Lai
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Community Faces of Utah, Salt Lake City, Utah, USA
| | - Ana C. Sanchez-Birkhead
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Community Faces of Utah, Salt Lake City, Utah, USA
- Hispanic Health Care Task Force, Salt Lake City, Utah, USA
| | - France A. Davis
- Community Faces of Utah, Salt Lake City, Utah, USA
- Calvary Baptist Church, Salt Lake City, Utah, USA
| | - Doriena Lee
- Community Faces of Utah, Salt Lake City, Utah, USA
- Calvary Baptist Church, Salt Lake City, Utah, USA
| | - Fahina Tavake-Pasi
- Community Faces of Utah, Salt Lake City, Utah, USA
- National Tongan American Society, Salt Lake City, Utah, USA
| | - Edwin Napia
- Community Faces of Utah, Salt Lake City, Utah, USA
- Urban Indian Center, Salt Lake City, Utah, USA
| | - Jeannette Villalta
- Community Faces of Utah, Salt Lake City, Utah, USA
- Hispanic Health Care Task Force, Salt Lake City, Utah, USA
| | - Valentine Mukundente
- Community Faces of Utah, Salt Lake City, Utah, USA
- Best of Africa, West Valley City, Utah, USA
| | - Ryan Mooney
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Heather Coulter
- Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Louisa A. Stark
- Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, Utah, USA
- Department of Human Genetics, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
40
|
Cataldi JR, O'Leary ST, Markowitz LE, Allison MA, Crane LA, Hurley LP, Brtnikova M, Beaty BL, Gorman C, Meites E, Lindley MC, Kempe A. Changes in Strength of Recommendation and Perceived Barriers to Human Papillomavirus Vaccination: Longitudinal Analysis of Primary Care Physicians, 2008-2018. J Pediatr 2021; 234:149-157.e3. [PMID: 33689710 PMCID: PMC10207027 DOI: 10.1016/j.jpeds.2021.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate among pediatricians and family physicians human papillomavirus (HPV) vaccination recommendation practices for 11- to 12-year-old youth; report parental refusal/deferral of HPV vaccination; and report barriers to HPV vaccination changed over time. STUDY DESIGN We surveyed nationally representative networks of pediatricians and family physicians in 2008, 2010, 2013-2014, and 2018. Male vaccination questions were not asked in 2008; barriers and parental vaccine refusal questions were not asked in 2010. RESULTS Response rates were 80% in 2008 (680/848), 72% in 2010 (609/842), 70% in 2013-2014 (582/829), and 65% in 2018 (588/908). The proportion of physicians strongly recommending HPV vaccination for 11- to 12-year-old patients increased from 53% in 2008 to 79% in 2018 for female patients and from 48% in 2014 to 76% in 2018 for male patients (both P < .0001). The proportion of physicians indicating ≥50% of parents refused/deferred HPV vaccination remained steady for female patients (24% in 2008 vs 22% in 2018, P = .40) and decreased for male patients (42% in 2014 vs 28% in 2018, P < .001). Physician barriers to providing HPV vaccination were rare and decreased over time. Increasing numbers of physicians reported perceived parental barriers of vaccine safety concerns (5% "major barrier" in 2008 vs 35% in 2018, P < .0001) and moral/religious concerns (5% in 2008 vs 25% in 2018, P < .0001). CONCLUSIONS Between 2008 and 2018, more primary care physicians reported recommending HPV vaccination for adolescents, fewer reported barriers, and more physicians reported parents who had vaccine safety or moral/religious concerns.
Collapse
Affiliation(s)
- Jessica R Cataldi
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Lauri E Markowitz
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mandy A Allison
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Lori A Crane
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Laura P Hurley
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Division of General Internal Medicine, Denver Health, Denver, CO
| | - Michaela Brtnikova
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Brenda L Beaty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Carol Gorman
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Elissa Meites
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Megan C Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| |
Collapse
|
41
|
Feemster KA, Head KJ, Panozzo CA, O'Dell SM, Zimet GD, Kornides ML. Efficacy of tailored messages to improve behavioral intent to accept HPV vaccination among mothers may be moderated by sociodemographics. Prev Med Rep 2021; 23:101413. [PMID: 34150474 PMCID: PMC8192722 DOI: 10.1016/j.pmedr.2021.101413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 12/04/2022] Open
Abstract
The efficacy of a tailored video intervention differed by sociodemographics. Further research should evaluate interventions tailored by sociodemographics. Tailoring interventions by child age and other factors may improve efficacy.
We assessed differences in response to a tailored recommendation intervention for HPV vaccine by participants’ sociodemographic characteristics in this exploratory sub-analysis of a larger web-based, randomized-controlled trial on tailored messaging among mothers with low intent to vaccinate their 11–14-year-old child against HPV. The intervention consisted of pre-recorded video messages tailored to 1–5 common concerns about HPV vaccine. In these exploratory analyses, we used generalized linear models to assess differences in post-intervention intent across intervention arms, stratified by sociodemographic characteristics among 496 trial participants. We found significantly higher post-intervention intent in the intervention participants versus the control group among mothers: 1) with younger children; 2) with white vs. black children; 3) with Non-Hispanic children; 4) who were younger; 5) with some college or vocational training; with household incomes of ≥$100,000; and 7) with 1–2 children. Our findings of effect modification by certain sociodemographic factors such as age, race/ethnicity, and household income should be considered when designing similar tailored messaging interventions.
Collapse
Affiliation(s)
- Kristen A Feemster
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Infectious Diseases, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Katharine J Head
- Indiana University School of Liberal Arts, Department of Communication Studies, Cavanaugh Hall 307C, 425 University Boulevard, Indianapolis, IN 46202, USA
| | | | - Sean M O'Dell
- Department of Psychiatry and Behavioral Health, Geisinger, 100 North Academy Avenue, Danville, PA 17822, USA.,Department of Population Health Sciences, Geisinger, 100 North Academy Avenue, Danville, PA 17822, USA
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 West 10 Street Suite 1001, Indianapolis, IN 46202, USA
| | - Melanie L Kornides
- Department of Family & Community Health, University of Pennsylvania School of Nursing, Division of Adolescent Medicine, Perelman School of Medicine, 418 Curie Boulevard, Office 401, Philadelphia, PA 19104, USA
| |
Collapse
|
42
|
Galbraith-Gyan KV, Lee SJ, Ramanadhan S, Viswanath K. Disparities in HPV knowledge by race/ethnicity and socioeconomic position: Trusted sources for the dissemination of HPV information. Cancer Causes Control 2021; 32:923-933. [PMID: 33999315 DOI: 10.1007/s10552-021-01445-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/06/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine the differences in HPV and HPV vaccine awareness, knowledge, and beliefs by race/ethnicity and socioeconomic position (SEP) among a national sample of non-Hispanic whites (NH-Whites), non-Hispanic Blacks (NH-Blacks), and Hispanics in the United States. We also examine differences in trusted health information sources by race/ethnicity and SEP. METHODS Data were obtained from the Health Information National Trends Survey, Cycle 1, conducted from January to April 2017. Descriptive statistics, bivariate analyses, multivariate logistic regression, and listwise deletion were used to examine HPV and HPV vaccine awareness and knowledge-related items, and trust in health information sources among NH-Whites, NH-Blacks, and Hispanics 18-49 years old. RESULTS HPV vaccine awareness was moderate with no significant differences across racial/ethnic groups. NH-Whites had significantly higher knowledge that HPV causes cervical cancer than NH-Blacks and Hispanics (p < 0.001). High SEP NH-Blacks (OR = 0.42, 95% CI = [0.24-0.73], p = 0.002]) and Hispanics (OR = 0.49, 95% CI = [0.31-0.79, p = 0.003]) had lower odds of knowing HPV causes a sexually transmitted disease than their white counterparts. Low SEP NH-Blacks (OR = 11.03, 95% CI = [3.05-39.86, p < 0.001]) had 11 times the odds of ever hearing about the HPV vaccine than low SEP NH-Whites. NH-Blacks had twice the odds of trusting health information from television (OR = 2.39, 95% CI = [1.52-3.78]. p < 0.001), and almost six times the odds of trusting health information from religious organizations than low SEP NH-Whites (OR = 5.76, 95% CI = [2.02-16.44, p < 0.001]). CONCLUSION Tailored communication strategies may address the low HPV knowledge among NH-Blacks and Hispanics from high and low SEP.
Collapse
Affiliation(s)
- Kayoll V Galbraith-Gyan
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.
| | - Stella Juhyun Lee
- Department of Media and Communication, Konkuk University, Seoul, Republic of Korea
| | - Shoba Ramanadhan
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| |
Collapse
|
43
|
Mansfield LN, Vance A, Nikpour JA, Gonzalez-Guarda RM. A systematic review of human papillomavirus vaccination among US adolescents. Res Nurs Health 2021; 44:473-489. [PMID: 33860541 DOI: 10.1002/nur.22135] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 11/07/2022]
Abstract
The human papillomavirus (HPV) causes many anogenital and oral cancers affecting young adults in the United States. Vaccination during adolescence can prevent HPV-associated cancers, but vaccine uptake among adolescents is low and influenced by factors serving as barriers and facilitators to HPV vaccination. In this systematic review, we synthesized research using the socioecological framework model to examine individual-level, relationship-level, community-level, and societal-level factors that influence HPV vaccine initiation and completion among US adolescents. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to guide the methodology for this review. An electronic search was conducted in January 2020 using PubMed, Cumulative Index of Nursing and Allied Health Literature, ProQuest Central, Scopus, and American Psychological Association PsycInfo databases. The Joanna Briggs Institute tools were used to assess the quality for the 57 studies included in this review. The most consistent influences of HPV vaccination included age at vaccination, awareness, and knowledge about HPV vaccination, socioeconomic status, insurance status, race/ethnicity, and preventative care behaviors at the individual level. Provider recommendation, familial/peer support of vaccination, and parental health behaviors were influences at the relationship level. Although fewer findings elucidated community-level and societal-level influences, high-poverty areas, high-risk communities with large proportions of racial/ethnic minority groups, healthcare facilities servicing children, and combined health policies appear to serve as facilitators of HPV initiation and completion. Findings from this review can inform culturally relevant and age-specific interventions and multi-level policies aiming to improve HPV vaccination coverage in the United States.
Collapse
Affiliation(s)
- Lisa N Mansfield
- School of Nursing, Duke University, Durham, North Carolina, USA.,Division of General Internal Medicine and Health Services Research, National Clinician Scholars Program, University of California, Los Angeles, Los Angeles, California, USA
| | - Ashlee Vance
- Institute for Healthcare Policy and Innovation, National Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan, USA
| | | | | |
Collapse
|
44
|
Kasting ML, Head KJ, DeMaria AL, Neuman MK, Russell AL, Robertson SE, Rouse CE, Zimet GD. A National Survey of Obstetrician/Gynecologists' Knowledge, Attitudes, and Beliefs Regarding Adult Human Papillomavirus Vaccination. J Womens Health (Larchmt) 2021; 30:1476-1484. [PMID: 33428518 DOI: 10.1089/jwh.2020.8727] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: Many women see an obstetrician/gynecologist (OB/GYN) annually and receive their primary care from an OB/GYN. Understanding OB/GYNs' human papillomavirus (HPV) vaccination practices, including knowledge of and barriers to vaccination, is essential to design effective interventions to increase vaccination. This study evaluated OB/GYN knowledge, attitudes, and beliefs regarding vaccinating both younger (18-26 years) and mid-adult (27-45 years) women. Materials and Methods: Data were collected from OB/GYN providers in October 2019 through a nationwide web-based survey. Items included the following: HPV-related vaccination practices, recommendation strength, knowledge (seven items), benefits (four items), and barriers (eight items). Results: The sample (n = 224) was majority were White (69%), men (56%), and practice in suburban clinics (55%). Most (84%) reported they usually or always recommend HPV vaccine to eligible patients, but estimated only about half (51%) of other OB/GYNs did the same. Recommendation strength varied by patient age with 84% strongly recommending it to patients ≤18 years, compared with 79% and 25% strongly recommending to younger and mid-adult patients, respectively (p < 0.01). Participants reported lower benefits (p = 0.007) and higher barriers (p < 0.001) for 27- to 45-year-old patients compared with younger patients. Cost was the most frequently reported barrier, regardless of patient age. Overall knowledge was high (m = 5.2/7) but 33% of participants did not know the vaccine was safe while breastfeeding. Conclusions: Although providers reported strongly and consistently recommending the HPV vaccination to their adult patients, there were gaps in knowledge and attitudinal barriers that need to be addressed. Provider performance feedback may be important in improving HPV vaccination awareness among providers.
Collapse
Affiliation(s)
- Monica L Kasting
- Department of Public Health, Purdue University, West Lafayette, Indiana, USA.,Cancer Prevention and Control Program, Indiana University Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
| | - Katharine J Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Andrea L DeMaria
- Department of Public Health, Purdue University, West Lafayette, Indiana, USA
| | - Monica K Neuman
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Allissa L Russell
- Department of Public Health, Purdue University, West Lafayette, Indiana, USA
| | - Sharon E Robertson
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Caroline E Rouse
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| |
Collapse
|
45
|
Sitaresmi MN, Rozanti NM, Simangunsong LB, Wahab A. Improvement of Parent's awareness, knowledge, perception, and acceptability of human papillomavirus vaccination after a structured-educational intervention. BMC Public Health 2020; 20:1836. [PMID: 33256697 PMCID: PMC7708115 DOI: 10.1186/s12889-020-09962-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/23/2020] [Indexed: 11/20/2022] Open
Abstract
Background Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11–13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability. Methods We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. Results A total of 506 parents participated. Before receiving the structured-educational intervention, parents’ awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p < 0.001). HPV vaccine’s acceptability increased from 74.3 to 87.4% (p < 0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r = 0.32 to 0.53, p < 0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine’s acceptability with OR 1.90 (95%CI:1.40–2.57) and OR 1.31(95%CI,1.05–1.63), respectively. Conclusions A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability.
Collapse
Affiliation(s)
- Mei Neni Sitaresmi
- Department of Pediatrics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ DR. Sardjito Hospital, Jalan Gejayan CT X no 18 Pelemkecut, Yogyakarta, 55281, Indonesia.
| | - Nisrina Maulida Rozanti
- School of Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lamria Besty Simangunsong
- Department of Pediatrics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ DR. Sardjito Hospital, Jalan Gejayan CT X no 18 Pelemkecut, Yogyakarta, 55281, Indonesia
| | - Abdul Wahab
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
46
|
Mizumachi K, Aoki H, Kitano T, Onishi T, Takeyama M, Shima M. How to recover lost vaccine acceptance? A multi-center survey on HPV vaccine acceptance in Japan. J Infect Chemother 2020; 27:445-449. [PMID: 33127289 DOI: 10.1016/j.jiac.2020.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The plummeting acceptance rate of the HPV vaccine in Japan is one of the most disappointing vaccine-related events in recent times. Since 2013, the national HPV vaccine coverage rate fell from more than 70% to less than 1%. This survey investigated parental HPV vaccine acceptance and the factors that influence it. METHODS A multi-center survey was conducted in eight hospitals in Nara prefecture, Japan, from July 2019 to March 2020. Parents were asked to answer a series of questions in a survey that included information on the HPV vaccine. RESULTS Among the 1884 parents who answered the questionnaire, 21.8% indicated that they had accepted the HPV vaccine even before reading the information provided in the questionnaire. The overall acceptance rate after everyone had read the information increased to 50.2% (p < 0.001). Among those who still did not accept the vaccine after reading the information (N = 925), 26.7% indicated that they might change their mind if more vaccine safety reports were to appear in the mass media; other potentially influencing factors were direct communication from health care providers (35.1%), a recommendation by government (19.5%), and peer behavior (16.8%). CONCLUSION The study showed that providing appropriate medical information significantly improves HPV vaccine acceptance. To reverse the loss of HPV vaccine acceptance in Japan, a multi-discipline approach that includes the mass media, health care providers, the government and the general population will be needed.
Collapse
Affiliation(s)
| | - Hirosato Aoki
- Department of Pediatrics, Nara Medical University, Japan; Department of Neonatolgy, Kanagawa Children's Medical Center, Japan
| | - Taito Kitano
- Department of Pediatrics, Nara Medical University, Japan; Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada.
| | - Tomoko Onishi
- Department of Pediatrics, Nara Medical University, Japan
| | | | - Midori Shima
- Department of Pediatrics, Nara Medical University, Japan
| |
Collapse
|
47
|
Vu M, Berg CJ, Escoffery C, Jang HM, Nguyen TT, Travis L, Bednarczyk RA. A systematic review of practice-, provider-, and patient-level determinants impacting Asian-Americans' human papillomavirus vaccine intention and uptake. Vaccine 2020; 38:6388-6401. [PMID: 32829979 PMCID: PMC7505643 DOI: 10.1016/j.vaccine.2020.07.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Asian-Americans have been documented to have low human papillomavirus (HPV) vaccine initiation and completion. No research has attempted to examine underlying mechanisms of HPV vaccine uptake disparities among Asian-Americans. Using the P3 (practice, provider, and patient) model, this study aimed to identify practice-, provider-, and patient-level determinants of Asian-Americans' HPV vaccine intention and uptake. METHODS We conducted a systematic review of published literature regarding practice-, provider- and patient-level determinants of vaccine intention (e.g., intention, willingness, or acceptability) and uptake (e.g., initiation or completion). Eligible studies were those presenting empirical/original data, focusing on Asian populations in the U.S., including outcomes related to HPV vaccine intention and uptake, and analyzing data on factors associated with these outcomes separately for Asian groups. RESULTS Twenty-six studies (19 quantitative and 7 qualitative studies) were included in the review. Most commonly studied subgroups were Koreans (n = 9), Chinese (n = 6), and Cambodians (n = 5). Studies showed varied prevalence across subgroups (intention: 23.4%-72%; initiation: 14%-67%; completion: 9%-63%). Only 3 studies included measurements of practice-level determinants (language services, insurance policy). Twelve studies measured provider-level determinants (most commonly documented: HPV vaccine recommendation). All studies measured patient-level determinants (most commonly documented: HPV and HPV vaccine knowledge, perceived safety, perceived susceptibility, and perceived relationship between HPV vaccine and sexual activity). CONCLUSIONS Existing research on determinants of HPV vaccine intention and uptake among Asian-Americans currently lacks measurements of practice-level constructs and perspectives of clinic staff and providers, which are needed to guide system-level interventions and provider training. Data regarding patient-level determinants suggest that interventions for Asian-American populations can focus on providing educational information in culturally-appropriate manners, leveraging familial influences, and attending to access-related or cultural beliefs about HPV vaccine. Interventions should take into account varied vaccine intention and uptake prevalence in different Asian subgroups.
Collapse
Affiliation(s)
- Milkie Vu
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington Cancer Center, George Washington University, Washington, DC, United States
| | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Winship Cancer Institute, Emory University, Atlanta, GA, United States
| | - Hyun M Jang
- Emory College of Arts & Science, Emory University, Atlanta, GA, United States
| | - Tien T Nguyen
- Hanoi-Amsterdam High School for the Gifted, Hanoi, Viet Nam
| | - Lisa Travis
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, United States
| | - Robert A Bednarczyk
- Winship Cancer Institute, Emory University, Atlanta, GA, United States; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA United States
| |
Collapse
|
48
|
Lahijani AY, King AR, Gullatte MM, Hennink M, Bednarczyk RA. HPV Vaccine Promotion: The church as an agent of change. Soc Sci Med 2020; 268:113375. [PMID: 32979772 DOI: 10.1016/j.socscimed.2020.113375] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/12/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023]
Abstract
Vaccination to prevent human papillomavirus (HPV) infections and associated cancers has been recommended for use in the US since 2006; however, vaccine uptake remains suboptimal. Many sociodemographic factors have been evaluated with regard to HPV vaccine uptake but there has been less focus on the role of religion and religiosity. Our qualitative case study aimed to identify community perceptions of HPV and HPV vaccination via seven focus group discussions (FGDs) with leaders and members of an African Methodist Episcopal (AME) church in metro-Atlanta, Georgia from April 2018 to July 2018. A Social and Behavior Change Communication (SBCC) conceptual framework was used to identify potential avenues to strengthen communication and health promotion strategies in the church community. Results showed diverse perceptions about HPV vaccine amongst the church community, ranging from viewing the HPV vaccine as essential to unnecessary for adolescents. Two key barriers to the HPV vaccine that may be addressed through the SBCC strategies were identified: 1) general mistrust in the healthcare system and 2) the expectation of abstinence among adolescents. For future HPV prevention opportunities, congregants highlighted they would be more receptive to receiving HPV vaccine promotion messages from pre-established trustworthy sources. Church leaders hold the trust of their congregation, therefore implementation of a church-based intervention utilizing the SBCC strategies has considerable potential to transform perceptions of the HPV vaccine and increase vaccination uptake. These findings may be implemented in future HPV vaccine promotion strategies within faith-based communities to promote safe and open dialogue for health communication messages to be disseminated in a familiar and trusted setting.
Collapse
Affiliation(s)
- Ariana Y Lahijani
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Adrian R King
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Mary M Gullatte
- Winship Cancer Institute, Emory University, 1365 Clifton Rd, Atlanta, GA, 30322, USA; Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, 30322, USA; Emory Healthcare, 235 Peachtree Street, NE, Atlanta, GA, 30303, USA
| | - Monique Hennink
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA; Winship Cancer Institute, Emory University, 1365 Clifton Rd, Atlanta, GA, 30322, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA; Emory Vaccine Center, Emory University, 954 Gatewood Road, Atlanta, GA, 30329, USA.
| |
Collapse
|
49
|
Gopalani SV, Sedani AE, Janitz AE, Clifton SC, Stoner J, Peck J, Comiford A, Salvatore AL, Campbell J. HPV vaccination and Native Americans: protocol for a systematic review of factors associated with HPV vaccine uptake among American Indians and Alaska Natives in the USA. BMJ Open 2020; 10:e035658. [PMID: 32895265 PMCID: PMC7478049 DOI: 10.1136/bmjopen-2019-035658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 04/06/2020] [Accepted: 07/07/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The nine-valent human papillomavirus (HPV) vaccine could prevent an estimated 92% of the cancers attributable to HPV types targeted by the vaccine. However, uptake of the HPV vaccine among American Indian and Alaska Native (AI/AN) adolescents has been low. AI/ANs also bear a disproportionate burden of cervical and other HPV-associated cancers. Increasing HPV vaccination rates is a national priority, but reviews and national surveys on HPV vaccination factors are lacking for the AI/AN population. The objective of this systematic review is to assess factors associated with HPV vaccination among AI/ANs in the USA. METHODS AND ANALYSIS A systematic review is proposed to synthesise the current literature on HPV vaccination factors in AI/ANs from 1 July 2006 until 30 September 2019. As applicable, controlled vocabulary terms, keywords and special features (eg, limits, explode and focus) will be incorporated into database searches. To maximise the identification of relevant studies, citation indexes and databases that index dissertations, preprints and grey literature are included. Studies will be screened and selected independently in two stages. In stage 1, titles and abstracts will be screened. In stage 2, full-text articles will be screened and selected. A data extraction form and quality assessment tool will be piloted, revised and implemented. If available, measures of frequency and association will be presented. A narrative synthesis of the included studies will also be undertaken and reported. ETHICS AND DISSEMINATION As our review will use publicly available data and publications, an Institutional Review Board review will not be required. We will disseminate the findings from this review through peer-reviewed publication(s) and conference presentation(s). POTENTIAL AMENDMENTS In the event of amendments to the protocol, we will provide the date, rationale, and description of the change for each amendment. PROSPERO REGISTRATION NUMBER CRD42020156865.
Collapse
Affiliation(s)
- Sameer Vali Gopalani
- Department of Epidemiology and Biostatistics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ami E Sedani
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Amanda E Janitz
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Shari C Clifton
- Robert M. Bird Health Sciences Library, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Julie Stoner
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Jennifer Peck
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ashley Comiford
- Community Health Promotion, Cherokee Nation, Tahlequah, Oklahoma, USA
| | - Alicia L Salvatore
- Value Institute, Christiana Care Health Services, Wilmington, Delaware, USA
| | - Janis Campbell
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| |
Collapse
|
50
|
Reiter PL, Pennell ML, Martinez GA, Perkins RB, Katz ML. HPV vaccine coverage across Hispanic/Latinx subgroups in the United States. Cancer Causes Control 2020; 31:905-914. [PMID: 32748100 DOI: 10.1007/s10552-020-01331-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/24/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Research on HPV vaccine coverage in the United States has typically aggregated Hispanic/Latinx individuals into a single group for analyses, an approach that has potentially masked variation between Hispanic/Latinx subgroups. To address this limitation, we examined HPV vaccine coverage across Hispanic/Latinx subgroups. METHODS We analyzed data on Hispanic/Latinx adolescents ages 13-17 (n = 16,335) from the 2012-2016 National Immunization Survey-Teen. Each adolescent was categorized into a subgroup: Mexican, Cuban, Puerto Rican, Central American, South American, other Spanish origin, or multi-subgroup. We examined HPV vaccine initiation (receipt of one or more doses) and completion (receipt of three doses) for males and females separately. Analyses used weighted logistic regression. RESULTS Vaccine coverage among males was highest among Central Americans (initiation: 57.5%; completion: 31.1%) and lowest among multi-subgroup males (initiation: 46.3%; completion: 19.9%). Among females, initiation ranged from 63.4% among Cubans to 71.2% among Puerto Ricans, and completion ranged from 33.6% among multi-subgroup females to 48.7% among South Americans. Hispanic/Latinx subgroups were similar on these outcomes in regression models. However, within several subgroups, vaccine coverage was higher among adolescents whose parents' preferred language was Spanish (i.e., potentially less acculturated) compared to those whose parents' preferred language was English. CONCLUSIONS Modest variation in HPV vaccine coverage exists across Hispanic/Latinx subgroups, with differences found by preferred language within several subgroups. Findings provide insight into HPV vaccine coverage among Hispanic/Latinx subgroups and can help guide future surveillance efforts and vaccination interventions.
Collapse
Affiliation(s)
- Paul L Reiter
- College of Public Health, The Ohio State University, Columbus, OH, USA.
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
| | - Michael L Pennell
- College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Glenn A Martinez
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Spanish and Portuguese, The Ohio State University, Columbus, OH, USA
| | | | - Mira L Katz
- College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| |
Collapse
|