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Maar M, Bourdon C, Berti J, Bisaillon E, Boesch L, Boston A, Chapdelaine J, Humphrey A, Kumar S, Maar-Jackson B, Martell R, Naokwegijig B, Preet Kaur D, Rice S, Rickaby B, Sutherland M, Reade M. Creating a Culturally Safe Online Data Collection Instrument to Measure Vaccine Confidence Among Indigenous Youth: Indigenous Consensus Method. JMIR Form Res 2024; 8:e52884. [PMID: 39133917 PMCID: PMC11347907 DOI: 10.2196/52884] [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: 09/18/2023] [Revised: 04/19/2024] [Accepted: 05/10/2024] [Indexed: 08/30/2024] Open
Abstract
BACKGROUND Participating in surveys can shape the perception of participants related to the study topic. Administering a vaccine hesitancy questionnaire can have negative impacts on participants' vaccine confidence. This is particularly true for online and cross-cultural data collection because culturally safe health education to correct misinformation is typically not provided after the administration of an electronic survey. OBJECTIVE To create a culturally safe, online, COVID-19 vaccine confidence survey for Indigenous youth designed to collect authentic, culturally relevant data of their vaccine experiences, with a low risk of contributing to further vaccine confusion among participants. METHODS Using the Aboriginal Telehealth Knowledge Circle consensus method, a team of academics, health care providers, policy makers, and community partners reviewed COVID-19 vaccine hesitancy surveys used in public health research, analyzed potential risks, and created a framework for electronic Indigenous vaccine confidence surveys as well as survey items. RESULTS The framework for safer online survey items is based on 2 principles, a first do-no-harm approach and applying a strengths-based lens. Relevant survey domains identified in the process include sociodemographic information, participants' connection to their community, preferred sources for health information, vaccination uptake among family members and peers, as well as personal attitudes toward vaccines. A total of 44 survey items were developed, including 5 open-ended items to improve the authenticity of the data and the analysis of the experiences of Indigenous youth. CONCLUSIONS Using an Indigenous consensus method, we have developed an online COVID-19 vaccine confidence survey with culturally relevant domains and reduced the risk of amplifying misinformation and negative impacts on vaccine confidence among Indigenous participants. Our approach can be adapted to other online survey development in collaboration with Indigenous communities.
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Affiliation(s)
- Marion Maar
- Human Sciences Division, Northern Ontario School of Medicine (NOSM) University, Sudbury, ON, Canada
| | - Caleigh Bourdon
- Undergraduate Medical Education, Northern Ontario School of Medicine (NOSM) University, Sudbury, ON, Canada
| | - Joahnna Berti
- Debajehmujig Storytellers, Debajehmujig Theatre Group, Manitowaning, ON, Canada
| | - Emma Bisaillon
- Interdisciplinary Health, Laurentian University, Sudbury, ON, Canada
| | - Lisa Boesch
- Human Sciences Division, Northern Ontario School of Medicine (NOSM) University, Sudbury, ON, Canada
| | - Alicia Boston
- Public Health Sudbury & Districts, Sudbury, ON, Canada
| | | | | | - Sandeep Kumar
- Postgraduate Medical Education, Northern Ontario School of Medicine (NOSM) University, Thunder Bay, ON, Canada
| | | | - Robert Martell
- Interdisciplinary Health, Laurentian University, Sudbury, ON, Canada
| | - Bruce Naokwegijig
- Debajehmujig Storytellers, Debajehmujig Theatre Group, Manitowaning, ON, Canada
| | - Davinder Preet Kaur
- Postgraduate Medical Education, Northern Ontario School of Medicine (NOSM) University, Thunder Bay, ON, Canada
| | - Sarah Rice
- Public Health Sudbury & Districts, Sudbury, ON, Canada
| | - Barbara Rickaby
- School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
| | | | - Maurianne Reade
- Clinical Sciences Divison, Northern Ontario School of Medicine (NOSM) University, Sudbury, ON, Canada
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Buck DiSilvestro J, Ulmer KK, Hedges M, Kardonsky K, Bruegl AS. Cervical Cancer: Preventable Deaths Among American Indian/Alaska Native Communities. Obstet Gynecol Clin North Am 2024; 51:125-141. [PMID: 38267123 DOI: 10.1016/j.ogc.2023.11.009] [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: 01/26/2024]
Abstract
American Indian/Alaska Native (AI/AN) individuals have twice the mortality rate of cervical cancer than the general US population. Participation in prevention programs such as cervical cancer screening and human papillomavirus (HPV) vaccination are under-utilized in this population. There are high rates of established cervical cancer risk factors among this community, with AI/AN people having a higher likelihood of infection with high-risk HPV strains not included in the 9-valent vaccine. There is a need for more robust and urgent prevention and treatment efforts in regard to cervical cancer in the AI/AN community.
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Affiliation(s)
- Jessica Buck DiSilvestro
- Brown University, Providence, RI, USA; Women & Infants Hospital, 101 Dudley Street, Providence, RI 02905, USA.
| | - Keely K Ulmer
- University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | | | - Kimberly Kardonsky
- Department of Family Medicine, University of Washington School of Medicine, Heath Sciences Center, E-304 Box 356391, Seattle, WA 98195, USA
| | - Amanda S Bruegl
- Division of Gynecologic Oncology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailstop L466, Portland, OR 97239, USA
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Sherman BM, Islam JY, Gartner DR. Regional Variation in HPV Knowledge and Awareness among American Indians and Alaska Natives: An Analysis of the Health Information National Trends Survey, 2011-2020. Cancer Epidemiol Biomarkers Prev 2023; 32:1625-1634. [PMID: 37606643 DOI: 10.1158/1055-9965.epi-23-0547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/24/2023] [Accepted: 08/18/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND American Indian and Alaskan Native (AIAN) people experience a disproportionately high incidence of human papillomavirus (HPV)-related cancers and mortality, and these rates vary across geographic regions. To address the unexplained regional differences among AIAN people, we describe regional variations and sociodemographic correlates of HPV-related knowledge and HPV vaccination awareness indicators. METHODS A cross-sectional study was implemented with data for 866 AIAN respondents pooled from eight cycles of the Health Information National Trends Survey. We used χ2 tests to determine whether there were regional differences in the indicators and then used multivariable, modified Poisson regression to explore associations between sociodemographic characteristics and HPV-related knowledge and vaccination awareness measures. RESULTS Of the 13 indicators, just one demonstrated regional variation. However, we observed a high level of uncertainty regarding HPV and HPV vaccine-related knowledge and experience. We also observed that women were more likely than men to have heard of HPV [adjusted prevalence ratio (aPR), 1.29; 95% confidence interval (CI):1.03-1.63], the HPV vaccine (aPR, 1.59; 95% CI: 1.15-2.22), and to have discussed it with their providers (aPR, 3.69; 95% CI: 1.47-9.28). There were also differences by age, education, and insurance status. CONCLUSIONS High levels of uncertainty and lack of regional variation in indicators suggest that there may be missed opportunities across Indian Country for engagement between health care providers and AIAN in HPV-related conversations. IMPACT Efforts toward improving HPV knowledge and vaccination should target all at-risk sexes (and genders), age groups, and education levels. Moreover, AIAN-serving health care providers should be empowered with sufficient understanding, so they are prepared for discussions with at-risk patients.
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Affiliation(s)
- Bendu M Sherman
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Jessica Y Islam
- Center for Immunization and Infection Research in Cancer, Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Danielle R Gartner
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
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Zhang X, Tang L. Cultural adaptation in HPV vaccine intervention among racial and ethical minority population: a systematic literature review. HEALTH EDUCATION RESEARCH 2022; 36:479-493. [PMID: 34542147 DOI: 10.1093/her/cyab034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/05/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Racial and ethnic minorities in the United States face higher risks of human papillomavirus (HPV) and are less likely to benefit from HPV vaccines. Effective HPV vaccine promotion efforts need to acknowledge and adapt to the cultural characteristics of these minority groups. This systematic review examines and evaluates the cultural adaptations in the HPV vaccine intervention studies conducted in racial and ethnic minority communities in the United States. We searched five databases and identified 26 peer-reviewed English-language journal articles published between 2010 and 2019. These articles were analyzed using Healey et al.'s (2017) cultural adaptation framework for community health interventions. Almost all of these interventions involved some cultural adaptation. However, there is a lack of use of theories in guiding intervention design, lack of systematic, planned cultural adaptations and insufficient in-depth understanding of the targeted population's cultural characteristics associated with their HPV-related attitudes, beliefs and behaviors. Future intervention studies should identify specific cultural characteristics related to vaccine attitudes and behaviors to create more targeted cultural adaptations in HPV vaccine promotion.
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Yzer M, Rhodes K, Nagler RH, Joseph A. Effects of culturally tailored smoking prevention and cessation messages on urban American Indian youth. Prev Med Rep 2021; 24:101540. [PMID: 34976614 PMCID: PMC8683983 DOI: 10.1016/j.pmedr.2021.101540] [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: 04/12/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
American Indian youth participated in a community-engaged experiment. Participants viewed a comparison message or one of two antismoking messages. Antismoking messages either used a culturally relevant argument or a health outcomes argument. The message with a cultural argument moved AI youth who had ever smoked to a more negative stance towards smoking. Cultural arguments are useful for encouraging American Indian youth not to smoke.
American Indians (AI) face significant disparities in smoking-related diseases. In addition, smoking prevalence increases exponentially between ages 11 and 18. Smoking prevention and cessation efforts aimed at AI youth therefore are important. In order to strengthen understanding of evidence-based message strategies for smoking prevention and cessation among AI youth. The objective of this study was to test whether a message that was tailored to AI cultural values associated with the sacredness of traditional tobacco can change variables that behavioral theories have identified as predictors of smoking (i.e., instrumental and experiential attitudes, injunctive and descriptive norms, perceived capacity and autonomy, and intention with respect to smoking). We conducted a randomized field experiment among 300 never-smoking and ever-smoking urban AI youth in Minneapolis-Saint Paul between May 18 and July 27, 2019. We used a 3 (message condition: cultural benefits of not smoking cigarettes, health benefits of not smoking cigarettes, comparison message about benefits of healthy eating) × 2 (smoking status: ever-smoked, never-smoked) between-subjects design. Multivariate analysis of variance showed that for ever-smokers, the cultural consequences of smoking message significantly lowered instrumental attitude (partial eta2 = 0.029), experiential attitude (partial eta2 = 0.041), perceived capacity (partial eta2 = 0.051), and smoking intention (partial eta2 = 0.035) compared to the healthy eating comparison message and the health consequences of smoking message. This was not observed among never-smokers, who already had very negative smoking perceptions. We conclude that messages that tailor to AI culture may be effective tools for discouraging smoking among AI youth.
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Feemster KA, Head KJ, Panozzo CA, O'Dell SM, Zimet GD, Kornides ML. Efficacy of tailored messages to improve behavioral intent to accept HPV vaccination among mothers may be moderated by sociodemographics. Prev Med Rep 2021; 23:101413. [PMID: 34150474 PMCID: PMC8192722 DOI: 10.1016/j.pmedr.2021.101413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 12/04/2022] Open
Abstract
The efficacy of a tailored video intervention differed by sociodemographics. Further research should evaluate interventions tailored by sociodemographics. Tailoring interventions by child age and other factors may improve efficacy.
We assessed differences in response to a tailored recommendation intervention for HPV vaccine by participants’ sociodemographic characteristics in this exploratory sub-analysis of a larger web-based, randomized-controlled trial on tailored messaging among mothers with low intent to vaccinate their 11–14-year-old child against HPV. The intervention consisted of pre-recorded video messages tailored to 1–5 common concerns about HPV vaccine. In these exploratory analyses, we used generalized linear models to assess differences in post-intervention intent across intervention arms, stratified by sociodemographic characteristics among 496 trial participants. We found significantly higher post-intervention intent in the intervention participants versus the control group among mothers: 1) with younger children; 2) with white vs. black children; 3) with Non-Hispanic children; 4) who were younger; 5) with some college or vocational training; with household incomes of ≥$100,000; and 7) with 1–2 children. Our findings of effect modification by certain sociodemographic factors such as age, race/ethnicity, and household income should be considered when designing similar tailored messaging interventions.
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Affiliation(s)
- Kristen A Feemster
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Infectious Diseases, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Katharine J Head
- Indiana University School of Liberal Arts, Department of Communication Studies, Cavanaugh Hall 307C, 425 University Boulevard, Indianapolis, IN 46202, USA
| | | | - Sean M O'Dell
- Department of Psychiatry and Behavioral Health, Geisinger, 100 North Academy Avenue, Danville, PA 17822, USA.,Department of Population Health Sciences, Geisinger, 100 North Academy Avenue, Danville, PA 17822, USA
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 West 10 Street Suite 1001, Indianapolis, IN 46202, USA
| | - Melanie L Kornides
- Department of Family & Community Health, University of Pennsylvania School of Nursing, Division of Adolescent Medicine, Perelman School of Medicine, 418 Curie Boulevard, Office 401, Philadelphia, PA 19104, USA
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Variations in reason for intention not to vaccinate across time, region, and by race/ethnicity, NIS-Teen (2008-2016). Vaccine 2018; 37:595-601. [PMID: 30580838 DOI: 10.1016/j.vaccine.2018.12.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/05/2018] [Accepted: 12/10/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination is expected to reduce HPV-related disease and cancer in the US. However, many parents are hesitant to obtain the vaccine for their children. The purpose of this study is to examine how the reasons for refusing the HPV vaccine vary across regions of the US, across time, and by race/ethnicity. METHODS This study used data on 13-17 year old adolescents collected by the National Immunization Survey - Teen (NIS-Teen) annually between 2008 and 2016. We evaluated the frequencies of parents who did not intend to vaccinate their children in the next year among unvaccinated children. Among these non-intenders, we evaluated how reasons for HPV vaccine hesitancy changed across time, by region of the US, and race/ethnicity. RESULTS The proportion of non-intenders among unvaccinated decreased from 72% in 2010 to 58% in 2016. The most frequent reason for vaccine hesitancy was that parents felt HPV vaccination was not necessary (22.4%), followed by lack of provider recommendation (16.2%), and lack of knowledge (15.6%). Lack of provider recommendation increased in frequency as a reason for HPV vaccine hesitancy until 2012, then decreased in frequency through 2016. Cost was one reason that was elevated in all regions compared to the Northeast. Black non-intenders were less likely to report safety, costs, or their children's fear as reasons for not intending to vaccinate their children compared to white non-intenders. Hispanic non-intenders were more likely to report lack of knowledge and that the vaccine is not a school requirement as reasons not to vaccinate their children compared to white non-intenders. CONCLUSIONS National advocacy for improving provider recommendation for HPV vaccination likely contributed to a sharp decline in HPV vaccine hesitancy due to lack of provider recommendation. Results indicate the need for multifaceted interventions to increase HPV vaccination.
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