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Olaoye O, Macdonald S. A systematic review of interventions to promote human papillomavirus (HPV) vaccination in Africa. Public Health 2024; 234:47-57. [PMID: 38954882 DOI: 10.1016/j.puhe.2024.05.015] [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: 12/25/2023] [Revised: 04/26/2024] [Accepted: 05/15/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE We conducted a systematic review to assess the scope and effectiveness of interventions to improve human papilloma virus (HPV) vaccination in Africa from 2006 to 2021. STUDY DESIGN Systematic review. METHODS Four databases (Medline, Embase, CINAHL and PsycINFO) were searched for articles published between 2006 and 2021. Articles were screened and included based on eligibility criteria using DistillerSR (Version 2.35). Data were extracted and reported using a narrative synthesis. A quality assessment was also conducted for each study using validated quality appraisal tools. RESULTS Out of 7603 articles identified by a systematic search, 18 articles met the inclusion criteria. Included studies comprised impact evaluation and cross-sectional studies published between 2012 and 2021 and conducted in eight African countries namely: Nigeria, Cameroon, South Africa, Kenya, Tanzania, Zambia, Mali, and Malawi. Study quality ranged from high to low quality. Interventions comprised fifteen educational and three multicomponent interventions. Out of thirteen impact evaluation studies (all educational interventions), twelve studies were effective in increasing HPV vaccine uptake and/or improving participants' knowledge, attitudes, and perceptions about the vaccine. Across five cross-sectional studies (two educational and three multicomponent interventions), HPV vaccine uptake rates ranged from 34% to 93.3%, with a consensus on safety and effectiveness in 67.9%-90.3% of participants post-intervention. CONCLUSION Educational and multicomponent interventions have been implemented to improve HPV vaccination in Africa. While educational interventions have proven effective at improving HPV vaccine uptake, a more diverse range of interventions with robust impact evaluation study designs are needed to strengthen the available evidence and improve vaccine uptake.
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Affiliation(s)
- O Olaoye
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8TB, United Kingdom.
| | - S Macdonald
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8TB, United Kingdom
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Cheema S, Abraham A, Maisonneuve P, Jithesh A, Chaabna K, Al Janahi R, Sarker S, Hussain A, Rao S, Lowenfels AB, Mamtani R. HPV infection and vaccination: a cross-sectional study of knowledge, perception, and attitude to vaccine uptake among university students in Qatar. BMC Public Health 2024; 24:2316. [PMID: 39187821 DOI: 10.1186/s12889-024-19792-0] [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: 01/30/2024] [Accepted: 08/13/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Human Papilloma Virus (HPV) infection is a significant public health concern in the Gulf Cooperation Council countries, being widely prevalent and the main risk factor for cervical cancer. We aimed to assess knowledge and perception towards HPV, acceptability of the HPV vaccine, and HPV vaccination rates among university students in Education City, Doha, Qatar. METHODS This cross-sectional survey utilized proportional quota-sampling, with quotas based on university, sex, and nationality, to recruit students from seven universities between February and September 2022. The English language questionnaire requested socio-demographic information, knowledge, and attitudes about HPV infection and the vaccine. The chi-square test, Student t-test, Mann-Whitney-Wilcoxon tests and multivariable ordinal logistic regression were used to assess differences in proportion, mean, and median according to broad HPV knowledge categories. RESULTS Three hundred and ninety-eight students were recruited (response rate = 82.3%), of whom 251 (63.1%) were female. Mean age was 21.7 years. Eighty-nine (22.4%, 95% CI 18.4-26.8%) students had poor knowledge about HPV, 220 (55.3%, 95% CI 50.2-60.2%) students had some awareness, and 89 (22.4%, 95% CI 18.4-26.8%) students were knowledgeable. Age, nationality, and field of study influenced the students' knowledge about HPV. Only 25 (6.3%) students had previously been vaccinated against HPV. However, 71% of the unvaccinated students reported being willing to get vaccinated if recommended by their healthcare provider. CONCLUSIONS Overall, 77.7% of the student population had some-to-good levels of knowledge about HPV-related infection, cancer, and vaccination. There are gaps in the student population's understanding and knowledge about HPV. Increasing knowledge can be key toward shared decision-making for HPV vaccination among eligible populations. Targeted public health campaigns and integration into childhood vaccination programs should be critical first steps, especially as most of the surveyed students had a positive outlook on getting vaccinated. Healthcare professionals should be incentivized to increase their HPV knowledge and communication skills, while policymakers can work toward easing barriers in integrating HPV vaccinations in the immunization schedule and encouraging overall HPV vaccination uptake.
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Affiliation(s)
- Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | | | | | | | - Albert B Lowenfels
- Department of Surgery, Department of Family Medicine, New York Medical College, Valhalla, NY, USA
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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3
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Xia S, Nan X. Motivating COVID-19 Vaccination through Persuasive Communication: A Systematic Review of Randomized Controlled Trials. HEALTH COMMUNICATION 2024; 39:1455-1478. [PMID: 37254940 DOI: 10.1080/10410236.2023.2218145] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We conducted a systematic review of published randomized controlled trials (N = 47) assessing the persuasive effects of COVID-19 communication on COVID-19 vaccine acceptance. Individual vs. collective appeals and gain vs. loss frames are among the most frequently assessed message features, but they generally do not make a difference in persuasion. Normative messages that highlight higher (vs. lower) prevalence of vaccine acceptance are more persuasive. Message sources overall have limited impact on COVID-19 vaccine acceptance, but sources that have a shared identity with the message receivers tend to be persuasive. More engaging message channels such as interactive chatbots and videos are promising communication tools but are generally under-utilized and under-studied. Compared to no communication or irrelevant communication, COVID-19 vaccine messages generally have a small advantage in increasing COVID-19 vaccine acceptance. Messages that include 1) vaccine safety and/or efficacy information; 2) collective appeals combined with embarrassment appeals; and 3) political leaders' vaccine endorsement are among the most effective messaging strategies. There is no evidence of any backfire effects of COVID-19 vaccine messages. We discuss the implications of our findings for persuasive message design in pandemic vaccine communication.
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Affiliation(s)
- Shilin Xia
- Department of Communication, University of Maryland
| | - Xiaoli Nan
- Department of Communication, University of Maryland
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4
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Lewin EB, Bellanti DM, Boyd CC, Orenstein WA, Bellanti JA. An Exploratory Study of an Online Vaccine Education Program in Middle-School Students to Promote Vaccine Acceptance. J Sch Nurs 2024; 40:257-265. [PMID: 35142586 DOI: 10.1177/10598405221076137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: While vaccines have reduced the incidence of vaccine-preventable diseases, vaccine hesitancy threatens the re-emergence of childhood infectious diseases. Purpose: This randomized controlled study evaluated an online vaccine education program to advance vaccine acceptance among middle-school students. Methodology: Study participants were randomly assigned to an intervention group who viewed the VEP videos or to a comparison group who viewed a science-based video unrelated to vaccines. Results: Knowledge scores improved in both groups and more favorable shifts in vaccine-related beliefs and attitudes occurred in the intervention than in the comparison group. Conclusions: This program can be feasibly delivered via an online platform to middle school students, resulting in shifts in vaccine-related knowledge, beliefs and attitudes. Implications: Delivering evidence-based content to instruct about vaccine effectiveness and safety is an area in which school nurses have demonstrated an important role as a resource for patient education to promote vaccine advocacy.
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Affiliation(s)
- Edward B Lewin
- Department of Pediatrics, Georgetown University Medical Center, Washington, DC
| | - Dawn M Bellanti
- Clinical Research Consultant, Project Manager, ICF International Inc
| | | | - Walter A Orenstein
- Department of Pediatrics and Emory Vaccine Center, School of Medicine, Emory University, Atlanta, GA
| | - Joseph A Bellanti
- Department of Pediatrics and Microbiology-Immunology and
- International Center for Interdisciplinary Studies of Immunology, Georgetown University Medical Center, Washington, DC
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5
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Santana C, Pines HA, Lemus H, Martinez ME, Nodora JN, Pulgarin SP, Crespo NC, Madanat H, McDaniels-Davidson C. HPV Vaccine Misperceptions Among Hispanics/Latinos in Southern California. J Racial Ethn Health Disparities 2024; 11:1557-1563. [PMID: 37195591 PMCID: PMC10191090 DOI: 10.1007/s40615-023-01631-4] [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: 01/06/2023] [Revised: 04/20/2023] [Accepted: 05/04/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Cervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites. METHODS HPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score. RESULTS Among the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p < 0.01). DISCUSSION Culturally relevant interventions are needed to address HPV vaccine misperceptions among Hispanics/Latinos as part of efforts toward HPV-associated cancer health equity.
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Affiliation(s)
- Christina Santana
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Heather A Pines
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
- School of Public Health and Human Longevity Science, University of California San Diego, San Diego Herbert Wertheim, San Diego, CA, USA
| | - Hector Lemus
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Maria Elena Martinez
- School of Public Health and Human Longevity Science, University of California San Diego, San Diego Herbert Wertheim, San Diego, CA, USA
- Moores Cancer Center, San Diego Health, University of California, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Jesse N Nodora
- School of Public Health and Human Longevity Science, University of California San Diego, San Diego Herbert Wertheim, San Diego, CA, USA
- Moores Cancer Center, San Diego Health, University of California, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Salma Parra Pulgarin
- School of Public Health and Human Longevity Science, University of California San Diego, San Diego Herbert Wertheim, San Diego, CA, USA
| | - Noe C Crespo
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
- Moores Cancer Center, San Diego Health, University of California, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Hala Madanat
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
- Division of Research and Innovation, San Diego State University, San Diego, CA, USA
| | - Corinne McDaniels-Davidson
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.
- Moores Cancer Center, San Diego Health, University of California, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.
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McKeithen MC, Gilkey MB, Kong WY, Oh NL, Heisler-MacKinnon J, Carlson R, James G, Grabert BK. Policy Approaches for Increasing Adolescent HPV Vaccination Coverage: A Systematic Review. Pediatrics 2024; 153:e2023064692. [PMID: 38623635 PMCID: PMC11035154 DOI: 10.1542/peds.2023-064692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 04/17/2024] Open
Abstract
CONTEXT US jurisdictions have enacted a wide range of policies to address low human papillomavirus (HPV) vaccination coverage among adolescents, but it is unclear which policies are effective. OBJECTIVE To systematically review the impact of governmental policies on adolescent HPV vaccination coverage. DATA SOURCES PubMed, Embase, and Scopus databases. STUDY SELECTION Eligible studies, published from 2009 to 2022, evaluated the impact of governmental policies on HPV vaccination coverage among adolescents ages 9 to 18. DATA EXTRACTION Two investigators independently extracted data on study sample, study design and quality, policy characteristics, and HPV vaccination outcomes. We summarized findings by policy type: school-entry requirements (SERs), federally-funded policies related to the Vaccines for Children program and Medicaid, educational requirements, and others. RESULTS Our search yielded 36 eligible studies. A majority of studies evaluating HPV vaccine SERs found positive associations between SERs and HPV vaccination coverage (8 of 14), particularly for SERs in Rhode Island and Washington, DC. All studies evaluating SERs for other adolescent vaccines observed positive spillover effects for HPV vaccination (7 of 7). Federally-funded policies related to Vaccines for Children and Medicaid were consistently associated with higher HPV vaccination coverage (7 of 9). Relatively few studies found associations between educational requirements and HPV vaccination coverage (2 of 8). LIMITATIONS Studies used limited vaccination data sources and non- or quasi-experimental designs. Some studies had no or poorly matched comparison groups. CONCLUSIONS Our findings suggest promise for SERs and federally-funded policies, but not educational requirements, for increasing HPV vaccination coverage among adolescents.
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Affiliation(s)
| | - Melissa B. Gilkey
- Gillings School of Global Public Health
- Lineberger Comprehensive Cancer Center
| | | | - N. Loren Oh
- Gillings School of Global Public Health
- School of Medicine
| | | | - Rebecca Carlson
- Health Sciences Library
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Greeshma James
- Duke Margolis Center for Health Policy, Duke University, Durham, North Carolina
| | - Brigid K. Grabert
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Thilly N, Michel M, Simon M, Bocquier A, Gagneux-Brunon A, Gauchet A, Gilberg S, Le Duc-Banaszuk AS, Bruel S, Mueller JE, Giraudeau B, Chevreul K. Effectiveness of a School- and Primary Care-Based HPV Vaccination Intervention: The PrevHPV Cluster Randomized Trial. JAMA Netw Open 2024; 7:e2411938. [PMID: 38780943 PMCID: PMC11117086 DOI: 10.1001/jamanetworkopen.2024.11938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 03/18/2024] [Indexed: 05/25/2024] Open
Abstract
Importance The human papillomavirus (HPV) vaccine is safe and effective, yet vaccination coverage remains below public health objectives in many countries. Objective To examine the effectiveness of a 3-component intervention on HPV vaccination coverage among adolescents aged 11 to 14 years 2 months after the intervention ended, each component being applied alone or in combination. Design, Setting, and Participants A cluster randomized trial with incomplete factorial design (PrevHPV) was conducted between July 1, 2021, and April 30, 2022, in French municipalities receiving 0, 1, 2, or 3 components of the intervention. Randomization was stratified by school district and municipalities' socioeconomic level. Analyses were carried out on 11- to 14-year-old adolescents living in all participating municipalities, regardless of what had been implemented. Intervention The PrevHPV intervention had 3 components: (1) educating and motivating 11- to 14-year-old adolescents in middle schools, along with their parents; (2) training general practitioners (GPs) on up-to-date HPV information and motivational interviewing techniques; and (3) free HPV vaccination at school. Main Outcomes and Measures The primary outcome was HPV vaccination coverage (≥1 dose) 2 months after the intervention ended among 11- to 14-year-old adolescents living in participating municipalities, based on the French national reimbursement database and data collected during the trial in groups randomized to implement at-school vaccination. Results A total of 91 municipalities comprising 30 739 adolescents aged 11 to 14 years (15 876 boys and 14 863 girls) were included and analyzed. Half the municipalities were in the 2 lowest socioeconomic quintiles and access to GPs was poor in more than two-thirds of the municipalities. Thirty-eight of 61 schools (62.3%) implemented actions and 26 of 45 municipalities (57.8%) had at least 1 trained GP. The median vaccination coverage increased by 4.0 percentage points (IQR, 2.0-7.3 percentage points) to 14.2 percentage points (IQR, 9.1-17.3 percentage points) at 2 months. At-school vaccination significantly increased vaccination coverage (5.50 percentage points [95% CI, 3.13-7.88 percentage points]) while no effect was observed for adolescents' education and motivation (-0.08 percentage points [95% CI, -2.54 to 2.39 percentage points]) and GPs' training (-1.46 percentage points [95% CI, -3.44 to 0.53 percentage points]). Subgroup analyses found a significant interaction between at-school vaccination and access to GPs, with a higher effect when access was poor (8.62 percentage points [95% CI, 5.37-11.86 percentage points] vs 2.13 percentage points [95% CI, -1.25 to 5.50 percentage points]; P = .007 for interaction). Conclusions and Relevance In this cluster randomized trial, within the context of the late COVID-19 pandemic period and limited school and GP participation, at-school HPV vaccination significantly increased vaccination coverage. The trial did not show a significant effect for training GPs and education and motivation, although it may be observed after more time has elapsed after the intervention. Trial Registration ClinicalTrials.gov Identifier: NCT04945655.
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Affiliation(s)
- Nathalie Thilly
- Université de Lorraine, APEMAC, Nancy, France
- Département Méthodologie, Promotion, Investigation, Université de Lorraine, CHRU-Nancy, Nancy, France
| | - Morgane Michel
- Université Paris Cité, ECEVE, UMR 1123, Inserm, Paris, France
- Unité d’épidémiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Maïa Simon
- Université de Lorraine, APEMAC, Nancy, France
- Département Méthodologie, Promotion, Investigation, Université de Lorraine, CHRU-Nancy, Nancy, France
| | | | - Amandine Gagneux-Brunon
- CIC-1408 Vaccinologie, CHU de Saint-Etienne, Saint-Priest-en-Jarez, France
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, Lyon, France
- Institut Presage Chaire Prevacci, Université Jean Monnet, Saint-Priest-en-Jarez, France
| | - Aurélie Gauchet
- Université Savoie Mont Blanc, Université Grenoble Alpes, LIP/PC2S, Grenoble, France
| | - Serge Gilberg
- Department of General Practice, Université Paris Cité, Paris, France
| | | | - Sébastien Bruel
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Université Saint-Etienne-Lyon, Saint-Etienne, France
- Health, Systemic, Process UR 4129 Research Unit, Université Claude Bernard Lyon 1, Lyon, France
| | - Judith E. Mueller
- Emerging Disease Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
- Université de Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Rennes, France
| | - Bruno Giraudeau
- Université de Tours, Université de Nantes, SPHERE U1246, Inserm, Tours, France
- Inserm CIC 1415, CHRU de Tours, Tours, France
| | - Karine Chevreul
- Université Paris Cité, ECEVE, UMR 1123, Inserm, Paris, France
- Unité d’épidémiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
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Brooks EM, Fugate-Laus K, Webel B, Naavaal S. Perceptions of a State-Level HPV Vaccine Mandate and Exemption Option in Rural Virginia: A Qualitative Study. Vaccines (Basel) 2024; 12:401. [PMID: 38675783 PMCID: PMC11054131 DOI: 10.3390/vaccines12040401] [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: 02/15/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; yet, despite the availability of safe and effective HPV vaccines, only half of eligible adolescents have completed the vaccine series. School-entry requirements are one proven strategy to increase vaccination rates among children and youth and reduce the burden of HPV-related cancer. This study investigated community perceptions of an HPV vaccine school-entry mandate in Virginia and the consequences of a low threshold exemption option included in the legislation. We conducted 40 interviews with community members including 15 interviews with parents, 19 with healthcare providers, and 6 with community leaders. Interviews asked about knowledge, beliefs, and attitudes concerning the HPV vaccine and mandate. Interviews were recorded, transcribed, and thematically analyzed. Despite healthcare provider support for the mandate, there was widespread confusion over the school-entry policy and concern that the exemption option undermined vaccination efforts. Understanding variations in community-level perceptions and response to school-based vaccination mandates is crucial for designing effective public health strategies. Findings suggest statewide vaccination initiatives should preemptively identify low uptake areas and provide targeted information to communities. Future mandates should avoid the use of ambiguous and contradictory language in vaccine-related legislation.
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Affiliation(s)
- E. Marshall Brooks
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Kendall Fugate-Laus
- Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Ben Webel
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Shillpa Naavaal
- Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA
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Mattebo M, Gottvall M, Grandahl M. School Nurses' Perceptions and Experiences of Delivering a School-Based Intervention to Improve Primary Prevention of Human Papillomavirus Among Adolescents-A Focus Group Study Following a Randomized Controlled Trial. J Sch Nurs 2024; 40:166-173. [PMID: 34632854 PMCID: PMC10924545 DOI: 10.1177/10598405211046174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The present qualitative study is a part of the process evaluation of a complex intervention, the randomized controlled trial, "Prevention of human papillomavirus (HPV) in a school-based setting." We aimed to explore participating school nurses' perceptions and experiences of delivering the educational HPV intervention to adolescents aged 16. Focus group interviews were conducted with school nurses (n = 20) and analyzed with inductive qualitative content analysis. The overall theme Easily adapted into the existing role as a school nurse permeated the participants' views. The nurses were in favor of delivering an intervention that increased the HPV vaccination rates and improved beliefs and awareness about HPV prevention. It suits their work and health-promoting aspect of their role well and can easily be adapted into the current school health consultant curriculum. Having material in different languages to share with adolescents and their parents to promote equal health was deemed important.
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Affiliation(s)
- Magdalena Mattebo
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Gottvall
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Health Sciences, The Red Cross University College, Huddinge, Sweden
| | - Maria Grandahl
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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10
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Tsui J, Shin M, Sloan K, Martinez B, Palinkas LA, Baezconde-Garbanati L, Cantor JC, Hudson SV, Crabtree BF. Understanding Clinic and Community Member Experiences with Implementation of Evidence-Based Strategies for HPV Vaccination in Safety-Net Primary Care Settings. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:147-162. [PMID: 37368117 PMCID: PMC11133176 DOI: 10.1007/s11121-023-01568-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 06/28/2023]
Abstract
HPV vaccination rates remain below target levels among adolescents in the United States, which is particularly concerning in safety-net populations with persistent disparities in HPV-associated cancer burden. Perspectives on evidence-based strategies (EBS) for HPV vaccination among key implementation participants, internal and external to clinics, can provide a better understanding of why these disparities persist. We conducted virtual interviews and focus groups, guided by the Practice Change Model, with clinic members (providers, clinic leaders, and clinic staff) and community members (advocates, parents, policy-level, and payers) in Los Angeles and New Jersey to understand common and divergent perspectives on and experiences with HPV vaccination in safety-net primary care settings. Fifty-eight interviews and seven focus groups were conducted (n = 65 total). Clinic members (clinic leaders n = 7, providers n = 12, and clinic staff n = 6) revealed conflicting HPV vaccine messaging, lack of shared motivation to reduce missed opportunities and improve workflows, and non-operability between clinic electronic health records and state immunization registries created barriers for implementing effective strategies. Community members (advocates n = 8, policy n = 11, payers n = 8, and parents n = 13) described lack of HPV vaccine prioritization among payers, a reliance on advocates to lead national agenda setting and facilitate local implementation, and opportunities to support and engage schools in HPV vaccine messaging and adolescents in HPV vaccine decision-making. Participants indicated the COVID-19 pandemic complicated prioritization of HPV vaccination but also created opportunities for change. These findings highlight design and selection criteria for identifying and implementing EBS (changing the intervention itself, or practice-level resources versus external motivators) that bring internal and external clinic partners together for targeted approaches that account for local needs in improving HPV vaccine uptake within safety-net settings.
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Affiliation(s)
- Jennifer Tsui
- University of Southern California, Los Angeles, CA, USA.
| | | | - Kylie Sloan
- University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Joel C Cantor
- Rutgers the State University of New Jersey, New Brunswick, NJ, USA
| | - Shawna V Hudson
- Rutgers the State University of New Jersey, New Brunswick, NJ, USA
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11
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Satybaldiyeva N, Martinez LS, Cooper B, Oren E. The Association between Message Framing and Intention to Vaccinate Predictive of Hepatitis A Vaccine Uptake. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:207. [PMID: 38397696 PMCID: PMC10888360 DOI: 10.3390/ijerph21020207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
As ongoing, sporadic outbreaks of hepatitis A virus (HAV) infections present public health challenges, it is critical to understand public perceptions about HAV, especially regarding vaccination. This study examines whether message framing changes the intention to vaccinate against HAV and self-reported vaccine behavior. Using a randomized controlled trial (N = 472) in February 2019 via Amazon Mechanical Turk, participants were randomized to one of four HAV vaccination message groups or a no-message control group. The message groups varied in their emphasis on the nature of outcomes (gain versus loss) and for whom (individual versus collective). The message frames were compared by intention to vaccinate, differences in message characteristics, and behavioral determinants. There was no difference in intention to vaccinate between gain- versus loss-framed messages (MD = 0.1, 95% CI = -0.1, 0.3) and individual- versus collective-framed messages (MD = 0.1, 95% CI = -0.1, 0.3). The intention to vaccinate against HAV in the no-message control group was very similar to that in the message groups. However, gain-framed messages were rated more positively in valence than loss-framed messages (MD = -0.5, 95% CI = -0.7, -0.3), which may be helpful for cultivating a positive public perception of HAV vaccination. The study also highlights the importance of comparing message frames to a no-message control in designing health communication messaging promoting HAV vaccination.
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Affiliation(s)
- Nora Satybaldiyeva
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (N.S.); (B.C.)
| | - Lourdes S. Martinez
- School of Communication, San Diego State University, San Diego, CA 92182, USA;
| | - Brittany Cooper
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (N.S.); (B.C.)
| | - Eyal Oren
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (N.S.); (B.C.)
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Webster EM, Ahsan MD, Kulkarni A, Peñate E, Beaumont S, Ma X, Wilson-Taylor M, Chang J, Ipp L, Safford MM, Cantillo E, Frey M, Holcomb K, Chapman-Davis E. Building knowledge using a novel web-based intervention to promote HPV vaccination in a diverse, low-income population. Gynecol Oncol 2024; 181:102-109. [PMID: 38150834 DOI: 10.1016/j.ygyno.2023.12.005] [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: 09/26/2023] [Revised: 11/24/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES HPV vaccination rates remain suboptimal despite proven efficacy. Data suggest misconceptions or lack of knowledge are leading barriers. Our study aimed to develop and pilot a novel interactive education resource designed to educate parents and patients about HPV vaccines. METHODS This is a prospective pilot study conducted in an urban teaching hospital pediatric clinic. The Patient Activated Learning System (PALS) intervention included 3 web-based videos with HPV vaccine-related educational content. Participants were parents of adolescent patients, aged 11-17 years, and young adult patients, aged 18-26 years. Enrolled participants completed an HPV vaccine knowledge survey before and after watching PALS; paired scores were evaluated. Acceptability and participant-reported impact of PALS modules were measured via Likert-scale surveys. RESULTS 132 individuals were approached; 101 (76%) enrolled and completed the study. Participants self-identified as Hispanic (50%), non-Hispanic Black (23%), non-Hispanic White (7%), Asian (6%), American/Alaskan/Hawaiian Native or Pacific Islander (5%). Half reported earning ≤$40,000 annually; 57% had only a high school education. Post-intervention knowledge scores were increased compared to baseline (9.87/27 points vs 17.53/27 points, p < 0.01). PALS modules were reported as enjoyable to use and understandable (89% and 93%, respectively), and improved participants' understanding of the importance of HPV vaccination (90%). Of the 18 patients unvaccinated at baseline, 39% received 1 shot of the HPV vaccine within one month. CONCLUSION The PALS HPV vaccine educational intervention was feasible, acceptable, and improved knowledge among a diverse, underserved population. Our intervention may positively influence HPV vaccination rates, with potential to overcome HPV vaccine hesitancy.
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Affiliation(s)
- Emily M Webster
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America.
| | - Muhammad Danyal Ahsan
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Amita Kulkarni
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Emilio Peñate
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Shanice Beaumont
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Xiaoyue Ma
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America
| | - Melanie Wilson-Taylor
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States of America
| | - Jane Chang
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States of America
| | - Lisa Ipp
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States of America
| | - Monika M Safford
- Department of Medicine, Weill Cornell Medicine, New York, NY, United States of America
| | - Evelyn Cantillo
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Melissa Frey
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Kevin Holcomb
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Eloise Chapman-Davis
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
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13
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Vu M, Berg CJ, Pham NHT, Tiro JA, Escoffery C, Spring B, Bednarczyk RA, Ta D, Kandula NR. U.S. Vietnamese parents' trusted sources of information and preferences for intervention messaging about HPV vaccination: A mixed methods study. PEC INNOVATION 2023; 3:100189. [PMID: 37521956 PMCID: PMC10371838 DOI: 10.1016/j.pecinn.2023.100189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023]
Abstract
Objective Assess trusted sources of information, perceived message effectiveness, and preferred dissemination strategies regarding adolescent HPV vaccination among U.S. Vietnamese parents. Methods Data came from an observational, explanatory sequential mixed-methods study with U.S. Vietnamese parents of adolescents (408 survey participants; 32 interview participants). Surveys and interviews were conducted in both Vietnamese and English. Mixed-methods data were integrated and analyzed for confirmation, expansion, or discordance. Results Both quantitative and qualitative findings confirm high trust in HPV vaccination information from providers, government agencies, and cancer organizations. Messages perceived as effective emphasize vaccine safety, experts' endorsement, importance of vaccination prior to HPV exposure, and preventable cancers. Qualitative findings expanded quantitative results, demonstrating a desire for evidence-based information in the Vietnamese language and addressing cultural concerns (e.g., effectiveness or potential side effects specific to Vietnamese adolescents, whether parents should delay HPV vaccination for Vietnamese adolescents). Quantitative and qualitative findings were incongruent about whether parents would trust information about HPV vaccination that is disseminated via social media. Conclusion We identified credible messengers, feasible strategies, and elements of impactful messages for interventions to increase adolescent HPV vaccination for U.S. Vietnamese. Innovation We focus on a high-risk, underserved population and integrate mixed-methods design and analysis.
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Affiliation(s)
- Milkie Vu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, United States of America
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, United States of America
- George Washington Cancer Center, George Washington University, United States of America
| | - Nhat-Ha T. Pham
- College of Arts and Sciences, University of Pennsylvania, United States of America
| | - Jasmin A. Tiro
- Department of Public Health Sciences, University of Chicago, United States of America
- Cancer Prevention and Population Science Program, Comprehensive Cancer Center, University of Chicago, United States of America
| | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, United States of America
- Emory Prevention Research Center, Emory University, United States of America
- Cancer Prevention and Control Program, Winship Cancer Institute, Emory University, United States of America
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, United States of America
| | - Robert A. Bednarczyk
- Cancer Prevention and Control Program, Winship Cancer Institute, Emory University, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, United States of America
- Department of Epidemiology, Rollins School of Public Health, Emory University, United States of America
- Emory Vaccine Center, Emory University, United States of America
| | - Danny Ta
- Nell Hodgson Woodruff School of Nursing, Rollins School of Public Health, Emory University, United States of America
| | - Namratha R. Kandula
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, United States of America
- Department of Medicine, Feinberg School of Medicine, Northwestern University, United States of America
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14
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Conageski C. Human Papillomavirus Vaccines. Clin Obstet Gynecol 2023; 66:433-447. [PMID: 37650661 DOI: 10.1097/grf.0000000000000788] [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: 09/01/2023]
Abstract
Human papillomavirus (HPV) vaccines are highly effective in preventing the transmission of HPV and thus downstream HPV-related lower genital tract neoplasias. First introduced in 2006, the HPV vaccine has demonstrated clinical efficacy in both men and women. Several commercially available vaccines now exist, but only one is available in the United States. Both prelicensure and postlicensure studies demonstrate robust safety profiles. HPV vaccines should be made available to everyone between the ages of 9 and 26 years of age. Newer vaccination recommendations in expanded populations rely on patient-provider shared decision making. Currently, available HPV vaccines offer little therapeutic benefit. Recent research has identified several new DNA vaccines and delivery modifications with early demonstrated success at eliminating prevalent HPV infections and precancerous lesions. Despite the success of the HPV vaccine, vaccination hesitancy and disinformation continue to threaten our ability to eliminate these deadly cancers. Informational, behavioral, and environmental interventions have mixed success in increasing vaccination rates, but several strategies do exist to increase rates of vaccination.
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Affiliation(s)
- Christine Conageski
- Department of OBGYN, University of Colorado School of Medicine, Aurora, Colorado
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15
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Balma B, Vasilakos L, Osman I, Elgonda A, Gewirtz O'Brien JR. COVID-19 vaccine attitudes among youth experiencing homelessness: a qualitative analysis with opportunities for action. BMC Public Health 2023; 23:1672. [PMID: 37648987 PMCID: PMC10469469 DOI: 10.1186/s12889-023-16413-0] [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: 04/18/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
Youth experiencing homelessness (YEH) are uniquely vulnerable to COVID-19 infection, yet are often excluded from response planning during the COVID-19 pandemic and other public health crises. As part of a larger community- and youth-engaged project through a national network of Prevention Research Centers, our qualitative study sought to describe youth perspectives that influence COVID-19 vaccine confidence and uptake, and identify youth-driven strategies to guide public health efforts to improve vaccine confidence and access. We conducted focus groups with youth experiencing homelessness (n = 20) and semi-structured interviews with staff members (n = 10) at youth-serving agencies to solicit youth perspectives about COVID-19 vaccination. Focus groups and interviews were recorded, transcribed, and analyzed using thematic qualitative analysis. In partnership with youth and cross-sector partners, we distilled eight salient themes that influenced COVID-19 vaccine uptake and confidence among YEH: 1. historical harms and mistrust of systems, 2. access to reliable health information, 3. prioritization of basic needs, 4. personal health influence, 5. barriers to healthcare, 6. fear and uncertainty of the vaccines, 7. sense of bodily autonomy, and 8. community influence. We also identified three youth-driven opportunities to increase COVID-19 vaccination among this population: emphasizing autonomy, leveraging trusted sources of information, and improving vaccine access.Our study elucidates perspectives of YEH on COVID-19 vaccination, and identifies several opportunities to improve youth vaccine confidence and access. It also underscores the importance of centering youth voice in response planning during current and future public health crises.
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Affiliation(s)
- Brandon Balma
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA.
| | - Lauren Vasilakos
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Ingie Osman
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Asha Elgonda
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Janna R Gewirtz O'Brien
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
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Chandeying N, Thongseiratch T. Systematic review and meta-analysis comparing educational and reminder digital interventions for promoting HPV vaccination uptake. NPJ Digit Med 2023; 6:162. [PMID: 37644090 PMCID: PMC10465590 DOI: 10.1038/s41746-023-00912-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
Global Human papillomavirus (HPV) vaccination rates remain low despite available WHO-approved vaccines. Digital interventions for promoting vaccination uptake offer a scalable and accessible solution to this issue. Here we report a systematic review and meta-analysis examining the efficacy of digital interventions, comparing educational and reminder approaches, for promoting HPV vaccination uptake (HVU). This study also identifies factors influencing the effectiveness of these interventions. We searched PubMed, PsycInfo, Web of Science, and the Cochrane Library from each database's inception to January 2023. Three raters independently evaluate the studies using a systematic and blinded method for resolving disagreements. From 1929 references, 34 unique studies (281,280 unique participants) have sufficient data. Client reminder (OR, 1.41; 95% CI, 1.23-1.63; P < 0.001), provider reminder (OR, 1.39; 95% CI, 1.11-1.75; P = 0.005), provider education (OR, 1.18; 95% CI, 1.05-1.34; P = 0.007), and client education plus reminder interventions (OR, 1.29; 95% CI, 1.04-1.59; P = 0.007) increase HVU, whereas client education interventions do not (OR, 1.08; 95% CI, 0.92-1.28; P = 0.35). Digital intervention effectiveness varies based on participants' gender and the digital platform used. Interventions targeting male or mixed-gender participants demonstrate greater benefit, and reminder platforms (SMS, preference reminders, or electronic health record alerts) are more effective in increasing HVU. Digital interventions, particularly client and provider reminders, along with provider education, prove significantly more effective than client education alone. Incorporating digital interventions into healthcare systems can effectively promote HPV vaccination uptake. Reminder interventions should be prioritized for promoting HVU.
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Affiliation(s)
- Nutthaporn Chandeying
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Therdpong Thongseiratch
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
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17
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Kwek MEJ, Ang JX, Mathur M, Kho LCL. Comparison of awareness, attitudes and knowledge on human papilloma virus vaccination in Singapore: 2019 versus 2013. Singapore Med J 2023:384042. [PMID: 37675669 DOI: 10.4103/singaporemedj.smj-2020-437] [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: 09/08/2023]
Abstract
Introduction This study aimed to assess the changes in the awareness, attitudes and knowledge regarding human papillomavirus (HPV) vaccination among the local population. The secondary aims were to identify barriers and to evaluate the effectiveness of national HPV vaccination campaigns over a six-year period in Singapore. Methods We conducted and compared two cross-sectional surveys in 2013 and 2019 among female participants attending a general gynaecology clinic. Results A total of 597 participants completed the survey in 2013 and 2019. The participants were comparable in their race, marital status, educational level, occupation and monthly household income. Knowledge scores for cervical cancer and HPV infection showed significant improvement from 2013 to 2019. There was no significant difference in knowledge scores for HPV vaccination, which resulted in similar uptake of the HPV vaccine. Age, educational level and knowledge of HPV vaccine were significant predictors of acceptance of the HPV vaccine. The top two reasons for declining the HPV vaccine were the lack of knowledge and cost, as noted in the 2019 survey. Conclusion The Singapore government's efforts to improve cervical cancer awareness through national campaigns and policy changes have led to an improvement in knowledge of HPV infection. However, this has not translated into improvements in the vaccine acceptance rates. The decision for vaccine uptake is complex, and there are multiple factors to be addressed to ensure cost-effective implementation of the strategies. Our study highlights the need for effective dissemination of vaccine information, additional subsidies and consideration of a mandatory school-based vaccination programme.
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Affiliation(s)
- Michelle E-Jyn Kwek
- Department of Obstetrics and Gynaecology, KK Women and Children's Hospital, Singapore
| | - Joella Xiaohong Ang
- Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore
| | - Manisha Mathur
- Department of Obstetrics and Gynaecology, KK Women and Children's Hospital, Singapore
| | - Lily Chye Lee Kho
- Department of Obstetrics and Gynaecology, KK Women and Children's Hospital, Singapore
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18
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Su Y, Zhang X, Zhang S. The impact of collective action dilemma on vaccine hesitancy: Evidence from China. Hum Vaccin Immunother 2023; 19:2256041. [PMID: 37747070 PMCID: PMC10521338 DOI: 10.1080/21645515.2023.2256041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023] Open
Abstract
Vaccine hesitancy has dramatically decreased the speed of vaccination and stalled global health development. While the factors influencing vaccine hesitancy and mitigation measures have been explored in depth by existing studies, research from the perspective of human interaction is lacking. Based on the theory of collective action, this paper analyzes how free riding behavior affects vaccine hesitancy and how the vaccine hesitancy caused by free riding behavior can be solved. Using 2,203 survey data sets from China, this paper examines the influence of the collective action dilemma - represented by free riding behavior - on COVID-19 vaccine hesitancy. The empirical results show that the existence of free riding behavior is an essential cause of vaccine hesitancy. Based on this conclusion, this paper discusses how to further alleviate the problem of vaccine hesitancy caused by collective action dilemmas by promoting cooperation. The findings of this paper may be helpful to promote various types of vaccines and further suggest that countries should assume the perspective of solving the collective action dilemma to achieve increased vaccination rates.
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Affiliation(s)
- Yiqing Su
- School of Public Policy and Management, Guangxi University, Nanning, China
| | - Xiaoting Zhang
- School of Public Policy and Management, Guangxi University, Nanning, China
| | - Shifei Zhang
- School of Public Policy and Management, Guangxi University, Nanning, China
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19
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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.
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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
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20
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Kikut AI. The doctor knows or the evidence shows: An online survey experiment testing the effects of source trust, pro-vaccine evidence, and dual-processing in expert messages recommending child COVID-19 vaccination to parents. PLoS One 2023; 18:e0288272. [PMID: 37478116 PMCID: PMC10361505 DOI: 10.1371/journal.pone.0288272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/24/2023] [Indexed: 07/23/2023] Open
Abstract
Increasing child vaccination rates is a critical step toward mitigating the spread of COVID-19. Both distrust in expert sources and concern about the safety and efficacy of vaccines may contribute to parent vaccine hesitancy. The present study is the first to test the effectiveness of building trust and providing evidence supporting child COVID-19 vaccines in recommendation messages for parents. Based on dual-processing theories, emphasis on source trustworthiness and pro-vaccine evidence may each be particularly effective when the other is not present. It was hypothesized that these two approaches would have main and interaction effects on perceived message effectiveness and pro-vaccine beliefs. A between-subjects 2 (trust-building appeal vs. no trust-building appeal) X 2 (pro-vaccine evidence vs. no pro-vaccine evidence) online survey experiment was conducted in December 2021 and January 2022 with United States parents/guardians of children <18 years old (n = 401). As hypothesized, trust and pro-vaccine evidence each had significant simple main effects on both outcomes. Analysis of variance showed a significant negative interaction effect of trust and pro-vaccine evidence on perceived message effectiveness [F(3, 394) = 6.47; η2 = 0.02, p = 0.002; 95% CI (0.01, 0.11)], supporting the dual-processing hypothesis. The interaction effect on pro-vaccine beliefs was also negative but not significant [F(3, 394) = 2.69; η2 = 0.01; p = 0.102; 95% CI (0.00, 0.03)]. Either highlighting evidence supporting vaccines or building trust in expert sources can influence parent vaccine support. Messages which include strong evidence supporting recommended behaviors may influence recommendation acceptance even among those with lower trust in expert sources and establishing trust may reduce the need to describe available evidence.
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Affiliation(s)
- Ava Irysa Kikut
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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21
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Olagoke A, Hebert-Beirne J, Floyd B, Caskey R, Boyd A, Molina Y. The effectiveness of a religiously framed HPV vaccination message among Christian parents of unvaccinated adolescents in the United States. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:215-224. [PMID: 37401883 DOI: 10.1080/17538068.2023.2171613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND The uptake of the human papillomavirus (HPV) vaccines has been controversial among religious parents due to beliefs that their children are expected to practice sexual purity and so do not need protection from a sex-related infection. Also, if at all they get infected in the future, God can protect them from sickness without a vaccine. Yet, most HPV vaccination messages are secular, lacking spiritual themes. This study compared the effectiveness of the Centers for Disease Control and Prevention (CDC) Vaccine Information Statement (VIS) on HPV with our intervention message- a scripture-embedded HPV vaccination message (using a randomized controlled trial design) on vaccination intention. METHODS The study was conducted online. Participants were 342 Christian parents (from any denomination) of unvaccinated adolescents aged 11-17 years. The intervention message used the Cognitive Metaphor Theory to map the constructs of the Biblical story of Noah and the Ark to HPV vaccination. We framed Noah as the parents, the flood as HPV, and the ark as the vaccination. Multiple linear regression was used to analyze the changes in vaccination intention before and after the intervention. RESULTS Our findings showed that parents who received the scripture-embedded message reported a higher intention to vaccinate their children than those who received the CDC VIS (β= 0.31, 95% confidence interval [95%CI] = 0.11-0.52; p=0.003). CONCLUSION Our findings support the need for equitable messaging regarding HPV vaccination. Faith-based messaging interventions that seek to increase HPV vaccination should be framed to address religious anti-vaccination beliefs.
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Affiliation(s)
- Ayokunle Olagoke
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | | | - Brenikki Floyd
- Division of Community Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Rachel Caskey
- Division of Community Health Sciences, University of Illinois Chicago, Chicago, IL, USA
- Sections of General Internal Medicine and Pediatrics, University of Illinois, Chicago, IL, USA
- University of Illinois, Chicago Cancer Center, Chicago, IL, USA
| | - Andrew Boyd
- Department of Biomedical and Health Information Science, University of Illinois, Chicago, IL, USA
| | - Yamilé Molina
- Division of Community Health Sciences, University of Illinois Chicago, Chicago, IL, USA
- University of Illinois, Chicago Cancer Center, Chicago, IL, USA
- Center for Research on Women and Gender, College of Medicine, University of Illinois, Chicago, IL, USA
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22
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Grosso FM, Baldassarre ME, Grosso R, Di Mauro F, Greco C, Greco S, Laforgia N, Di Mauro A. Do social media interventions increase vaccine uptake? Front Public Health 2023; 11:1077953. [PMID: 37457259 PMCID: PMC10340521 DOI: 10.3389/fpubh.2023.1077953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 05/31/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction The Italian mass COVID-19 vaccination campaign has included children aged 5-11 years as part of the target population since December 2021. One of the biggest challenges to vaccine uptake was vaccine hesitancy among parents and children's caregivers. Primary care pediatricians (PCPs), as the first point of contact between the National Health Service (NHS) and parents/caretakers, initiated various communication strategies to tackle this hesitancy. This study aims to evaluate the impact of a PCP-led social media intervention and a digital reminder service (DRS) on parental hesitancy regarding vaccinating their 5-11-year-old children against COVID-19. Methods A prospective cohort study was designed, and the chosen target populations were parents and caretakers of children aged 5-11 years. Two PCP cohorts were recruited. The first group received a social media intervention and a DRS; while the second group did not. Both cohorts had access to traditional face-to-face and telephone-based counseling. The vaccination coverage rate in the two groups was evaluated. Results A total of 600 children were enrolled. The exposed cohort (277 patients) received social media intervention, DRS, and counseling options (face-to-face and telephone-based), whereas the non-exposed cohort (323 patients) received only counseling options. In total, 89 patients from the exposed cohort did not receive any dose of the COVID-19 vaccine (32.5%), 165 were fully immunized (59.5%), and 23 received only one dose (8.5%). A total of 150 non-exposed patients did not receive any dose of the COVID-19 vaccine (47%), 147 were fully immunized (45.5%), and 24 only received one dose (7.4%). The difference between the two groups was statistically significant (chi square = 11.5016; p = 0.0006). Conclusion Social media and DRS interventions had a positive impact on vaccine uptake and may be helpful in tackling vaccine hesitancy. Better-designed studies are needed to corroborate these findings.
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Affiliation(s)
- Francesca Maria Grosso
- Department of Biomedical Sciences for Health, Postgraduate School of Public Health, University of Milan, Milan, Italy
| | - Maria Elisabetta Baldassarre
- Department of Biomedical Science and Human Oncology, Neonatal Intensive Care Unit, Aldo Moro University of Bari, Bari, Italy
| | - Roberto Grosso
- Pediatric Primary Care, National Pediatric Health Care System, Bari, Italy
| | - Federica Di Mauro
- Department of Prevention, Local Health Authority of Bari, Bari, Italy
| | - Chiara Greco
- Department of Biomedical Science and Human Oncology, Hygiene and Preventive Medicine (Public Health), Aldo Moro University of Bari, Bari, Italy
| | - Silvia Greco
- Department of Pediatrics, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Nicola Laforgia
- Department of Biomedical Science and Human Oncology, Neonatal Intensive Care Unit, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Mauro
- Pediatric Primary Care, National Pediatric Health Care System, Margherita di Savoia, Barletta-Andria-Trani, Italy
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Escoffery C, Petagna C, Agnone C, Perez S, Saber LB, Ryan G, Dhir M, Sekar S, Yeager KA, Biddell CB, Madhivanan P, Lee S, English AS, Savas L, Daly E, Vu T, Fernandez ME. A systematic review of interventions to promote HPV vaccination globally. BMC Public Health 2023; 23:1262. [PMID: 37386430 PMCID: PMC10308645 DOI: 10.1186/s12889-023-15876-5] [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: 09/22/2022] [Accepted: 05/11/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Despite the human papillomavirus (HPV) vaccine being a safe, effective cancer prevention method, its uptake is suboptimal in the United States (U.S.). Previous research has found a variety of intervention strategies (environmental and behavioral) to increase its uptake. The purpose of the study is to systematically review the literature on interventions that promote HPV vaccination from 2015 to 2020. METHODS We updated a systematic review of interventions to promote HPV vaccine uptake globally. We ran keyword searches in six bibliographic databases. Target audience, design, level of intervention, components and outcomes were abstracted from the full-text articles in Excel databases. RESULTS Of the 79 articles, most were conducted in the U.S. (72.2%) and in clinical (40.5%) or school settings (32.9%), and were directed at a single level (76.3%) of the socio-ecological model. Related to the intervention type, most were informational (n = 25, 31.6%) or patient-targeted decision support (n = 23, 29.1%). About 24% were multi-level interventions, with 16 (88.9%) combining two levels. Twenty-seven (33.8%) reported using theory in intervention development. Of those reporting HPV vaccine outcomes, post-intervention vaccine initiation ranged from 5% to 99.2%, while series completion ranged from 6.8% to 93.0%. Facilitators to implementation were the use of patient navigators and user-friendly resources, while barriers included costs, time to implement and difficulties of integrating interventions into the organizational workflow. CONCLUSIONS There is a strong need to expand the implementation of HPV-vaccine promotion interventions beyond education alone and at a single level of intervention. Development and evaluation of effective strategies and multi-level interventions may increase the uptake of the HPV vaccine among adolescents and young adults.
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Affiliation(s)
- Cam Escoffery
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, 404-727-4701, USA.
| | - Courtney Petagna
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, 404-727-4701, USA
| | - Christine Agnone
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, 404-727-4701, USA
| | - Stephen Perez
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, 404-727-4701, USA
| | - Lindsay B Saber
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, 404-727-4701, USA
| | - Grace Ryan
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Meena Dhir
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, 404-727-4701, USA
| | - Swathi Sekar
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, 404-727-4701, USA
| | - Katherine A Yeager
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Caitlin B Biddell
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, Durham, NC, USA
| | - Purnima Madhivanan
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Stephanie Lee
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Amanda S English
- Institute for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Lara Savas
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Eliza Daly
- Prevention Research Center, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Thuy Vu
- Health Promotion Research Center, School of Public Health, University of Washington, Seattle, WA, 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
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Le D, Kim HJ, Wen KY, Juon HS. Disparities in awareness of the HPV vaccine and HPV-associated cancers among racial/ethnic minority populations: 2018 HINTS. ETHNICITY & HEALTH 2023; 28:586-600. [PMID: 36045478 PMCID: PMC10512437 DOI: 10.1080/13557858.2022.2116630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 08/18/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Human papillomavirus (HPV) is a common virus that currently infects nearly 80 million people in the United States (U.S.) and can lead to cancer. HPV vaccination provides safe, effective, and lasting protection against HPV infections. Nevertheless, vaccination rates remain suboptimal. The purpose of this study was to examine the relationship between sociodemographic characteristics, HPV and HPV vaccine awareness, and knowledge of HPV-associated cancers among U.S. adults. DESIGN Using responses from 3504 U.S. adults (aged 18 years and older) from the Health Information National Trends Survey 5 Cycle 2 (January-May 2018), we performed descriptive analysis to assess the level of awareness of HPV and HPV vaccines and knowledge of HPV-associated cancer. Multivariable regression analysis (including race, gender, age, level of education, marital status, number of children younger than 18) was conducted with weighted analysis. RESULTS About 62% of respondents had heard of HPV and HPV vaccine. Asians had a lower level of awareness than non-Hispanic Whites of HPV (36.4% vs. 66.1%) and HPV vaccine (48.7% vs. 67.1%). Multivariable analysis showed that race/ethnicity was associated with outcomes, with Asians being less likely to have heard about HPV (aOR = 0.17, 95% CI: 0.07-0.38) and non-Hispanic Blacks (aOR = 0.57, 95% CI: 0.35-0.91) and Hispanics (aOR = 0.54, 95% CI: 0.36-0.80) being less likely to have heard of the HPV vaccine than non-Hispanic Whites. In addition, gender, age, marital status, and education were associated with awareness of HPV and the HPV vaccine; in particular, individuals who were female, younger (18-45), married, and more highly educated were more likely to have heard of HPV and HPV vaccine. CONCLUSION Results highlight disparities in HPV and HPV vaccine awareness among racial/ethnic minority populations. Future interventions and legislation should target racial/ethnic minority populations to foster improvements in HPV vaccine uptake and reduce disparities in HPV-associated cancers.
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Affiliation(s)
- Daisy Le
- School of Nursing, The George Washington University, 1919 Pennsylvania Avenue, NW, Suite 500, Washington, DC 20006, USA
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, 3rd Floor, Washington, DC 20052, USA
| | - Hee Jun Kim
- Research Institute of Nursing Science, College of Nursing, Ajou University, 206 World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea
| | - Kuang-Yi Wen
- Department of Medical Oncology, Thomas Jefferson University
| | - Hee-Soon Juon
- Department of Medical Oncology, Thomas Jefferson University
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Oketch SY, Ochomo EO, Orwa JA, Mayieka LM, Abdullahi LH. Communication strategies to improve human papillomavirus (HPV) immunisation uptake among adolescents in sub-Saharan Africa: a systematic review and meta-analysis. BMJ Open 2023; 13:e067164. [PMID: 37012006 PMCID: PMC10083777 DOI: 10.1136/bmjopen-2022-067164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVES Developing countries face the greatest cervical cancer disease burden and mortality with suboptimal immunisation uptake. This review explores the communication strategies adopted, successes, challenges and lessons learnt in sub-Saharan countries to enhance human papillomavirus (HPV) immunisation. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Hinari, Cochrane Library, Trip database, CINAHL, Web of Science, Scopus and seven grey resources were searched through May 2022. ELIGIBILITY CRITERIA We included observational studies addressing communication strategies for HPV immunisation uptake. DATA EXTRACTION AND SYNTHESIS Two independent reviewers used standardised methods to search, screen and code included studies. Data extraction and assessment of risk of bias were done in duplicate to enhance validity of the results. Meta-analysis was conducted using the random-effects model. Findings were summarised and synthesised qualitatively. RESULTS Communication intervention to facilitate decision-making achieved uptake rate of 100% (95% CI 0.99% to 1.00%), followed by intervention to enable communication, which achieved 92% (95% CI 0.92% to 0.92%). Communication intervention to inform and educate achieved 90% (95% CI 0.90% to 0.90%).Targeting both healthcare workers and community leaders with the communication intervention achieved 95% (95% CI 0.91% to 0.98%), while teachers and school boards achieved 92% (95% CI 0.84% to 1.01%). Targeting policymakers achieved 86% (95% CI 0.78% to 0.93%).Based on the method of communication intervention delivery, use of training achieved an uptake rate of 85% (95% CI 0.84% to 0.87%); similarly, drama and dance achieved 85% (95% CI 0.84% to 0.86%). However, use of information, education and communication materials achieved 82% (95% CI 0.78% to 0.87%). CONCLUSION HPV vaccine communication is critical in ensuring that the community understands the importance of vaccination. The most effective communication strategies included those which educate the population about the HPV vaccine, facilitate decision-making on vaccine uptake and community ownership of the vaccination process immunisation. PROSPERO REGISTRATION NUMBER CRD42021243683.
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Affiliation(s)
- Sandra Y Oketch
- Research Department, African Institute for Development Policy, Nairobi, Kenya
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Edwin O Ochomo
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Jeniffer A Orwa
- Department of Resource Development and Knowledge Management, Kenya Medical Research Institute, Nairobi, Kenya
| | - Lilian M Mayieka
- Department of Resource Development and Knowledge Management, Kenya Medical Research Institute, Nairobi, Kenya
| | - Leila H Abdullahi
- Research Department, African Institute for Development Policy, Nairobi, Kenya
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26
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Huff KA, Braun A, Salvaggio MR, McGough P, Frank-Pearce SG, Kendzor DE, Bui TC. Promoting HPV Vaccination in People with HIV: Factors to Consider. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5345. [PMID: 37047959 PMCID: PMC10094493 DOI: 10.3390/ijerph20075345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
People with HIV (PWH) and their sexual partners have increased risk of human papillomavirus (HPV) infection. Despite recommended HPV vaccination for PWH aged 18-26 years, vaccination rates among PWH remain low. This qualitative study used the Information-Motivation-Behavioral Skills (IMBS) model to identify factors influencing the decisions of PWH around promoting HPV vaccination to their sexual partners. Fourteen PWH with diverse sociodemographic characteristics participated in four focus-group discussions. Data were analyzed using thematic content analysis; codes and themes included IMBS constructs. For the information construct, the need for improved HPV education emerged as the driving factor for HPV vaccine uptake and discussing HPV vaccines with partners. Focal reasons for being unvaccinated included low knowledge of HPV risk, asymptomatic cancer-causing HPV, HPV vaccines, and vaccine eligibility. Salient factors in the motivation construct included the preventive benefits of HPV vaccination to both self and sexual partners. Salient factors in the behavioral skills construct included: accessing vaccine, low self-confidence and skills for promoting vaccination, relationships with sexual partners, partners' vaccine hesitancy, and stigma. Race/ethnicity impacted HPV vaccination promotion; important determinants included perceptions of HPV-related diseases as "White people's diseases" among Black people, and discrimination against those with HPV-related diseases among the Hispanic population.
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Affiliation(s)
- Kinsey A. Huff
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.A.H.); (D.E.K.)
| | - Ashlea Braun
- Department of Nutritional Sciences, College of Education and Human Sciences, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Michelle R. Salvaggio
- Infectious Diseases Section, Department of Internal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Patrick McGough
- Oklahoma City-County Health Department, Oklahoma City, OK 73111, USA;
| | - Summer G. Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104, USA;
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Darla E. Kendzor
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.A.H.); (D.E.K.)
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104, USA;
| | - Thanh Cong Bui
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (K.A.H.); (D.E.K.)
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104, USA;
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27
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Askelson N, Ryan G, McKernan S, Scherer A, Daly E, Avdic L. Engaging new partners in human papillomavirus (HPV) vaccine promotion: Considerations for training private practice dental professionals in HPV vaccine promotion. J Public Health Dent 2023. [PMID: 36891831 DOI: 10.1111/jphd.12566] [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: 06/17/2022] [Revised: 09/28/2022] [Accepted: 01/17/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES With rates of the human papillomavirus (HPV) vaccination remaining low and rates of oropharyngeal cancer rising, engaging new partners to promote vaccination is necessary. We aimed to identify dental hygienists' and dentists' knowledge about HPV, the HPV vaccine, and preferences for continuing education. METHODS This mixed-methods study recruited dental hygienists and dentists working in private practice in Iowa to participate in a mailed cross-sectional survey (dental hygienists) and qualitative telephone interviews (dental hygienists and dentists). Survey and interview topics included existing knowledge about HPV vaccination, HPV vaccination promotion efforts, barriers to HPV vaccine promotion, and preferences for continuing education (CE). RESULTS We received 470 surveys from dental hygienists (response rate = 22.6%) and interviewed 19 dental hygienists and 20 dentists. Vaccine efficacy and safety, along with communication strategies, were key topics of interest for CE. Dental hygienists' most commonly identified barriers were lack of knowledge (67%) and low comfort levels (42%). CONCLUSIONS Knowledge was identified as a key barrier to providing a strong recommendation for HPV vaccination and convenience was the most important factor to consider for any future CE. Our team is in the process of designing a CE course based on this information to help dental professionals effectively engage in HPV vaccine promotion in their practices.
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Affiliation(s)
- Natoshia Askelson
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Grace Ryan
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Susan McKernan
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Aaron Scherer
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Eliza Daly
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Lejla Avdic
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
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28
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Niccolai LM, Johnson NP, Torres A, Sullivan EL, Hansen CE. Messaging of Different Disease Outcomes for Human Papillomavirus Vaccination: A Systematic Review. J Adolesc Health 2023; 72:334-343. [PMID: 36529616 DOI: 10.1016/j.jadohealth.2022.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 08/12/2022] [Accepted: 10/13/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The purpose of this systematic review was to assess how messaging for human papillomavirus (HPV) vaccination to prevent different health outcomes (sexually transmitted infection, anogenital warts ([AGW], and/or cancer) influences intentions or initiation for the vaccine series. METHODS We searched PubMed, MEDLINE, and Embase databases for all previously published articles with an evaluation, discussion, or comparison of messages containing content about HPV infections, AGW, precancers, or cancer through June 3, 2021. Results about messages were summarized by study population and design. RESULTS We identified 25 studies evaluating or comparing messages containing content about HPV-associated outcomes. Study designs included randomized trials (n = 12), cross-sectional surveys (n = 8), and qualitative approaches (n = 5). Few studies directly compared different messages using randomized designs or included vaccination uptake as the outcome. While many studies found support for cancer prevention messages, some studies also found equal or greater support for messages focusing on prevention of sexually transmitted infection/AGW. Variability was observed within and between studied populations (parents/adults, adolescents, young adults, healthcare providers, and adult males) and gender (male and female adolescents). DISCUSSION A greater understanding and deeper attention to myriad health outcomes of HPV infections could increase vaccination uptake in a variety of populations for health promotion across the lifespan.
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Affiliation(s)
- Linda M Niccolai
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.
| | - Nicholaus P Johnson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Ashlynn Torres
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Erin L Sullivan
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Caitlin E Hansen
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
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Harper K, Short MB, Bistricky S, Kusters IS. 1-2-3! Catch-Up for HPV: A Theoretically Informed Pilot Intervention to Increase HPV Vaccine Uptake among Young Adults. AMERICAN JOURNAL OF HEALTH EDUCATION 2023. [DOI: 10.1080/19325037.2022.2163005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
| | | | - Steven Bistricky
- University of Houston-Clear Lake
- University of Colorado at Colorado Springs, Colorado Springs
- Lyda Hill Institute for Human Resilience, Colorado Springs
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30
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Dang JHT, McClure S, Gori ACT, Martens T, Mojadedi A, Smith U, Austin CJ, Chen MS. Implementation and evaluation of a multilevel intervention to increase uptake of the human papillomavirus vaccine among rural adolescents. J Rural Health 2023; 39:136-141. [PMID: 35798683 PMCID: PMC9771865 DOI: 10.1111/jrh.12690] [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] [Indexed: 02/01/2023]
Abstract
PURPOSE Geographic disparities exist in uptake of the human papillomavirus vaccine (HPV). In 2020, the National Immunization Survey-Teen reported that adolescents living in nonmetropolitan statistical areas (MSAs) had lower HPV vaccination coverage (≥ 1 dose) compared to adolescents living in MSA principal cities. This paper describes the implementation and evaluation of a multilevel pilot intervention study to increase uptake of the HPV vaccine among adolescent patients ages 11-17 of a rural health clinic. METHODS This parent, primary care team, and clinic multilevel pilot intervention was guided by evidence-based approaches to increase HPV vaccinations, formative research, and input from the community. HPV vaccination initiation and completion rates were analyzed at baseline and 23 months follow-up. FINDINGS The proportion of adolescent patients ages 11-17 who had initiated the HPV vaccine series was significantly greater at follow-up compared to baseline, (82.7% compared to 52.4%), χ2 (1, n = 498) = 49.2, P < .0001. The proportion of adolescent patients ages 11-17 who had completed the HPV vaccine series was also significantly greater at follow-up compared to baseline, (58.0% compared to 27.0%), χ2 (1, n = 498) = 50.8, P < .0001. CONCLUSIONS The multilevel intervention significantly increased HPV initiation and completion rates among adolescent patients ages 11-17 at this rural health clinic. This study demonstrates the feasibility of utilizing a multilevel intervention to address low HPV vaccination rates among rural adolescents and the potential of employing this strategy for a large-scale randomizing-controlled trial.
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Affiliation(s)
- Julie H. T. Dang
- Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, School of Medicine, Sacramento, California, USA
- University of California, Davis Comprehensive Cancer Center, Sacramento, California, USA
| | | | - Alexandra C. T. Gori
- University of California, Davis Comprehensive Cancer Center, Sacramento, California, USA
| | | | | | - Ulissa Smith
- Neighborhood Wellness Foundation, Sacramento, California, USA
| | | | - Moon S. Chen
- University of California, Davis Comprehensive Cancer Center, Sacramento, California, USA
- Division of Hematology and Oncology, Department of Internal Medicine, University of California, Davis, School of Medicine, Sacramento, California, USA
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Potential factors influencing COVID-19 vaccine acceptance and hesitancy among university students in Banglad esh: a cross-sectional comparative study. Epidemiol Infect 2022; 151:e11. [PMID: 36537315 PMCID: PMC9874038 DOI: 10.1017/s0950268822001820] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study investigated Coronavirus disease 2019 (COVID-19) vaccine acceptance, and compared the potential factors influencing vaccine acceptance and hesitancy between public university (PuU) and private university (PrU) students in Bangladesh. An anonymous, self-administered questionnaire was sent to 640 PuU and 660 PrU students in Google Form between 25th September and 22nd November 2021, which resulted in the participation of 1034 (461 PuU vs. 573 PrU) respondents (response rate: 72.03% vs. 86.81%). The pooled vaccine acceptance rates among PuU and PrU students were almost similar (88.1%, 95% confidence interval (CI) 85.1-91.1 vs. 87.6%, 95% CI 84.6-90.6). Employing binary logistic regression to assess the association between various potential factors and vaccine acceptance, the study revealed that out of 10 predictors, 'safety' and 'efficacy' had highly significant positive associations with vaccine acceptance in both cohorts (P = 0.000, P = 0.005). 'Political roles' was found to have varied effects- a significant (P = 0.02) negative and a significant positive (P = 0.002) association with vaccine acceptance in PuU and PrU students, respectively. Additionally, 'communication' (P = 0.003) and 'trust' (P = 0.01) were found to have significant positive associations in PrU students while 'rumours' (P = 0.03) had negative association in PuU students. The odds of accepting the COVID-19 vaccine were 1.5 vs. 0.9 in PuU and PrU students. Although chi-square analysis did not show any significant association between gender and vaccine acceptance, discrepancies were found in the factors that potentially affect vaccine uptake decision between PuU and PrU students. COVID-19 vaccine uptake may be improved if vaccine-related information becomes available and is communicated to large numbers of people effectively. The implementation of multidisciplinary interventional educational programmes may also be considered as a preferred approach to improve student's engagement in pandemic awareness and vaccine readiness.
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Alcendor DJ, Matthews-Juarez P, Smoot D, Hildreth JEK, Tabatabai M, Wilus D, Brown KY, Juarez PD. The COVID-19 Vaccine and Pregnant Minority Women in the US: Implications for Improving Vaccine Confidence and Uptake. Vaccines (Basel) 2022; 10:2122. [PMID: 36560532 PMCID: PMC9784552 DOI: 10.3390/vaccines10122122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/25/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
The American College of Obstetricians and Gynecologists (AGOG) recommends the FDA-approved Pfizer and Moderna mRNA COVID-19 vaccines and boosters for all eligible pregnant women in the US. However, COVID-19 vaccine confidence and uptake among pregnant minority women have been poor. While the underlying reasons are unclear, they are likely to be associated with myths and misinformation about the vaccines. Direct and indirect factors that deter minority mothers in the US from receiving the mRNA COVID-19 vaccines require further investigation. Here, we examine the historical perspectives on vaccinations during pregnancy. We will examine the following aspects: (1) the influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccinations during pregnancy; (2) the exclusion of pregnant and lactating women from COVID-19 vaccine trials; (3) COVID-19 vaccine safety during pregnancy, obstetric complications associated with symptomatic COVID-19 during pregnancy, COVID-19 vaccine hesitancy among pregnant minority women, and racial disparities experienced by pregnant minority women due to the COVID-19 pandemic as well as their potential impact on pregnancy care; and (4) strategies to improve COVID-19 vaccine confidence and uptake among pregnant minority women in the US. COVID-19 vaccine hesitancy among minority mothers can be mitigated by community engagement efforts that focus on COVID-19 vaccine education, awareness campaigns by trusted entities, and COVID-19-appropriate perinatal counseling aimed to improve COVID-19 vaccine confidence and uptake.
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Affiliation(s)
- Donald J. Alcendor
- Department of Microbiology, Immunology and Physiology, Center for AIDS Health Disparities Research, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Patricia Matthews-Juarez
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Duane Smoot
- Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - James E. K. Hildreth
- Department of Microbiology, Immunology and Physiology, Center for AIDS Health Disparities Research, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
- Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Mohammad Tabatabai
- School of Graduate Studies and Research, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Derek Wilus
- School of Graduate Studies and Research, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Katherine Y. Brown
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Paul D. Juarez
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
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Marfo EA, King KD, Adjei CA, MacDonald SE. Features of human papillomavirus vaccination education strategies in low- and middle-income countries: a scoping review. Public Health 2022; 213:61-67. [PMID: 36371953 DOI: 10.1016/j.puhe.2022.09.013] [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] [Received: 02/02/2022] [Revised: 09/05/2022] [Accepted: 09/17/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We aimed to describe studies on human papillomavirus (HPV) vaccination education strategies from low- and middle-income countries in the published literature that could be applicable in Sub-Sahara Africa. STUDY DESIGN This scoping review was guided by Arksey and O'Malley's methodological framework advanced by Levac et al. METHODS We searched four electronic health sciences databases for relevant reports published between January 2006 and January 2021. Two reviewers screened for inclusion and extracted data for analysis and synthesis. Descriptive statistics and narrative descriptions were used to summarize the findings. RESULTS The database search retrieved 1757 reports, of which 48 were from low- and middle-income countries and met the inclusion criteria. Of these, there were 39 interventional studies (81.3%). Less than one-fifth of the studies (n = 9) reported a theoretical basis for their strategies. Most strategies sought to improve knowledge and awareness about HPV (75%, n = 36), whereas outcomes for the remaining studies were related to increasing HPV vaccine acceptability. HPV education strategies (1) primarily targeted females, (2) were mostly provided by health professionals, and (3) used various modalities of learning, including in-person sessions, text-based materials, media, theater, and online delivery. CONCLUSIONS HPV educational strategies are underresearched in most LMICs, suggesting the need for more primary observational, interventional, and experimental research, as well as program evaluations, focused on HPV educational strategies and theoretically informed. Once additional studies are added to the body of evidence, it will be valuable to review and synthesize diverse sources of evidence to determine what educational strategies are most useful and have the greatest impact on HPV vaccination in these settings, particularly Sub-Saharan Africa.
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Affiliation(s)
- E A Marfo
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - K D King
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - C A Adjei
- School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana
| | - S E MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Bennett C, Edwards D, Sherman SM, Baker P, Waheed DEN, Vorsters A, Sarıca Çevik H, Karafillakis E, Prue G, Kelly D. Which interventions improve HPV vaccination uptake and intention in children, adolescents and young adults? An umbrella review. Sex Transm Infect 2022; 98:599-607. [PMID: 36396162 DOI: 10.1136/sextrans-2022-055504] [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: 04/07/2022] [Accepted: 08/16/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination offers protection against the virus responsible for cervical, oropharyngeal, anal, vulval and penile cancers. However, there is considerable variation across, and even within, countries as to how HPV vaccination is offered and accepted. This review aimed to identify what interventions exist to promote uptake and how effective they are. METHODS We conducted an umbrella review using the JBI (Joanna Briggs Institute) methodology to evaluate routine or catch-up interventions to increase HPV vaccination uptake and/or intention for children aged 9 years and older, adolescents and young adults up to 26. Comprehensive searches for English language quantitative systematic reviews, published between January 2011 and July 2021, were conducted across five databases. After reviewing titles and abstract, relevant papers were independently assessed in detail. MAIN RESULTS From 1046 records identified, 10 articles were included in the review. They reported on 95 randomised controlled trials, 28 quasi-experimental studies, 14 cohort studies, 6 non-randomised pretest/post-test studies with control groups, 5 single-group pretest/post-test studies, 1 single-group post-test study and 1 randomised longitudinal study. Some interventions promoted change at the individual, community or organisational level, while others used a multicomponent approach. Face-to-face presentations, printed information and supplementing both strategies with additional components appear effective at increasing vaccination intention, while reminders and multicomponent strategies, especially ones that include some intervention aimed at provider level, appear effective at increasing vaccination uptake. Interventions that did not lead to an improvement in HPV vaccination intention or uptake varied in design and impacts were inconsistent across children/adolescents, young adults or parents. CONCLUSION The evidence suggests that there is no single solution to increasing vaccination uptake and that different approaches may be better suited to certain populations. However, generalisations are limited by poor reporting and a paucity of studies beyond the USA. Further high-quality studies, therefore, are needed to understand how best to increase HPV vaccination uptake in different target populations.
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Affiliation(s)
- Clare Bennett
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Deborah Edwards
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Sue M Sherman
- School of Psychology, Keele University, Staffordshire, UK
| | - Peter Baker
- European Cancer Organisation, Brussels, Belgium
| | | | - Alex Vorsters
- Vaccine & infectious disease institute, University of Antwerp, Antwerp, Belgium
| | | | - Emilie Karafillakis
- The Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, London, UK
| | - Gillian Prue
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | - Daniel Kelly
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Sun L, Hu J, Gao H, Wang S, Wang B, Wang J, Li H, Wang J, Yuan C, Zhang X. Long-term effect of mobile phone-based education and influencing factors of willingness to receive HPV vaccination among female freshmen in Shanxi Province, China. Hum Vaccin Immunother 2022; 18:2051990. [PMID: 35446735 PMCID: PMC9225224 DOI: 10.1080/21645515.2022.2051990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This study was conducted to characterize the long-term effect of mobile-based education on Chinese female freshmen and disclose the possible predictors of their willingness to get vaccinated based on the information-motivation-behavioral skills (IMB) model. METHODS We randomly assigned 509 participants to a 7-day mobile-based educational intervention or control group and collected information about general information, health, and sexual behavior, HPV vaccination intention and action, HPV-related knowledge, cognition, and behavioral skill by an online self-administrated questionnaire at baseline, post-intervention, and at the 1-month and 3-month follow-ups. RESULTS The intervention arm showed an improvement in IMB scores after education. Despite the persistent improvement in knowledge, the improvement in their motivation and behavioral skills decreased at the 1-month and 3-month follow-ups. Participants' vaccination willingness was elevated after the baseline survey in both the intervention and control groups, while the overall appointment/vaccination rate was only 3.73% 3 months later. The intention to get vaccinated was associated with knowing HPV (adjusted OR: 2.37, 95% CI: 1.44 - 3.89), perceiving more barriers (adjusted OR: 2.16, 95% CI: 1.44 - 3.25), higher subjective norms (adjusted OR: 2.05, 95% CI: 1.26 - 3.32), and having more behavioral skills (adjusted OR: 2.95, 95% CI: 1.79 - 4.87). CONCLUSION Seven-day mobile-based education was effective to increase IMB model scores among female freshmen. However, the improvement in motivation and behavioral skills was not persistent. Information, perceived barriers, subjective norms, and behavioral skills were discovered to be influencing factors of vaccination intention. Future research with longer, more convenient, and more tailored education to the main influencing factors is warranted.
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Affiliation(s)
- Liying Sun
- Department of Pediatrics and Adolescent Gynecology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jingjing Hu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Huihui Gao
- Department of Pediatrics and Adolescent Gynecology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Sunyi Wang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Binghan Wang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiawen Wang
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hui Li
- Division of Health Promotion, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Changzheng Yuan
- Department of Pediatrics and Adolescent Gynecology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
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36
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Li PC, Theis SR, Kelly D, Ocampo T, Berglund A, Morgan D, Markert R, Fisher E, Burtson K. Impact of an Education Intervention on COVID-19 Vaccine Hesitancy in a Military Base Population. Mil Med 2022; 187:e1449-e1455. [PMID: 34557913 PMCID: PMC8500140 DOI: 10.1093/milmed/usab363] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/09/2021] [Accepted: 08/19/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) vaccine hesitancy is a major impediment to achieving herd immunity and overcoming the current pandemic. Our aim was to decrease the prevalence of vaccine hesitancy through an education intervention. METHOD An education intervention, consisting of a PowerPoint presentation addressing the two mRNA COVID-19 vaccine concerns/myths and a question and answer panel comprising health care providers from various specialties, was implemented to address vaccine hesitancy among personnel associated with Wright-Patterson Air Force Base through a series of virtual and in-person seminars. Participants completed a post-seminar survey as a retrospective self-assessment to identify attitudes and views surrounding vaccine hesitancy and the impact of the education intervention. Chi-squared test was used to examine relationships between categorical variables, and multiple logistic regression was used to identify risk factors for vaccine hesitancy pre- and post-seminar. All analyses were done using SPSS Statistics Version 25.0 (IBM, Armonk, NY). Institutional Review Board approval was not obtained before this study as it began as a non-research initiative and received non-research determination post hoc. RESULTS Five hundred participants completed the survey. Mean age was 44.7 years with 13.4 and 86.6% medical and non-medical personnel, respectively. Nearly all (98.8%) had not received their first shot of the vaccine series. 402 (80.9%) were receptive to vaccination, and 95 (19.1%) were hesitant post-seminar. Of the 139 participants who reported they were initially hesitant after our intervention, 50 (36%) indicated that they were now receptive to the vaccine, while 89 (64%) remained hesitant. Of those 50, 48 (96%) had moderate to great amount of trust in COVID-19 vaccine information presented by physicians/other providers. Six respondents who wanted the vaccine before the intervention no longer wanted the vaccine. A medical occupation (OR = 4.85, 95% CI = 2.63-8.96, P < .001), little or no trust in COVID-19 vaccine information from physicians/other providers (OR = 19.48, 95% CI = 7.31-51.90, P < 0.001), and being age 30 or younger (OR = 1.81, 95% CI = 1.02-3.2, P = 0.041) were independent predictors of vaccine hesitancy. Trust in providers was a significant factor in change of intent from vaccine hesitant to receptive post-intervention (OR 0.13, 95% CI = 0.03-0.59, P = .008). Age and occupation were not significant factors associated with change in intent. CONCLUSION Our education intervention was effective in reducing COVID-19 vaccine hesitancy in a military base population. Study limitations include applications toward other military and non-military populations, the possibility of nonresponse bias, and absence of prior validated interventions. Area for future studies includes improvement upon educational intervention, development of other effective methods, and application of intervention in other populations.
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Affiliation(s)
- Peter C Li
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Samuel R Theis
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Devin Kelly
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Thad Ocampo
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Andrew Berglund
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Damien Morgan
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Ronald Markert
- Department of Medicine, Wright State University, Dayton, OH 45409, USA
| | - Evan Fisher
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
| | - Kathryn Burtson
- USAF Internal Medicine, Wright-Patterson Medical Center, WPAFB, OH 45433, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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McCulloh RJ, Darden PM, Snowden J, Ounpraseuth S, Lee J, Clarke M, Newcomer SR, Fu L, Hubberd D, Baldner J, Garza M, Kerns E. Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUp): study protocol for a randomized, controlled trial. Trials 2022; 23:911. [PMID: 36307830 PMCID: PMC9616622 DOI: 10.1186/s13063-022-06819-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19. METHODS Custodial parents/caregivers with ≥ 1 child eligible for COVID-19 vaccination who have not yet received the vaccine will be randomized to download one of two mHealth apps. The intervention app will address logistical and motivational barriers to pediatric COVID-19 vaccination. Participants will receive eight weekly push notifications followed by two monthly push notifications (cues to action) regarding vaccinating their child. Through branching logic, users will access customized content based on their locality, degree of rurality-urbanicity, primary language (English/Spanish), race/ethnicity, and child's age to address COVID-19 vaccine knowledge and confidence gaps. The control app will provide push notifications and information on general pediatric health and infection prevention and mitigation strategies based on recommendations from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). The primary outcome is the proportion of children who complete COVID-19 vaccination series. Secondary outcomes include the proportion of children who receive ≥ 1 dose of COVID-19 vaccine and changes in parent/caregiver scores from baseline to immediately post-intervention on the modified WHO SAGE Vaccine Hesitancy Scale adapted for the COVID-19 vaccine. DISCUSSION The COVID-19 pandemic inflicts disproportionate harm on individuals from underserved communities, including those in rural settings. Maximizing vaccine uptake in these communities will decrease infection rates, severe illness, and death. Given that most US families from these communities use smart phones, mHealth interventions hold the promise of broad uptake. Bundling multiple mHealth vaccine uptake interventions into a single app may maximize the impact of deploying such a tool to increase COVID-19 vaccination. The new knowledge to be gained from this study will directly inform future efforts to increase COVID-19 vaccination rates across diverse settings and provide an evidentiary base for app-based vaccine communication tools that can be adapted to future vaccine-deployment efforts. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov NCT05386355 . Registered on May 23, 2022.
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Affiliation(s)
- Russell J McCulloh
- Children's Hospital & Medical Center, 8200 Dodge St., Omaha, NE, 68114, USA.
| | - Paul M Darden
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Jessica Snowden
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Songthip Ounpraseuth
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Jeannette Lee
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Martina Clarke
- College of Information Science & Technology, University of Nebraska Omaha, 172 Peter Kiewit Institute, 1110 South 67th Street, Omaha, NE, 68182, USA
| | - Sophia R Newcomer
- School of Public Health and Community Health Sciences, University of Montana, Skaggs Building Room 177, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Linda Fu
- Office of the Director, National Institutes of Health, 11601 Landsdown Sreet, Rockville, MD, 20852, USA
| | - DeAnn Hubberd
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Jaime Baldner
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Maryam Garza
- University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Ellen Kerns
- University of Nebraska Medical Center, 42nd and Emile St., Omaha, NE, 68131, USA
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38
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McCulloh RJ, Darden P, Snowden J, Ounpraseuth S, Lee J, Clarke M, Newcomer SR, Fu L, Hubberd D, Baldner J, Garza M, Kerns E. Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUP): a randomized, controlled trial. RESEARCH SQUARE 2022:rs.3.rs-2070396. [PMID: 36238712 PMCID: PMC9558439 DOI: 10.21203/rs.3.rs-2070396/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19. Methods: Custodial parents/caregivers with ≥1 child eligible for COVID-19 vaccination who have not yet received the vaccine will be randomized to download one of two mHealth apps. The intervention app will address logistical and motivational barriers to pediatric COVID-19 vaccination. Participants will receive eight weekly push notifications followed by two monthly push notifications (cues to action) regarding vaccinating their child. Through branching logic, users will access customized content based on their locality, degree of rurality-urbanicity, primary language (English/Spanish), race/ethnicity, and child's age to address COVID-19 vaccine knowledge and confidence gaps. The control app will provide push notifications and information on general pediatric health and infection prevention and mitigation strategies based on recommendations from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). The primary outcome is the proportion of children who complete COVID-19 vaccination series. Secondary outcomes include the proportion of children who receive ≥1 dose of COVID-19 vaccine and changes in parent/caregiver scores from baseline to immediately post-intervention on the modified WHO SAGE Vaccine Hesitancy Scale adapted for the COVID-19 vaccine. Discussion: The COVID-19 pandemic inflicts disproportionate harm on individuals from underserved communities, including those in rural settings. Maximizing vaccine uptake in these communities will decrease infection rates, severe illness, and death. Given that most US families from these communities use smart phones, mHealth interventions hold the promise of broad uptake. Bundling multiple mHealth vaccine-uptake interventions into a single app may maximize the impact of deploying such a tool to increase COVID-19 vaccination. The new knowledge to be gained from this study will directly inform future efforts to increase COVID-19 vaccination rates across diverse settings and provide an evidentiary base for app-based vaccine communication tools that can be adapted to future vaccine-deployment efforts. Clinical Trials Registration: Name of the registry: clinicaltrials.gov Trial registration number: NCT05386355 Date of registration: May 23, 2022 URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT05386355.
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Cox JE, Bogart LM, Elliott MN, Starmer AJ, Meleedy-Rey P, Goggin K, Banerjee T, Samuels RC, Hahn PD, Epee-Bounya A, Allende-Richter S, Fu CM, Schuster MA. Improving HPV Vaccination Rates in a Racially and Ethnically Diverse Pediatric Population. Pediatrics 2022; 150:189547. [PMID: 36127315 DOI: 10.1542/peds.2021-054186] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Nationally, 54.2% of youth are fully vaccinated for human papilloma virus (HPV) with persistent gender and racial/ethnic disparities. We used a quality improvement approach to improve completion of the HPV vaccine series by age 13 years. As a secondary aim, we examined racial/ethnic and gender differences in vaccine uptake. METHODS The study setting included 2 pediatric, academic, primary care practices in Massachusetts. We designed a multilevel patient-, provider-, and systems-level intervention addressing parental hesitancy, provider communication, and clinical operations. Rates of HPV series completion by age 13 were monitored using a control p chart. Bivariate and multivariate analyses evaluated vaccine completion differences on the basis of clinic size, gender, and race/ethnicity. RESULTS Between July 1, 2014, and September 30, 2021, control p charts showed special cause variation with HPV vaccine initiation by age 9 years, increasing from 1% to 52%, and vaccine completion by 13 years, increasing from 37% to 77%. Compared with White and Black children, Hispanic children were more likely to initiate the HPV vaccine at age 9 (adjusted odds ratio [95% confidence interval] = (1.4-2.6)] and complete the series by age 13 (adjusted odds ratio [95% confidence interval] = 2.3 (1.7-3.0). CONCLUSIONS A multilevel intervention was associated with sustained HPV vaccine series completion by age 13 years. Hispanic children were more likely to be vaccinated. Qualitative family input was critical to intervention design. Provider communication training addressed vaccine hesitancy. Initiation of the vaccine at age 9 and clinicwide vaccine protocols were key to sustaining improvements.
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Affiliation(s)
- Joanne E Cox
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Laura M Bogart
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,RAND Corporation, Santa Monica, California
| | | | - Amy J Starmer
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Kathy Goggin
- Schools of Medicine and Pharmacy, Health Services and Outcome Research, Children's Mercy Hospital and University of Missouri, Kansas City, Missouri
| | - Taruna Banerjee
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,Organizational Quality and Patient Safety, Cambridge Health Alliance, Cambridge Massachusetts
| | - Ronald C Samuels
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,Division of General Pediatrics, Children's Hospital at Montefiore, Bronx, New York
| | - Phillip D Hahn
- Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts
| | - Alexandra Epee-Bounya
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sophie Allende-Richter
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Chong-Min Fu
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mark A Schuster
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,RAND Corporation, Santa Monica, California
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Landier W, Bhatia S, Richman JS, Campos Gonzalez PD, Cherven B, Chollette V, Aye J, Castellino SM, Gramatges MM, Lindemulder S, Russell TB, Turcotte LM, Colditz GA, Gilkey MB, Klosky JL. Implementation of a provider-focused intervention for maximizing human papillomavirus (HPV) vaccine uptake in young cancer survivors receiving follow-up care in pediatric oncology practices: protocol for a cluster-randomized trial of the HPV PROTECT intervention. BMC Pediatr 2022; 22:541. [PMID: 36096775 PMCID: PMC9466329 DOI: 10.1186/s12887-022-03562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/21/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Childhood cancer survivors are at high risk for developing new cancers (such as cervical and anal cancer) caused by persistent infection with the human papillomavirus (HPV). HPV vaccination is effective in preventing the infections that lead to these cancers, but HPV vaccine uptake is low among young cancer survivors. Lack of a healthcare provider recommendation is the most common reason that cancer survivors fail to initiate the HPV vaccine. Strategies that are most successful in increasing HPV vaccine uptake in the general population focus on enhancing healthcare provider skills to effectively recommend the vaccine, and reducing barriers faced by the young people and their parents in receiving the vaccine. This study will evaluate the effectiveness and implementation of an evidence-based healthcare provider-focused intervention (HPV PROTECT) adapted for use in pediatric oncology clinics, to increase HPV vaccine uptake among cancer survivors 9 to 17 years of age. METHODS This study uses a hybrid type 1 effectiveness-implementation approach. We will test the effectiveness of the HPV PROTECT intervention using a stepped-wedge cluster-randomized trial across a multi-state sample of pediatric oncology clinics. We will evaluate implementation (provider perspectives regarding intervention feasibility, acceptability and appropriateness in the pediatric oncology setting, provider fidelity to intervention components and change in provider HPV vaccine-related knowledge and practices [e.g., providing vaccine recommendations, identifying and reducing barriers to vaccination]) using a mixed methods approach. DISCUSSION This multisite trial will address important gaps in knowledge relevant to the prevention of HPV-related malignancies in young cancer survivors by testing the effectiveness of an evidence-based provider-directed intervention, adapted for the pediatric oncology setting, to increase HPV vaccine initiation in young cancer survivors receiving care in pediatric oncology clinics, and by procuring information regarding intervention delivery to inform future implementation efforts. If proven effective, HPV PROTECT will be readily disseminable for testing in the larger pediatric oncology community to increase HPV vaccine uptake in cancer survivors, facilitating protection against HPV-related morbidities for this vulnerable population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04469569, prospectively registered on July 14, 2020.
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Affiliation(s)
- Wendy Landier
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, 1600 7th Ave. South, Lowder 500, Birmingham, Alabama, 35233, USA.
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Alabama at Birmingham, 1600 7th Ave. South, Lowder 512, Birmingham, Alabama, 35233, USA.
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, 1600 7th Ave. South, Lowder 500, Birmingham, Alabama, 35233, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Alabama at Birmingham, 1600 7th Ave. South, Lowder 512, Birmingham, Alabama, 35233, USA
| | - Joshua S Richman
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, 1600 7th Ave. South, Lowder 500, Birmingham, Alabama, 35233, USA
| | - Paula D Campos Gonzalez
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, 1600 7th Ave. South, Lowder 500, Birmingham, Alabama, 35233, USA
| | - Brooke Cherven
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, 2015 Uppergate Drive, ECC#412, Atlanta, GA, 30322, USA
| | - Veronica Chollette
- Healthcare Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr., Room 3E344, MSC 9762, Rockville, MD, 20850, USA
| | - Jamie Aye
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Alabama at Birmingham, 1600 7th Ave. South, Lowder 512, Birmingham, Alabama, 35233, USA
| | - Sharon M Castellino
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, 2015 Uppergate Drive, ECC#412, Atlanta, GA, 30322, USA
| | - Maria M Gramatges
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Baylor College of Medicine, 1102 Bates St., Suite 1200, Houston, TX, 77030, USA
| | - Susan Lindemulder
- Department of Pediatrics, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon, 97239, USA
| | - Thomas B Russell
- Department of Pediatrics, Wake Forest University, Medical Center Boulevard, Winston-Salem, North Carolina, 27157, USA
| | - Lucie M Turcotte
- Department of Pediatrics, University of Minnesota, D-557 Mayo Building, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Graham A Colditz
- Department of Surgery, Washington University at St. Louis School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 317 Rosenau Hall, CB #7440, 135 Dauer Drive, Chapel Hill, North Carolina, 27599, USA
| | - James L Klosky
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, 2015 Uppergate Drive, ECC#412, Atlanta, GA, 30322, USA
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Dube E, MacDonald SE, Manca T, Bettinger JA, Driedger SM, Graham J, Greyson D, MacDonald NE, Meyer S, Roch G, Vivion M, Aylsworth L, Witteman H, Gélinas-Gascon F, Marques Sathler Guimaraes L, Hakim H, Gagnon D, Béchard B, Gramaccia JA, Khoury R, Tremblay S. Understanding the influence of online information, misinformation, disinformation and reinformation on COVID-19 vaccine acceptance: Protocol for a multicomponent study. JMIR Res Protoc 2022; 11:e41012. [PMID: 36191171 PMCID: PMC9578524 DOI: 10.2196/41012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background The COVID-19 pandemic has generated an explosion in the amount of information shared on the internet, including false and misleading information on SARS-CoV-2 and recommended protective behaviors. Prior to the pandemic, web-based misinformation and disinformation were already identified as having an impact on people’s decision to refuse or delay recommended vaccination for themselves or their children. Objective The overall aims of our study are to better understand the influence of web-based misinformation and disinformation on COVID-19 vaccine decisions and investigate potential solutions to reduce the impact of web-based misinformation and disinformation about vaccines. Methods Based on different research approaches, the study will involve (1) the use of artificial intelligence techniques, (2) a web-based survey, (3) interviews, and (4) a scoping review and an environmental scan of the literature. Results As of September 1, 2022, data collection has been completed for all objectives. The analysis is being conducted, and results should be disseminated in the upcoming months. Conclusions The findings from this study will help with understanding the underlying determinants of vaccine hesitancy among Canadian individuals and identifying effective, tailored interventions to improve vaccine acceptance among them. International Registered Report Identifier (IRRID) DERR1-10.2196/41012
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Affiliation(s)
- Eve Dube
- Anthropology Department, Laval University, Pavillon Charles-De Koninck, 1030 Avenue des Sciences humaines, Quebec, CA
| | | | - Terra Manca
- Faculty of Nursing, University of Alberta, Edmonton, CA
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, CA
| | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, CA
| | - Janice Graham
- Department of Pediatrics, Dalhousie University, Halifax, CA
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, CA
| | | | - Samantha Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, CA
| | | | - Maryline Vivion
- Department of Social and Preventive medicine, Laval University, Quebec, CA
| | | | - Holly Witteman
- Department of Family and Emergency Medicine, Laval University, Quebec, CA
| | - Félix Gélinas-Gascon
- Department of Computer Science and Software Engineering, Laval University, Quebec, CA
| | | | - Hina Hakim
- Department of Family and Emergency Medicine, Laval University, Quebec, CA
| | - Dominique Gagnon
- Department of Biohazard, Quebec National Institute of Public Health, Québec, CA
| | | | | | - Richard Khoury
- Department of Computer Science and Software Engineering, Laval University, Quebec, CA
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Awareness of human papillomavirus and acceptability of the vaccine among women in Palestine: is it time for policy adjustment? BMC Womens Health 2022; 22:352. [PMID: 35986304 PMCID: PMC9389825 DOI: 10.1186/s12905-022-01930-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/11/2022] [Indexed: 11/28/2022] Open
Abstract
Background Progress has been made in the reduction of morbidity and mortality of cervical cancer by the implementation of human papillomavirus (HPV) vaccination programs. This study aimed to assess the awareness of Palestinian women about HPV as well as their knowledge and acceptability of the HPV vaccine and to examine the factors associated with good awareness. Methods This was a national cross-sectional study. Adult women were recruited from hospitals, primary healthcare centers, and public spaces in 11 Palestinian governorates using convenience sampling. A structured questionnaire was used for data collection. For each correctly answered question, one point was given. The total score was calculated and categorized into poor (0–10) and good awareness (11–21). Results The questionnaire was completed by 7223 women out of 8086 who were approached (response rate = 89.3%). A total of 7058 questionnaires were included in the final analysis; 4403 from the West Bank and Jerusalem (WBJ) and 2655 from the Gaza Strip. Women recruited from the Gaza Strip were younger, getting lower monthly incomes, and with fewer chronic diseases than women recruited from the WBJ. Only 33 women (0.5%) displayed good awareness of HPV and its vaccine with 0.7% of women from WBJ and only 0.2% of women from the Gaza Strip. Completing post-secondary education, being employed or a student, and having a higher monthly income were associated with an increase in the likelihood of having good awareness. Among women who had heard of HPV (n = 571, 8.1%), only 46 women (8.1%) reported familiarity with its vaccine. Women from the WBJ were more likely than women from the Gaza Strip to have heard about the HPV vaccine (0.9% vs. 0.2%). Most women agreed to receive the HPV vaccine themselves or for their daughters if it was given without cost or with a co-payment. No differences were found in the likelihood of agreeing to receive the HPV vaccine among women in the WBJ versus the Gaza Strip. Conclusion The overall awareness of HPV and its vaccine was extremely low. Inclusion of the HPV vaccine in the national immunization program could change this, especially as the HPV vaccine appeared to be acceptable.
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Fisher H, Chantler T, Mounier-Jack S, Audrey S. Human papillomavirus vaccine communication materials for young people in English-speaking countries: A content analysis. HEALTH EDUCATION JOURNAL 2022; 81:513-528. [PMID: 35910267 PMCID: PMC9326800 DOI: 10.1177/00178969221092135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To undertake a content analysis of human papillomavirus (HPV) vaccine communication materials available to young people. DESIGN Content analysis. SETTING Majority English-speaking countries. METHODS Between March and April 2020, a web engine was utilised to search for and retrieve relevant communication materials. Content analysis was used to describe how the following key issues were covered: (1) side effects, (2) safety, (3) practicalities related to receiving the HPV vaccine and (4) gender-specific information. RESULTS A total of 44 separate communication materials were retrieved, predominantly videos, webpages and leaflets. There was a focus on mild side effects of the vaccine (43.2%), with less frequent reference being made to moderate or serious side effects (22.7%). Reassurance concerning the safety profile of vaccine was communicated by referencing the widespread use of the HPV vaccine (31.8%). Information regarding formal criteria for entry into the vaccination programme emphasised country-specific eligibility criteria (59.1%), the setting in which vaccination was offered (38.6%) and the number of doses required (38.6%). Content intended to improve young people's experiences of receiving the HPV vaccine was less often provided (22.7%). Gender-specific content usually related to specific HPV-related diseases (52.3%) and/or the availability of cervical cancer screening programmes (52.3%). CONCLUSION A variety of different communication tools were retrieved encompassing a wide variety of formats and content, reflective of different vaccination programmes and the varied priorities of organisations producing the materials. Findings will inform the co-production of a tailored educational package to improve access to information by populations of young people identified as having lower HPV vaccine uptake.
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Affiliation(s)
- Harriet Fisher
- National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tracey Chantler
- National Institute for Health Research Health Protection Research Unit in Vaccinations and Immunisation, London School of Hygiene and Tropical Medicine, London, UK
| | - Sandra Mounier-Jack
- National Institute for Health Research Health Protection Research Unit in Vaccinations and Immunisation, London School of Hygiene and Tropical Medicine, London, UK
| | - Suzanne Audrey
- National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Hopfer S, Phillips KKD, Weinzierl M, Vasquez HE, Alkhatib S, Harabagiu SM. Adaptation and Dissemination of a National Cancer Institute HPV Vaccine Evidence-Based Cancer Control Program to the Social Media Messaging Environment. Front Digit Health 2022; 4:819228. [PMID: 35966142 PMCID: PMC9363572 DOI: 10.3389/fdgth.2022.819228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Social media offers a unique opportunity to widely disseminate HPV vaccine messaging to reach youth and parents, given the information channel has become mainstream with 330 million monthly users in the United States and 4.2 billion users worldwide. Yet, a gap remains on how to adapt evidence-based vaccine interventions for the in vivo competitive social media messaging environment and what strategies to employ to make vaccine messages go viral. Push-pull and RE-AIM dissemination frameworks guided our adaptation of a National Cancer Institute video-based HPV vaccine cancer control program, the HPV Vaccine Decision Narratives, for the social media environment. We also aimed to understand how dissemination might differ across three platforms, namely Instagram, TikTok, and Twitter, to increase reach and engagement. Centering theory and a question-answer framework guided the adaptation process of segmenting vaccine decision story videos into shorter coherent segments for social media. Twelve strategies were implemented over 4 months to build a following and disseminate the intervention. The evaluation showed that all platforms increased following, but Instagram and TikTok outperformed Twitter on impressions, followers, engagement, and reach metrics. Although TikTok increased reach the most (unique accounts that viewed content), Instagram increased followers, engagement, and impressions the most. For Instagram, the top performer, six of 12 strategies contributed to increasing reach, including the use of videos, more than 11 hashtags, COVID-19 hashtags, mentions, and follow-for-follow strategies. This observational social media study identified dissemination strategies that significantly increased the reach of vaccine messages in a real-world competitive social media messaging environment. Engagement presented greater challenges. Results inform the planning and adaptation considerations necessary for transforming public health HPV vaccine interventions for social media environments, with unique considerations depending on the platform.
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Affiliation(s)
- Suellen Hopfer
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
- *Correspondence: Suellen Hopfer
| | - Kalani Kieu-Diem Phillips
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Maxwell Weinzierl
- Department of Computer Science, University of Texas at Dallas, Richardson, TX, United States
| | - Hannah E. Vasquez
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Sarah Alkhatib
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Sanda M. Harabagiu
- Department of Computer Science, University of Texas at Dallas, Richardson, TX, United States
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Imanishi Y, Kinoshita T, Sakamoto M, Ichimiya M, Mitsunami M, Takahashi T, Shigemi D, Song M, Inaba K. Importance of human papillomavirus vaccination leaflets focusing on the safety profile targeted pediatricians in Japan. Vaccine 2022; 40:5010-5015. [PMID: 35842338 DOI: 10.1016/j.vaccine.2022.07.008] [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: 07/18/2021] [Revised: 05/25/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To investigate the association between providing leaflets to support pediatricians in explaining the safety of the human papillomavirus (HPV) vaccine and mother's decision to vaccinate their daughters in Japan. METHODS In this cross-sectional study, we conducted a survey of mothers to evaluate the effect of leaflets that were created to support pediatricians in explaining the safety profile of the HPV vaccine. Mothers who provided consent for vaccination before receiving an explanation were excluded from the study. The primary outcome was the mother's decision to vaccinatetheir daughters with the HPV vaccine after receiving an explanation from pediatricians using our leaflets. RESULTS Among 161 eligible mothers, 101 decided on HPV vaccination (decided group) and 60 did not (decided against group). There was no difference in the maternal background between the 2 groups. The decided group had a significantly more positive impression of the leaflets than the undecided group. In multivariable logistic regression analysis, a detailed explanation for possible adverse events and specific solutions to them was associated with the mother's decision to have their daughters vaccinated (odds ratio 2.35, 95% confidence interval 1.02-5.44), but not the pathology of cervical cancer and the HPV vaccination process. CONCLUSION Leaflets emphasizing an explanation of adverse events may contribute to mothers' decision making for HPV vaccination.
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Affiliation(s)
- Yousuke Imanishi
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan; Minpapi Association, Tokyo, Japan.
| | | | - Masahiko Sakamoto
- Minpapi Association, Tokyo, Japan; Department of Pediatrics, Saku Central Hospital, Nagano, Japan
| | - Megumi Ichimiya
- Minpapi Association, Tokyo, Japan; Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Makiko Mitsunami
- Minpapi Association, Tokyo, Japan; Master of Medical Sciences in Clinical Investigation, Harvard Medical School, Boston, USA
| | - Takayuki Takahashi
- Minpapi Association, Tokyo, Japan; Department of Obstetrics and Gynecology, Keio University, Tokyo, Japan
| | | | - Mihyon Song
- Minpapi Association, Tokyo, Japan; Marunouchi no Mori Ladies Clinic, Tokyo, Japan
| | - Kanako Inaba
- Minpapi Association, Tokyo, Japan; Department of Obstetrics and Gynecology, Kanto Central Hospital, Tokyo, Japan
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Determinants of Human Papillomavirus Vaccine recommendation among Middle Eastern and Lebanese Healthcare Providers. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Yarnall JN, Seashore C, Phillipi CA, Hatch JE, King B, Hart C, Lohr JA. Timing of Vaccine Decision-Making Among First-Time Parents. Acad Pediatr 2022; 22:551-558. [PMID: 34748968 DOI: 10.1016/j.acap.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/04/2021] [Accepted: 10/19/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Decreased childhood vaccination can lead to local outbreaks of vaccine-preventable disease. In a pilot study from our group, 72% of parents of newborns reported initiating their vaccine decision-making for that child prior to conception. Since a sound understanding of the timing of parental vaccine decision-making is needed to direct educational efforts, we surveyed a national cohort of first-time parents to extend our preliminary findings. METHODS From March 2019 to March 2020, first-time parents of newborns in mother-baby units of the Better Outcomes through Research for Newborns (BORN) network completed the Vaccine Preference Development Survey (VPDS). The VPDS measures intent to vaccinate, timing of vaccine decision-making, and sources of influence. Univariate and multivariate analyses explored associations between intent to vaccinate and timing of vaccine decision-making with demographic variables. RESULTS Twenty-three sites provided surveys through site-specific nonrandom systemic sampling; 91% (1393/1524) of surveys were used in the analysis. Most parents planned to fully vaccinate (1191/1380, 86.3%) and started vaccine decision-making prior to conception (850/1378, 61.7%). Maternal age, race and ethnicity, relationship status, and education were all significantly associated with planning to fully vaccinate and preconception decision-making (P < .001). Preconception decision-making correlated strongly with intent to fully vaccinate (P < .001). Parents influenced by personal education, medical professionals, and family/friends were more likely to endorse preconception decision-making; those strongly influenced by internet/social media were less likely to allow all vaccines or start decision-making prior to conception. CONCLUSIONS Vaccine decision-making occurs preconception for most new parents. Initiating vaccine discussions during the birth hospitalization may be too late.
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Affiliation(s)
- J Nathan Yarnall
- Emory University School of Medicine (JN Yarnall), Atlanta, Ga; Children's Healthcare of Atlanta (JN Yarnall), Atlanta, Ga.
| | - Carl Seashore
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC; UNC Health - Children's (C Seashore, C Hart), Chapel Hill, NC
| | | | - Joseph E Hatch
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC
| | - Beth King
- Academic Pediatric Association (B King), McLean, Va
| | - Chayla Hart
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC; UNC Health - Children's (C Seashore, C Hart), Chapel Hill, NC
| | - Jacob A Lohr
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC
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Suzuki Y, Sukegawa A, Ueda Y, Sekine M, Enomoto T, Melamed A, Wright JD, Miyagi E. Effect of a web-based cervical cancer survivor story on the willingness and behavioral change for Human Papillomavirus Vaccination among Japanese parents with at least one daughter aged 11 to 18 years old: Randomized Controlled Trial. JMIR Public Health Surveill 2022; 8:e34715. [PMID: 35421848 PMCID: PMC9178460 DOI: 10.2196/34715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/25/2022] [Accepted: 04/12/2022] [Indexed: 01/23/2023] Open
Abstract
Background Providing adequate information to parents who have children eligible for human papillomavirus (HPV) vaccination is essential to overcoming vaccine hesitancy in Japan, where the government recommendation has been suspended. However, prior trials assessing the effect of brief educational tools have shown only limited effects on increasing the willingness of parents to vaccinate their daughters. Objective The aim of this trial is to assess the effect of a cervical cancer survivor’s story on the willingness of parents to get HPV vaccination for their daughters. Methods In this double-blinded, randomized controlled trial (RCT) implemented online, we enrolled 2175 participants aged 30-59 years in March 2020 via a webpage and provided them with a questionnaire related to the following aspects: awareness regarding HPV infection and HPV vaccination, and willingness for HPV vaccination. Participants were randomly assigned (1:1) to see a short film on a cervical cancer survivor or nothing, stratified by sex (male vs female) and willingness for HPV vaccination prior to randomization (yes vs no). The primary endpoint was the rate of parents who agreed for HPV vaccination for their daughters. The secondary endpoint was the rate of parents who agreed for HPV vaccination for their daughters and the HPV vaccination rate at 3 months. The risk ratio (RR) was used to assess the interventional effect. Results Of 2175 participants, 1266 (58.2%) were men and 909 (41.8%) were women. A total of 191 (8.8%) participants were willing to consider HPV vaccination prior to randomization. Only 339 (15.6%) participants were aware of the benefits of HPV vaccination. In contrast, 562 (25.8%) participants were aware of the adverse events of HPV vaccination. Although only 476 (21.9%) of the respondents displayed a willingness to vaccinate their daughters for HPV, there were 7.5% more respondents in the intervention group with this willingness immediately after watching the short film (RR 1.41, 95% CI 1.20-1.66). In a subanalysis, the willingness in males to vaccinate daughters was significantly higher in the intervention group (RR 1.50, 95% CI 1.25-1.81); however, such a difference was not observed among females (RR 1.21, 95% CI 0.88-1.66). In the follow-up survey at 3 months, 1807 (83.1%) participants responded. Of these, 149 (8.2%) responded that they had had their daughters receive vaccination during the 3 months, even though we could not see the effect of the intervention: 77 (7.9%) in the intervention group and 72 (8.7%) in the control group. Conclusions A cervical cancer survivor’s story increases immediate willingness to consider HPV vaccination, but the effect does not last for 3 months. Furthermore, this narrative approach to parents does not increase vaccination rates in children eligible for HPV vaccination. Trial Registration UMIN Clinical Trials Registry UMIN000039273; https://tinyurl.com/bdzjp4yf
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Affiliation(s)
- Yukio Suzuki
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Yokohama, JP.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, US
| | - Akiko Sukegawa
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, JP
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, JP
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, JP
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, JP
| | - Alexander Melamed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, US
| | - Jason D Wright
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, US
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, JP
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Occa A, Stahl HM, Julien-Bell S. Helping Children to Participate in Human Papillomavirus-Related Discussions: Mixed Methods Study of Multimedia Messages. JMIR Form Res 2022; 6:e28676. [PMID: 35404265 PMCID: PMC9039810 DOI: 10.2196/28676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/13/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) can cause several types of cancers and genital warts. A vaccine is available to prevent HPV infections, and several efforts have been made to increase HPV education and, eventually, vaccination. Although previous studies have focused on the development of messages to educate children about HPV and the existence of the HPV vaccine, limited research is available on how to help children better communicate with their parents and health care professionals about the HPV vaccination. In addition, limited research is available on the target audience of this study (Italian children). OBJECTIVE This manuscript describes a study assessing the feasibility of using an evidence-based animated video and a web-based game to help children (aged 11-12 years) participate in discussions about their health-in particular when such conversations center around the HPV vaccination-and improve several HPV-related outcomes. The study also compares the effects of these 2 educational multimedia materials on children's knowledge and perceptions of HPV prevention. METHODS A mixed methods approach consisting of focus group discussions and an experiment with children (N=35) was used to understand children's experiences with, and perceptions of, the animated video and the game and to measure possible improvements resulting from their interaction with these materials. RESULTS Both the animated video and a web-based game increased children's knowledge and positive perceptions about HPV and HPV vaccination. Any single message was not more effective than the others. The children discussed aspects of the features and characters they liked and those that need improvements. CONCLUSIONS This study shows that both materials were effective for improving children's education about the HPV vaccine and for helping them to feel more comfortable and willing to communicate with their parents and health care professionals about their health. Several elements emerged that will allow further improvements in the design and development of the messages used in this study as well as the creation of future campaigns.
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Affiliation(s)
- Aurora Occa
- Department of Communication, University of Kentucky, Lexington, KY, United States
| | - Hayley M Stahl
- Department of Communication, University of Kentucky, Lexington, KY, United States
| | - Sarah Julien-Bell
- Department of Communication, University of Illinois at Urbana, Urbana, IL, United States
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Ou L, Youngstedt SD. The Role of Vaccination Interventions to Promote HPV Vaccine Uptake Rates in a College-Aged Population: a Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:244-250. [PMID: 32564253 PMCID: PMC8986718 DOI: 10.1007/s13187-020-01806-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This systematic review provided synthesized evidence regarding the effectiveness of the interventions promoting the human papillomavirus (HPV) vaccination in college-aged population. The HPV infection is the most prevailing sexually transmitted disease. Despite the availability and effectiveness of the 9-Valent HPV vaccine, the vaccine coverage among young adults remained low. In witness to the increasing burden of HPV-related infections and cancers, research focused on the vaccination interventions should be conducted to determine the effectiveness of the vaccination strategy and address the gap. The search was conducted through PubMed, Cochrane, and CINAL. Studies were included if they (1) included vaccination programs, (2) target population was young adults aged 17-26, (3) examined factors associated with the intervention effectiveness, (4) were published in English, and (5) were published between February 2010 and February 2020. HPV-related knowledge and intentions toward HPV vaccination were all reported increased after the intervention. Increased HPV vaccination intentions were found associated with the increased vaccine initiation and completion. Among bisexual or homosexual individuals, females were found more likely to complete the HPV dose 2 and 3. The review findings suggested using vaccination interventions incorporated with educational components to promote vaccine uptake among young adults. Supportive interventions tailored to different populations and settings are crucial to address the suboptimal HPV-related knowledge and vaccination status among the young beneficiaries.
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Affiliation(s)
- Lihong Ou
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ USA
| | - Shawn D. Youngstedt
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ USA
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