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Boatman D, Jarrett Z, Starkey A, Conn ME, Kennedy-Rea S. HPV vaccine misinformation on social media: A multi-method qualitative analysis of comments across three platforms. PEC INNOVATION 2024; 5:100329. [PMID: 39206222 PMCID: PMC11350258 DOI: 10.1016/j.pecinn.2024.100329] [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: 03/20/2024] [Revised: 07/29/2024] [Accepted: 08/03/2024] [Indexed: 09/04/2024]
Abstract
Objective The purpose of this study was to characterize similarities and differences in HPV vaccine misinformation narratives present in the comment sections of top-performing initial creator posts across three social media platforms. Methods A qualitative multi-method design was used to analyze comments collected from social media posts. A sample of 2996 comments were used for thematic analysis (identifying similar themes) and content analysis (identifying differences in comment type, opinion, and misinformation status). Results Misinformation was pervasive in comment sections. Cross-cutting misinformation themes included adverse reactions, unnecessary vaccine, conspiracy theories, and mistrust of authority. The proportion of comments related to these themes varied by platform. Initial creator posts crafted to be perceived as educational or with an anti-vaccine opinion had a higher proportion of misinformation in the comment sections. Facebook had the highest proportion of misinformation comments. Conclusion Differences in the proportion of cross-cutting themes in the comment sections across platforms suggests the need for targeted communication strategies to counter misinformation narratives and support vaccine uptake. Innovation This study is innovative due to its characterization of misinformation themes across three social media platforms using multiple qualitative methods to assess similarities and differences and focusing on conversations occurring within the comment sections.
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Affiliation(s)
- Dannell Boatman
- West Virginia University School of Medicine, Department of Cancer Prevention & Control, United States of America
- West Virginia University Cancer Institute, United States of America
| | - Zachary Jarrett
- West Virginia University School of Medicine, Department of Cancer Prevention & Control, United States of America
- West Virginia University Cancer Institute, United States of America
| | - Abby Starkey
- West Virginia University School of Medicine, Department of Cancer Prevention & Control, United States of America
- West Virginia University Cancer Institute, United States of America
| | - Mary Ellen Conn
- West Virginia University School of Medicine, Department of Cancer Prevention & Control, United States of America
- West Virginia University Cancer Institute, United States of America
| | - Stephenie Kennedy-Rea
- West Virginia University School of Medicine, Department of Cancer Prevention & Control, United States of America
- West Virginia University Cancer Institute, United States of America
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Brady K, Lee A, Bassler J, Young Pierce J, Daniel CL. Human papillomavirus vaccine beliefs and intentions Post-COVID-19 vaccine release among mothers in Alabama. Vaccine 2024; 42:126046. [PMID: 38853035 DOI: 10.1016/j.vaccine.2024.06.014] [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: 11/22/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE The current study sought to determine if the release of COVID-19 vaccines influenced Alabama mothers' attitudes and behaviors regarding HPV vaccination of their adolescent children. METHODS A social media survey was conducted August - September 2022 among mothers of adolescents ages 9-18, who self-identified as Alabama residents and their child(ren)'s primary medical decision maker. The survey assessed demographics, vaccine knowledge and opinions, vaccination history, influences on vaccination decisions, and how COVID-19 vaccine release affected vaccine opinions. Univariable and multivariable analyses were conducted. RESULTS Of 241 responses, most participants were white (82.0 %, n = 196), non-Hispanic (96.6 %, n = 230), and privately insured (64.5 %, n = 151), with annual household incomes ≥$61,000 (45.4 %, n = 103). The majority (60.8 %) reported that their child either had or planned to receive the HPV vaccine. The release of COVID-19 vaccines did not change the majority of parental opinions towards HPV, with 78.5 % (n = 161) reporting no change. Among those who experienced a change, 25 % (n = 5) reported an increased likelihood of having their child vaccinated for HPV and 75 % (n = 15) reported a decrease in likelihood. Moderate and high HPV knowledge scores were associated in multivariable analysis with increased likelihood of having their child vaccinated for HPV ("moderate" knowledge AOR: 12.4, 95 % CI: 1.98-78.1; "high" knowledge AOR: 12.8, 95 % CI: 2.00-82.1). Positive HPV opinion scores in the univariable analysis similarly showed increased odds (AOR = 1.5). CONCLUSIONS These findings indicate that, in this population, COVID-19 vaccine release did not significantly impact subsequent HPV vaccination decision making. Parental perceptions regarding vaccination are critical to informing future interventions.
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Affiliation(s)
- Kiley Brady
- University of South Alabama, College of Medicine at Mobile, Alabama
| | - Alyssa Lee
- University of South Alabama, Mitchell Cancer Institute.
| | | | | | - Casey L Daniel
- University of South Alabama, College of Medicine at Mobile, Alabama.
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Chawla N, Marshall J, Dubinskaya A, Wakefield D, Shepherd J, Pimentel VM. Knowledge of the Human Papillomavirus Vaccine and Willingness to Accept Vaccination in the Postpartum Period. J Low Genit Tract Dis 2024:00128360-990000000-00126. [PMID: 39058318 DOI: 10.1097/lgt.0000000000000827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
OBJECTIVES Human papillomavirus (HPV) vaccines prevent cervical cancer. The inpatient postpartum period presents a unique window for vaccination. Our study investigates HPV vaccine knowledge, barriers to vaccination, and willingness to get vaccinated during inpatient postpartum care. MATERIALS AND METHODS We conducted a cross-sectional survey of 147 participants, age 18 to 26, who delivered at our institution between November 1, 2019, and April 30, 2020. Participants completed a questionnaire that included demographics, vaccine knowledge, hesitancies, and willingness to vaccinate. We used descriptive statistics and compared groups with chi-square or Wilcoxon rank sum for categorical variables and t-test for continuous variables. RESULTS Of the 147 patients, 58 (39.46%) were fully vaccinated against HPV and 89 (60.54%) of participants were unvaccinated or partially vaccinated. There was a greater proportion of African American and Asian participants among unvaccinated women (28.1% vs 20.7% and 16.9% vs 1.7%, respectively). Most unvaccinated participants (52.9%) were willing to get vaccinated in the postpartum unit. Both vaccinated and unvaccinated groups were similarly aware that the HPV vaccine prevents cervical and oropharyngeal cancers and genital warts. The top barrier to future vaccination was forgetting to complete the vaccination series. CONCLUSIONS Most women were not fully vaccinated but were willing to receive their first dose while in the postpartum unit. African American women were less likely to be vaccinated and expressed more unwillingness to accept vaccination. We identified barriers to HPV vaccination that can be tackled with the initiation of inpatient postpartum vaccination.
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Affiliation(s)
- Nidhi Chawla
- Touro College of Osteopathic Medicine, Middletown, NY
| | - Jennifer Marshall
- Department of Obstetrics and Gynecology, Saint Francis Hospital and Medical Center, Hartford, CT
| | | | - Dorothy Wakefield
- Department of Research, Saint Francis Hospital and Medical Center, Hartford, CT
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Li J. Relationships among health-related social media use, knowledge, worry, and cervical cancer screening: A cross-sectional study of US females. PATIENT EDUCATION AND COUNSELING 2024; 124:108283. [PMID: 38593482 DOI: 10.1016/j.pec.2024.108283] [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: 01/05/2024] [Revised: 03/19/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study aimed to explore the relationship between health-related social media use and HPV-related health knowledge, attitudes, and practices (KAP). METHOD Data were derived from a subset of the national cohort from the 2022 Health Information National Trends Survey (HINTS 6), including only women aged 21 to 65 years old (n = 2013). Ordinary least squares regression and structural equation modeling were used to answer the research question and test hypotheses. RESULTS Participants with a family history of cancer, higher education, and White showed more HPV knowledge. Older females were associated with lower HPV knowledge, less worry and fewer timely cervical cancer screening. Additionally, HPV knowledge positively predicted worry and cervical cancer screening. Health-related social media use positively predicted HPV knowledge, worry, and cervical cancer screening. CONCLUSION This study identified populations with HPV knowledge and hesitated cervical cancer screening and tested hypothesized models that combine social media use with the KAP survey. PRACTICE IMPLICATIONS Future health interventions should strategically leverage the role of social media to enhance public awareness of HPV knowledge and cancer concerns. By promoting HPV knowledge and awareness, such interventions can subsequently encourage timely cervical cancer screening.
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Affiliation(s)
- Jinxu Li
- Department of Communication and Journalism, Texas A&M University, USA.
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5
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Waller J, Waite F, Marlow L. Awareness and knowledge about HPV and primary HPV screening among women in Great Britain: An online population-based survey. J Med Screen 2024; 31:91-98. [PMID: 37875156 PMCID: PMC11083738 DOI: 10.1177/09691413231205965] [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: 06/15/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES Human papillomavirus (HPV) primary testing for cervical screening is being implemented around the world. We explored HPV awareness, and knowledge about primary screening in Great Britain (England, Scotland and Wales), where it has been in place for several years, ahead of extended screening intervals being implemented in England. SETTING/METHODS Women aged 18-70 (n = 1995) were recruited by YouGov from their online panel in August 2022. The weighted sample (n = 1930) was population-representative by age, region, education and social grade. We measured HPV awareness, knowledge (excluding those unaware of HPV) using eight true/false items, and understanding of the role of HPV testing in cervical screening. RESULTS Overall, 77.6% (1499/1930) of women were aware of HPV. When asked to identify the statement describing how cervical screening works, only 12.2% (236/1930) correctly selected the statement reflecting HPV primary screening (13.5% (194/1436) in screening-eligible women). Excluding those unaware of HPV, most participants had heard about the virus in the context of cervical screening (981/1596; 61.5%) or HPV vaccination (1079/1596; 67.6%). Mean knowledge score was 3.7 out of 8 (SD = 2.2) in this group. Most knew that an HPV-positive result does not mean a woman will definitely develop cervical cancer (1091/1499; 72.8%) but far fewer were aware of the long timeline for HPV to develop into cervical cancer (280/1499; 18.7%). CONCLUSIONS Only three-quarters of women in Britain are aware of HPV, and knowledge of primary screening is very low, even among screening-age women. This points to continued need for awareness-raising campaigns to ensure informed choice about screening and mitigate public concern when screening intervals are extended.
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Affiliation(s)
- Jo Waller
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Frances Waite
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Laura Marlow
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
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Díaz-Cortés H, Hedges MS, Pacheco-Spann LM, Findley V, Leyva SC, Moran KM, DeStephano CC, Li Z, Colon-Otero G. A feasibility study assessing knowledge, vaccine hesitancy, and completion rates of free HPV vaccination in low-income uninsured adults. PREVENTIVE ONCOLOGY & EPIDEMIOLOGY 2024; 2:2332260. [PMID: 39156949 PMCID: PMC11326483 DOI: 10.1080/28322134.2024.2332260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Background Human Papillomavirus (HPV) vaccination rates remain low in the U.S., particularly among minorities and low-income, uninsured patients. We report preliminary data on a pilot study program providing education and free HPV vaccination at a clinic serving low-income uninsured adults. Methods From October 2020 through October 2022, we assessed HPV vaccination knowledge, awareness, and prevalence of hesitancy towards receiving the vaccine among low-income uninsured patients age 18-45. The Parents Attitudes about Childhood Vaccines (PACV) survey was modified and used to evaluate vaccine hesitancy. An educational video on HPV was shown to patients declining vaccination. Results 43 patients were enrolled. 69.8% had heard of the HPV vaccine and 85.7% were non-hesitant based on PACV scores of 0-49. Black participants had a statistically significant higher PACV score (more hesitant) than White participants. Familiarity with the HPV vaccine correlated with lower PACV scores. Only 27% completed all three HPV vaccine doses. Discussion The availability of an education program together with free HPV vaccination are not sufficient to achieve adequate vaccination rates in low-income, uninsured adults. Innovative, culturally sensitive education and supportive interventions, in addition to access to free HPV vaccination, are warranted in order to improve vaccination rates in this underserved population.
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Affiliation(s)
- Hiram Díaz-Cortés
- University of Puerto Rico School of Medicine, PO Box 365067, San Juan, Puerto Rico, USA
| | - Mary S. Hedges
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida, 32224, USA
| | | | - Victoria Findley
- Volunteers in Medicine Clinic, 3728 Philips Hwy, Suite 34, Jacksonville Florida, 32207, USA
| | | | - Kaitlin M. Moran
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida, 32224, USA
| | | | - Zhuo Li
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida, 32224, USA
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Farhan K, Imam SI, Tariq MB, Ahmed A, Suheb MK, Akilimali A. Connecting the dots: Human papillomavirus vaccination gaps and the upsurge of oral human papillomavirus infection in United States of America. Int J Gynaecol Obstet 2024; 165:529-530. [PMID: 38084756 DOI: 10.1002/ijgo.15306] [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: 09/22/2023] [Accepted: 12/04/2023] [Indexed: 04/17/2024]
Abstract
SynopsisThis Editorial calls attention to the worrisome rise in oral HPV infections in the USA, which has been related to an increase in oral sex activity. It emphasizes the need for increased vaccination rates, dispelling myths and addressing disparities in oropharyngeal cancer prevention.
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Affiliation(s)
- Kanza Farhan
- Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Syed Irtiza Imam
- Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan
| | | | - Aliza Ahmed
- Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Mahammed Khan Suheb
- Department of Critical Care, St. Luke's Aurora Medical Center, Milwaukee, Wisconsin, USA
| | - Aymar Akilimali
- Department of Research, Medical Research Circle (MedReC), Bukavu, DR Congo
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8
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Orji C, Brown CM, Barner J, Moczygemba L, Morales-Campos D. Determinants of Human Papillomavirus (HPV) vaccination intentions among young adult college students using the theory of planned behavior. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-14. [PMID: 38466334 DOI: 10.1080/07448481.2024.2325935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 02/22/2024] [Indexed: 03/12/2024]
Abstract
Purpose: To determine college students' intentions to be Human Papillomavirus (HPV) vaccinated. Methods: The study was comprised of college students aged 18-45 years. A survey was developed based on the Theory of Planned Behavior (TPB). The significance of the TPB constructs-attitude, subjective norms, and perceived behavioral control-and an additional construct-knowledge-in predicting intention were assessed. Results: The regression model containing attitude, subjective norms and perceived behavioral control accounted for 40% of the variance in intention. Attitude and subjective norms were significant predictors, while perceived behavioral control was not. Provider recommendation was the only significant covariate. Knowledge did not significantly contribute to the model. Discussion: The TPB was useful in predicting HPV vaccination intentions. A focus on attitude, subjective norms and provider recommendation may be useful in creating new or enhancing existing interventions.
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Affiliation(s)
- Chinelo Orji
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - Carolyn M Brown
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - Jamie Barner
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - Leticia Moczygemba
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
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9
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Garolla A, Graziani A, Grande G, Ortolani C, Ferlin A. HPV-related diseases in male patients: an underestimated conundrum. J Endocrinol Invest 2024; 47:261-274. [PMID: 37770654 PMCID: PMC10859347 DOI: 10.1007/s40618-023-02192-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Human papillomavirus (HPV) infection is the most common sexually transmitted disease, in males and females worldwide. While the role of HPV in female diseases is well known and largely studied, males have negligibly been included in these programs, also because the proportion of women suffering and dying from HPV-related diseases is much larger than men. The aim of this review is to focus on HPV-related diseases in male patients. METHODS We performed a literature analysis on the electronic database PubMed. We considered randomized trials, observational and retrospective studies, original articles having as topic the relationship between HPV male infection and the following items: oral, anal penile cancers, warts, condylomas, male infertility, altered sperm parameters, anti-sperm antibodies (ASA). We also included experimental in vitro studies focused on the effects of HPV infection on oocyte fertilization, blastocyst development, and trophoblastic cell invasiveness. In addition, studies describing the adjuvant administration of the HPV vaccination as a possible strategy to promote HPV clearance from semen in infected males were included. RESULTS Regarding head and neck HPV-related diseases, the most important non-neoplastic disease is recurrent respiratory papillomatosis (RRP). Regarding neoplastic diseases, the proportion of head and neck cancers attributable to HPV has increased dramatically worldwide. In addition, nowadays, it is thought that half of head and neck squamous cell carcinomas (HNSCCs) cases in the United States are caused by infection with high-risk HPV. HPV is noteworthy in andrological practice too. It was described as having a high HPV prevalence, ranging between 50 and 70%, in male penile shaft, glans penis/coronal sulcus, semen as well as in scrotal, perianal, and anal regions. Moreover, in male patients, HPV infection has been associated, among other diseases, with penile cancers. HPV semen infection has been reported in about 10% in men from the general population and about 16% in men with unexplained infertility, although these data seem widely underestimated according to clinical experience. In particular, HPV semen infection seems to be most related to asthenozoospermia and to anti-sperm antibodies (ASAs). CONCLUSIONS HPV infection represents a health problem with a detrimental social and public impact. Despite this evidence, little has been done to date to widely promote vaccination among young males.
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Affiliation(s)
- A Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy.
| | - A Graziani
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - G Grande
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - C Ortolani
- Section of Otolaryngology, Department of Neurosciences, University of Padova, Padua, Italy
| | - A Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
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10
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Rojo EM, Taylor KD, McFarland W. Low Human Papillomavirus Vaccination in a Low-Income Urban Population. HEALTH EDUCATION & BEHAVIOR 2023; 50:810-814. [PMID: 37329276 PMCID: PMC10638855 DOI: 10.1177/10901981231179938] [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: 06/19/2023]
Abstract
Despite widespread availability of human papillomavirus (HPV) vaccines and recommendations for routine use, awareness and uptake of HPV vaccination are not universal. We assessed self-reported history of HPV vaccination in a sample of low-income men and women recruited from the community using respondent-driven sampling as part of the National HIV Behavioral Surveillance (NHBS) survey in San Francisco. Of the 384 respondents, a minority (12.5%) reported they had received the HPV vaccine. In multivariate analysis, independent associations with HPV vaccination history were female sex (adjusted odds ratio [AOR] = 3.76, 95% confidence interval [CI] = [1.73, 8.17]), younger age (AOR = 0.89 per year, 95% CI = [0.86, 0.92]), and education above high school (AOR = 2.84, 95% CI = [1.37, 5.90]). Missed opportunities for HPV vaccination were evident in 84.4% of respondents having visited a health care provider in the last year, including 40.1% tested for a sexually transmitted infection, and entry into higher education programs (33.4%).
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Affiliation(s)
| | - Kelly D. Taylor
- University of California San Francisco, San Francisco, CA, USA
| | - Willi McFarland
- University of California San Francisco, San Francisco, CA, USA
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Terada M, Shimazu T, Saito J, Odawara M, Otsuki A, Yaguchi-Saito A, Miyawaki R, Kuchiba A, Ishikawa H, Fujimori M, Kreps GL. Age, gender and socioeconomic disparities in human papillomavirus (HPV) awareness and knowledge among Japanese adults after a 7-year suspension of proactive recommendation for the HPV vaccine: A nationally representative cross-sectional survey. Vaccine 2023; 41:7147-7158. [PMID: 37866996 DOI: 10.1016/j.vaccine.2023.10.024] [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: 05/25/2023] [Revised: 09/21/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023]
Abstract
The Japanese government's 2013 suspension of its proactive recommendation for Human papillomavirus (HPV) vaccination resulted in low HPV vaccination coverage and was unique. However, data on awareness and knowledge of HPV vaccines in the general population was limited. Here, to investigate more recent awareness and knowledge of HPV vaccines by age, gender, and socioeconomic status, we used data from the INFORM Study 2020, a nationally representative cross-sectional survey of self-administered questionnaires with 1,998 Japanese individuals aged 20 to 59 years. We found that 47.5% of females and 21.0% of males had heard of HPV, and 33.6% of females and 16.8% of males had knowledge of HPV vaccine efficacy. After adjusting for potential confounders, females aged 50-54 years were more likely to be aware of HPV than females aged 20-24 (AOR, 2.02, 95%CI: 1.12-3.65). Females (AOR, 2.13, 95%CI: 1.48-3.07) and males (AOR, 1.64, 95%CI: 1.03-2.59) with higher education had more awareness than those with less education. Females with higher education had more knowledge about HPV vaccine efficacy than those with less education (AOR, 1.70; 95%CI: 1.16-2.50). We found a generally low level of awareness and knowledge about HPV vaccines in Japan, which might be attributable to the suspension of proactive recommendations. Additionally, we identified disparities in awareness and knowledge by age, gender, socioeconomic status, and health literacy. Enhancing HPV awareness and understanding of HPV vaccines and implementing targeted efforts for specific subpopulations within Japan after the resumption of proactive recommendation for HPV vaccines, are imperative.
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Affiliation(s)
- Marina Terada
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan.
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Aki Otsuki
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan; Faculty of Human Sciences, Tokiwa University, Ibaraki, Japan
| | - Rina Miyawaki
- School of Arts and Letters, Meiji University, Tokyo, Japan
| | - Aya Kuchiba
- Division of Biostatistical Research, Institution for Cancer Control/Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan; Graduate School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan
| | - Hirono Ishikawa
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Maiko Fujimori
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Gary L Kreps
- Center for Health and Risk Communication, George Mason University, Fairfax, VA, USA
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Stephens ES, Dema E, McGee-Avila JK, Shiels MS, Kreimer AR, Shing JZ. Human Papillomavirus Awareness by Educational Level and by Race and Ethnicity. JAMA Netw Open 2023; 6:e2343325. [PMID: 37962885 PMCID: PMC10646733 DOI: 10.1001/jamanetworkopen.2023.43325] [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: 07/13/2023] [Accepted: 10/04/2023] [Indexed: 11/15/2023] Open
Abstract
Importance Understanding disparities in human papillomavirus (HPV) awareness is crucial, given its association with vaccine uptake. Objective To investigate differences in HPV awareness by educational attainment, race, ethnicity, and their intersectionality. Design, Setting, and Participants This cross-sectional study used the Health Information National Trends Survey (HINTS) 5 cycles 1 to 4 data (January 26, 2017, to June 15, 2020). The data were analyzed from December 12, 2022, to June 20, 2023. A sample of the noninstitutionalized civilian US population 18 years or older was included in the analysis. Main Outcomes and Measures Weighted prevalence of HPV awareness, HPV vaccine awareness, and knowledge that HPV causes cancer, stratified by educational attainment and by race and ethnicity. Interaction between educational attainment and race and ethnicity was assessed using a Wald test. Results A total of 15 637 participants had educational attainment data available; of these, 51.2% were women, and the median age was 58 (IQR, 44-69) years. A total of 14 444 participants had race and ethnicity information available; of these, 4.6% were Asian, 13.9% were Black, 15.3% were Hispanic, 62.6% were White, and 3.6% were of other race or ethnicity (including American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, and more than 1 race or ethnicity). Awareness of HPV by educational attainment ranged from 40.4% for less than high school to 78.2% for college or higher; awareness by race and ethnicity ranged from 46.9% among Asian individuals to 70.2% among White individuals. Awareness of HPV vaccines across educational attainment ranged from 34.7% among those with less than high school to 74.7% among those with a college degree or higher and by race and ethnicity from 48.4% among Asian individuals to 68.2% among White individuals. Among adults who were aware of HPV, knowledge that HPV causes cervical cancer differed by educational attainment, ranging from 51.7% among those with less than high school to 84.7% among those with a college degree or higher, and by race and ethnicity, ranging from 66.0% among Black individuals to 77.9% among Asian individuals. The interaction between educational attainment and race and ethnicity on HPV awareness and HPV vaccine awareness was not significant; however, within each educational attainment level, awareness differed by race and ethnicity, with the lowest awareness consistently among Asian individuals regardless of educational attainment. Within each racial and ethnic group, HPV awareness and HPV vaccine awareness significantly decreased with decreasing educational attainment. Conclusions and Relevance Disparities in HPV awareness were evident across social factors, with the lowest awareness among Asian individuals and individuals with lower educational attainment. These results emphasize the importance of considering social factors in HPV awareness campaigns to increase HPV vaccination.
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Affiliation(s)
- Erica S. Stephens
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Emily Dema
- Institute for Global Health, University College London, London, United Kingdom
| | - Jennifer K. McGee-Avila
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Aimée R. Kreimer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Jaimie Z. Shing
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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Bloom JC, Kaufmann N, Koss S, Edwards HA, Perkins RB, Faden DL. Deciphering Knowledge and Opinions of Human Papillomavirus and Human Papillomavirus Vaccination for Facilitation of Point-of-Care Vaccination in Adults. JAMA Otolaryngol Head Neck Surg 2023; 149:870-877. [PMID: 37651109 PMCID: PMC10472267 DOI: 10.1001/jamaoto.2023.2073] [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: 03/25/2023] [Accepted: 06/11/2023] [Indexed: 09/01/2023]
Abstract
Importance Human papillomavirus (HPV) vaccination rates remain significantly below rates for other common childhood vaccines, which has implications for future rates of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). Objective To assess whether individuals who were aware of the association between HPV and OPSCC would be more likely to have been previously vaccinated. Design, Setting, and Participants This survey study included patients aged 18 to 45 years who sought routine outpatient care at the otolaryngology clinic at Boston Medical Center from September 1, 2020, to May 19, 2021. A survey (HPV-Associated Head and Neck Cancer Epidemiology, Awareness and Demographics) [HEAD]) composed of validated questions to assess patient knowledge of HPV and HPV vaccination and barriers to vaccination was delivered to participants. The survey was paired with a novel point-of-care vaccination program housed within an otolaryngology department. Main Outcomes and Measures The main outcome was prevalence of knowledge of the relationship between HPV infection and OPSCC based on survey responses. The association of knowledge of HPV-associated OPSCC with likelihood of having been vaccinated was assessed in the overall cohort and by demographic characteristics using multivariate logistic regression. Results Of 405 patients given the survey, 288 (71.1%) responded. Of these patients, 271 (94.1%) had surveys included; 158 (58.3%) were female, and median age was 29 years (IQR, 24-35 years). The baseline vaccination rate in the surveyed population was low (26.6%; n = 72) overall (10.6% among men [12 of 113]; 37.9% among women [60 of 158]). Few participants understood the relationship between HPV infection and OPSCC (63 of 271 [23.3%]) or that HPV-associated OPSCC is the most common HPV-associated cancer type (9 of 121 [7.4%]). Compared with men, women were more likely to have been previously vaccinated (odds ratio [OR], 6.5; 95% CI, 3.0-13.9), more aware that HPV causes cancer (OR, 3.7; 95% CI, 1.9-7.1), and more likely to have heard about HPV and HPV vaccination from their health care practitioner (OR, 2.6; 95% CI, 1.2-5.7). Knowledge of the relationship between HPV infection and cancer and between HPV and OPSCC was associated with increased likelihood of having been vaccinated (HPV and cancer: OR, 4.1 [95% CI, 1.8-9.5]; HPV and OPSCC: OR, 3.7 [95% CI, 1.8-7.6]). Among 156 unvaccinated participants, 12 of 98 men (12.2%) and 7 of 131 women (5.3%) received point-of-care vaccination. Conclusions Most participants in this survey study were unaware that HPV causes OPSCC. Understanding that HPV causes OPSCC was associated with increased likelihood of having been vaccinated. However, most patients surveyed were not informed of this relationship by their health care practitioners. Targeted education aimed at unvaccinated adults establishing the relationship between HPV infection and OPSCC, paired with point-of-care vaccination, may be an innovative strategy for increasing HPV vaccination rates in adults.
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Affiliation(s)
- Jacob C. Bloom
- Department of Otolaryngology–Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts
| | - Nicole Kaufmann
- Department of Epidemiology, Harvard University School of Public Health, Boston, Massachusetts
| | - Shirley Koss
- Department of Otolaryngology–Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts
| | - Heather A. Edwards
- Department of Otolaryngology–Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts
| | - Rebecca B. Perkins
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts
| | - Daniel L. Faden
- Department of Otolaryngology–Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
- Mass Eye and Ear, Boston, Massachusetts
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Nesser W, Ayodele O. Human Papilloma Virus Knowledge Among University Students, Staff, and Faculty in the State of Indiana During 2016, 2019, and 2022. J Community Health 2023; 48:718-723. [PMID: 36988774 PMCID: PMC10052299 DOI: 10.1007/s10900-023-01210-y] [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] [Accepted: 03/09/2023] [Indexed: 03/30/2023]
Abstract
Studies of Human Papillomavirus (HPV) knowledge among university students have previously been conducted, typically to the exclusion of faculty and staff. The study aim was to assess HPV knowledge among university students, staff, and faculty in the state of Indiana during 2016, 2019, and 2022. The three samples comprised a total of 1275, 1056, and 403 students, staff, and faculty respectively during 2016, 2019, and 2022. Ages ranged from 18 to 70 + each year of the study. A 27-item survey was administered including sociodemographic questions and quantitative HPV knowledge questions were modified from a previously validated instrument. Descriptive statistics characterized the study participants and differences in scores were reported. Among the overall sample who answered receiving the vaccine question (n = 1917), 39% had received the HPV vaccine. HPV knowledge significantly increased among students from 2016 to 2019 but decreased in 2022. Among staff, there was a significant knowledge difference between 2016 and 2022, but no significant knowledge difference among the faculty. About 86% of the total sample did not know that HPV usually does not need any treatment. Further, participants correct knowledge scores were less than average on the following items: HPV can cause throat cancer (49%); HPV can be transmitted by skin-to-skin contact (42%). More education and campus-wide efforts need to be implemented to increase awareness and accurate HPV-knowledge. Targeted and individual messaging for students, staff, and faculty may be a way to increase awareness of HPV and improve HPV knowledge.
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Affiliation(s)
- Whitney Nesser
- Department of Applied Health Sciences, Indiana State University, 401 N. 4th Street, Room 470, Terre Haute, IN, 47809, USA.
| | - Olabode Ayodele
- Department of Applied Health Sciences, Indiana State University, 401 N. 4th Street, Room 461, Terre Haute, IN, 47809, USA
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Chido-Amajuoyi OG, Osaghae I, Shete S. Reasons patients cite to their health-care professional for not initiating or completing human papillomavirus vaccination. JNCI Cancer Spectr 2023; 7:pkad047. [PMID: 37478343 PMCID: PMC10423071 DOI: 10.1093/jncics/pkad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Vaccination against human papillomavirus (HPV) is critical to the prevention of HPV-associated cancers. This study aimed to describe the reasons patients cited for not initiating or completing the HPV vaccination series, as reported by health-care professionals. METHODS Study data were obtained from a University of Texas MD Anderson Cancer Center population-based cross-sectional survey of health-care professionals practicing in Texas. Prevalence estimates of reasons cited for not initiating or completing HPV vaccination were estimated by patient population (parents of children and adult patients). RESULTS The study included 973 primary care clinicians, of whom 45.53% were physicians and 54.47% were midlevel care professionals. For parents who did not initiate HPV vaccination for their child, the most commonly cited reasons were the belief that the vaccine was not needed (52.54%, 95% CI = 48.90% to 56.15%), that the child was not sexually active (52.54%, 95% CI = 48.90% to 56.15%), and safety concerns/side effects (47.05%, 95% CI = 43.44% to 50.69%). Among age-eligible adults who did not initiate HPV vaccination, lack of knowledge and awareness was the most commonly cited reason (30.52%, 95% CI = 27.71% to 33.50%). For noncompletion of the HPV vaccine series, parents most commonly cited competing priorities (41.29%, 95% CI = 37.76% to 44.91%), followed by adverse reactions after the first dose (16.05%, 95% CI = 13.56% to 18.90%). Similarly, for noncompletion of the HPV vaccine series among adults, competing priorities was the most cited reason (31.04%, 95% CI = 28.20% to 34.02%). CONCLUSION These findings highlight the importance of addressing misconceptions and improving education about HPV vaccination to increase vaccination uptake rates and prevent HPV-related cancers.
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Affiliation(s)
| | - Ikponmwosa Osaghae
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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16
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Vasireddy D, Sathiyakumar T, Mondal S, Sur S. Factors Affecting Human Papillomavirus Vaccine Trends in the United States of America. Cureus 2023; 15:e42617. [PMID: 37641757 PMCID: PMC10460605 DOI: 10.7759/cureus.42617] [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] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
Background Routine immunization of both girls and boys starting from nine years of age with the human papillomavirus (HPV) vaccine is the current recommendation. The objective of this retrospective study using National Health and Nutrition Examination Survey data was to evaluate the influence of sociodemographic factors on the series initiation and completion of the HPV vaccine from 2011 to 2020. Methodology The chi-square test was used to examine the statistical significance of the association between categorical variables and receipt of the HPV vaccine. The Cochran-Armitage test for trend was employed to assess the statistical significance of temporal trends in risk factors associated with rates of HPV vaccination. These trends were further quantified by a significant rate ratio by comparing them against the most recent survey years. Results HPV vaccine uptake was higher in the 9-14-year age group across survey years and had increased for both males and females over that time. The first dose of the HPV vaccine was most likely to be received by the 11-18-year age group. In the most recent survey of 2017-2020, the highest number of vaccination series completion was achieved for Gardasil®. Conclusions Improved physician efforts and strategies to vaccinate males, low socioeconomic strata patients, and ethnic minorities in more numbers are needed.
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Affiliation(s)
- Deepa Vasireddy
- Department of Pediatrics, Pediatric Group of Acadiana, Lafayette, USA
| | | | - Sumona Mondal
- Department of Mathematics, Clarkson University, Potsdam, USA
| | - Shantanu Sur
- Department of Biology, Clarkson University, Potsdam, USA
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17
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Onyeaka HK, Muoghalu C, Deary EC, Ajayi KV, Kyeremeh E, Dosunmu TG, Jawla M, Onaku E, Nwani SP, Asante KO, Amonoo HL. The Role of Health Information Technology in Improving Awareness of Human Papillomavirus and Human Papillomavirus Vaccine Among U.S. Adults. Telemed J E Health 2023; 29:886-895. [PMID: 36394492 PMCID: PMC10277992 DOI: 10.1089/tmj.2022.0381] [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: 09/07/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 11/19/2022] Open
Abstract
Objective: Although human papillomavirus (HPV) vaccines prevent cancer-causing HPV infections and cervical precancers, there is suboptimal awareness and limited global accessibility of HPV and HPV vaccine. Emerging evidence suggests that health information technology (HIT) may influence HPV-related awareness and improve vaccine adoption. The objective of this study was to evaluate the link between HIT and HPV-related awareness Methods: Data were obtained from 1,866 U.S. adults aged 18-45 years who completed the 2017 and 2018 Health Information National Trends Survey. We conducted multivariable logistic regression to analyze the association between HIT utilization and HPV-related awareness. Results: Awareness of HPV and HPV vaccine were 72.7% and 67.5%, respectively. Participants who used electronic means to look up health information (adjusted odds ratio [aOR] = 3.05; p = 0.001), communicate with health care provider (aOR = 1.68; p = 0.026), look up test results (aOR = 1.94; p = 0.005), and track health costs (aOR = 1.65; p = 0.04) were more likely to report HPV awareness than those who did not. Participants who used an electronic device to look up health information (aOR = 3.10; p = 0.003), communicate with clinicians (aOR = 1.72; p = 0.008), look up test results (aOR = 1.63; p = 0.021), and track health care charges (aOR = 1.90; p = 0.006) were more likely to report HPV vaccine awareness than those who did not. Discussion and Conclusion: Our findings suggest a positive association between HIT utilization and HPV-related awareness. Given the rapid and exponential increase in mobile technology access globally, these results are encouraging and offer a potential opportunity to leverage digital technology in primary cancer prevention for HPV-related cancers, especially in low- and middle-income countries with unsophisticated health infrastructures.
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Affiliation(s)
- Henry K. Onyeaka
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Chioma Muoghalu
- Department of Clinical Informatics, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Pediatrics, Presbyterian Hospital, Clovis, New Mexico, USA
| | - Emma C. Deary
- Department of Psychiatry, Brigham and Women Hospital, Boston, Massachusetts, USA
| | - Kobi V. Ajayi
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA
- Laboratory of Community Health Evaluation Science and Systems (CHESS), Texas A&M University, College Station, Texas, USA
| | - Emmanuel Kyeremeh
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
| | | | - Muhammed Jawla
- Department of Epidemiology, Louisiana State University School of Health Sciences, New Orleans, Louisiana, USA
| | | | - Somtochi P Nwani
- Faculty of Pharmaceutical Sciences, University of Nigeria, Enugu, Nigeria
| | | | - Hermioni L. Amonoo
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Brigham and Women Hospital, Boston, Massachusetts, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Chu H, Liu S. Psychological Distance, Construal Level, and Parental Vaccine Hesitancy for COVID-19, HPV, and Monkey Pox Vaccines. SCIENCE COMMUNICATION 2023; 45:279-309. [PMID: 38602977 PMCID: PMC10331124 DOI: 10.1177/10755470231182614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Building on the construal-level theory and the multi-dimensional model of behavioral barriers, this study examined whether psychological distance and construal level explain the association between behavioral intention and behavioral barriers that may lead to parental vaccine hesitancy. Results of multilevel structural equation models show that low vaccination intention, far distance perception, and abstract construal of vaccines led to more global concerns, such as vaccine safety and relevance. Such effects emerged when people considered specific vaccines, such as coronavirus disease 2019 (COVID-19), human papillomavirus (HPV), and monkeypox vaccines, and when they considered multiple vaccines in general.
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Affiliation(s)
| | - Sixiao Liu
- University of Pennsylvania, Philadelphia, USA
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19
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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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20
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Wang SM, Keegan EA, Bryan KM, Kazma J, Das KJ, Long BJ, BuAbbud A. Human papillomavirus vaccination receipt and provider counseling rates among high-risk patients. Vaccine 2023; 41:2961-2967. [PMID: 37029002 DOI: 10.1016/j.vaccine.2023.03.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE We describe provider documented counseling patterns and perception regarding HPV vaccination among patients with a history of cervical dysplasia. METHODS All patients ages 21-45 who underwent colposcopy at a single academic medical center from 2018 to 2020were sent a self-administered survey through the electronic medical record patient portal to assess their attitudes regarding human papillomavirus (HPV) vaccination. Demographic information, HPV vaccination history, and documented obstetrics and gynecology provider counseling at the time of colposcopy were examined. RESULTS Of 1465patients, 434 (29.6 %) reported or had documented receipt of at least one dose of the human papillomavirus vaccine. The remainder reported they were not vaccinated or had no documentation of vaccination. Proportion of vaccinated patients was higher among White compared to Black and Asian patients (P = 0.02). On multivariate analysis, private insurance (aOR 2.2, 95 % CI 1.4-3.7) was associated with vaccinated status while Asian race (aOR 0.4, 95 % CI 0.2-0.7) and hypertension (aOR 0.2, 95 % CI 0.08-0.7) were less likely to be associated with vaccination status. Among patients with unvaccinated or unknown vaccination status, 112 (10.8 %) received documented counseling regardingcatch-up human papillomavirus vaccination at a gynecologic visit. Patients seen by a sub-specialist obstetrics and gynecologic provider were more likely to have documented provider counseling regarding vaccination compared to those seen by a generalist obstetric/gynecologist provider (26 % vs 9.8 %, p < 0.001). Patients cited lack of physician discussion (53.7 %) and the belief that they were too old to receive the HPV vaccine (48.8 %) as the main reasons for remaining unvaccinated. CONCLUSION HPV vaccination and the rate of obstetric and gynecologic provider counseling regarding HPV vaccination among patients undergoing colposcopy remains low. When surveyed, many patients with a history of colposcopy cited provider recommendation as afactor in their decision to undergo adjuvant HPV vaccination, demonstrating the importance of provider counseling in thisgroup.
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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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Shafie AA, Moreira ED, Di Pasquale A, Demuth D, Yin JYS. Knowledge, Attitudes and Practices toward Dengue Fever, Vector Control, and Vaccine Acceptance Among the General Population in Countries from Latin America and Asia Pacific: A Cross-Sectional Study (GEMKAP). Vaccines (Basel) 2023; 11:vaccines11030575. [PMID: 36992159 DOI: 10.3390/vaccines11030575] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
Dengue represents a major public health concern. With effective vaccines in development, it is important to identify motivational factors to maximize dengue vaccine uptake. A cross-sectional, quantitative, electronic survey was administered to a nationally representative adult population (n = 3800) in Argentina, Brazil, Colombia, Mexico, Indonesia, Malaysia, and Singapore. Willingness to vaccinate against dengue, and Knowledge, Attitudes, and Practices (KAP) toward dengue, vector control, prevention, and vaccination were determined. The Capability, Opportunity, Motivation for Behavior change (COM-B) framework was used to identify factors correlated with dengue vaccine(s) uptake. KAP scores (standardized, 0–100% scale) resulted in a low global score for Knowledge (48%) and Practice (44%), and a moderate score for Attitude (66%); scores were comparable across countries. Of all respondents, 53% had a high willingness (Score: 8–10/10) to vaccinate against dengue, which was higher (59%) in Latin America (Argentina, Brazil, Colombia, Mexico) than in Asia Pacific (40%) (Indonesia, Malaysia, Singapore). Key factors significantly (p < 0.05) associated with increased willingness to vaccinate included accessibility to the public (subsidies and incentives) and trust in the healthcare system and government. A common approach to dengue prevention across endemic countries––with some country-specific customization, including education, vaccination, and vector control (multi-pronged)––may reduce dengue burden and improve outcomes.
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Affiliation(s)
- Asrul Akmal Shafie
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, George Town 11800, Malaysia
| | - Edson Duarte Moreira
- Associação Obras Sociais Irmã Dulce Hospital Santo Antônio and Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador 40420-000, Brazil
| | - Alberta Di Pasquale
- Regional Medical Affairs, Growth and Emerging Markets, Takeda Pharmaceuticals International AG Singapore Branch, Singapore 018981, Singapore
| | - Dirk Demuth
- Evidence Generation and Publications, Growth and Emerging Markets, Takeda Pharmaceuticals International AG Singapore Branch, Singapore 018981, Singapore
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Adegboyega A, Obielodan O, Wiggins AT, Dignan M, Williams LB. Beliefs and knowledge related to human papillomavirus (HPV) vaccine among African Americans and African immigrants young adults. Cancer Causes Control 2023; 34:479-489. [PMID: 36854988 DOI: 10.1007/s10552-023-01678-y] [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: 11/16/2021] [Accepted: 02/10/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Despite the disparate human papillomavirus (HPV) infection rates among sexually active Black young adults, HPV vaccine uptake remains low among this population. This study aimed to explore HPV beliefs, attitudes, and knowledge among Black young adults and provide recommendations on ways to improve vaccine uptake. METHODS We used a mixed-method, convergent design to conduct five focus groups and administered a 40-item electronic survey that was developed with health belief model (HBM) constructs. We assessed HPV and vaccine knowledge, barriers, and attitudes toward vaccination. We analyzed quantitative data using descriptive statistics and bivariate methods. Focus group transcripts were analyzed using content analysis. Results were integrated to obtain a better understanding of the topic. RESULTS Forty individuals participated in the study. The mean age was 22.2 ± 4.5 years and 55% identified as African immigrants. Integrated data revealed themes mapped to relevant HBM constructs. Almost one third (32.5%) of participants were unaware of their susceptibility to HPV infection and its severity. From focus group discussions, the majority (75%) believed that vaccines are beneficial. Major cues to action include promoting HPV vaccine uptake via community wide informational sessions, provider recommendation, and social and mass media campaigns. CONCLUSION Barriers to vaccine uptake, limited HPV knowledge, and lack of vaccine recommendation are important factors contributing to low vaccine uptake among Black young adults. Interventions to decrease barriers to HPV vaccination, increase HPV knowledge, address misconceptions, and unfavorable beliefs are needed to promote HPV vaccine uptake.
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Affiliation(s)
- Adebola Adegboyega
- College of Nursing, University of Kentucky, Lexington, KY, 40536-0232, USA.
| | | | - Amanda T Wiggins
- College of Nursing, University of Kentucky, Lexington, KY, 40536-0232, USA
| | - Mark Dignan
- Prevention Research Center, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Lovoria B Williams
- College of Nursing, University of Kentucky, Lexington, KY, 40536-0232, USA
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Dickson T, Hirko KA, Ford S. Provider Confidence and Perceived Barriers when Recommending the Human Papillomavirus Vaccine to Parents. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023:10.1007/s13187-022-02248-7. [PMID: 36737584 DOI: 10.1007/s13187-022-02248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/04/2022] [Indexed: 06/18/2023]
Abstract
Provider recommendation for the HPV vaccine is considered a critical determinant of vaccine uptake compared to other interventions such as parent education. However, providers cite continued barriers to discuss the vaccines with parents including sexual concerns and other misconceptions. The purpose of this mixed methods study was to evaluate physician knowledge and comfort discussing the vaccine with parents and perceived barriers to vaccine uptake among pediatric residents and attending physicians at a university-affiliated county health clinic. Physicians completed surveys guided by HPV Roundtable information to assess HPV vaccine knowledge, comfortability, and parental barriers to administration. A total of 28 pediatric physicians (20 residents and 8 attendings) completed the survey. HPV vaccine knowledge was high among providers in this study, with 75% of providers reporting high confidence. The majority of physicians in this study reported being comfortable or very comfortable talking to parents about the HPV vaccine (82.1%), recommending the HPV vaccine (89.3%), and recommending the HPV vaccine specifically to hesitant parents (82.1%). Attendings were more comfortable than residents talking to (p = .009) and recommending the vaccine to parents (p = .002). However, physicians reported parents' sexual concerns, vaccine safety, and misconceptions as the predominant barriers. These findings suggest that persistent stigma about the HPV vaccine as prevention for sexually transmitted infection, rather than the HPV vaccine as cancer prevention persist. Findings from this study suggest the need for HPV vaccine education for parents and provider training on targeted communication strategies.
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Affiliation(s)
- Taylar Dickson
- College of Human Medicine, Michigan State University, Flint, MI, 48502, USA
| | - Kelly A Hirko
- Department of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - Sabrina Ford
- Department of Gynecology, Obstetrics & Reproductive Biology, East Lansing, MI, 48824, USA.
- Institute for Health Policy, College of Human Medicine, Michigan State University, East Lansing, MI, 48824, USA.
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Villavicencio A, Kelsey G, Nogueira NF, Zukerberg J, Salazar AS, Hernandez L, Raccamarich P, Alcaide ML. Knowledge, attitudes, and practices towards HPV vaccination among reproductive age women in a HIV hotspot in the US. PLoS One 2023; 18:e0275141. [PMID: 36656804 PMCID: PMC9851547 DOI: 10.1371/journal.pone.0275141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the US, responsible for cervical cancer and increased risk of Human Immunodeficiency Virus (HIV) acquisition. Despite an effective HPV vaccine, women's HPV vaccination coverage and rates remain far below desired levels. This study aimed to evaluate HPV knowledge, attitudes, and vaccination practices as well as factors associated with HPV vaccination among women of reproductive age living in Miami, Florida, a Southern US city with a high incidence of STIs and low HPV vaccination coverage. METHODS From April to June 2022, 100 HIV-negative, cisgender, sexually active women aged 18-45 years were recruited from the Miami community. Participants completed validated questionnaires using REDCap© electronic surveys, assessing socio-demographics and sexual behaviors; HPV knowledge, screening, vaccination practices; barriers and motivators to HPV vaccination. A cumulative HPV knowledge score (HPV score) was generated. Factors associated with HPV vaccination were analyzed by Chi-square, Fisher's exact test, studentized t-test, and multivariate logistic regression (MLR). RESULTS A total of 100 participants were enrolled, and 84 who knew their vaccination status were included in the analysis. Of these, 43 reported receiving at least 1 HPV vaccine dose (vaccinated group) and 41 reported never being vaccinated (unvaccinated group). Mean age was 24.7 (SD 4.03) years for the vaccinated group and 31.4 (SD 8.33) for the unvaccinated group. Mean HPV score was 18.9/29 (SD 6.05) for the vaccinated group and 9.1/29 (SD 8.82) for the unvaccinated group. Amongst vaccinated participants, 76.74% reported a history of HPV/Pap smear screening vs 87.80% in the unvaccinated group. Barriers to HPV vaccination included: 14.6% low-risk perception, 29.3% healthcare barriers, and 46.3% vaccine hesitancy and personal beliefs. Motivators t HPV vaccination included: risk perception and vaccine beliefs (71.42%), healthcare-related (60.71%) and social motivators (55.95%). In the first MLR, one-point increases in HPV score were significantly associated with higher odds of HPV vaccination until an HPV score of 16, and a one-year increase in age was associated with a 16% lower odds of HPV vaccination (aOR = 0.84, 95% CI [0.72, 0.99]; p = 0.035). Contraception use was also associated with HPV vaccination (aOR 8.36 (95% CI [1.41, 49.62]; p = 0.020). Race, ethnicity, college education status, and number of sexual partners were not significant predictors of HPV vaccination. In the second MLR evaluating vaccination motivators as predictors of HPV vaccination, we found that individuals who were motivated by healthcare had 3.03 (95% CI [1.02, 9.00]; p = 0.046) times the odds of HPV vaccination compared to individuals without healthcare-related motivators. CONCLUSION Findings suggest suboptimal HPV knowledge and low vaccination rates among women of reproductive age. Public health efforts should focus on increasing basic HPV knowledge among women with little-to-no HPV knowledge to increase vaccine uptake.
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Affiliation(s)
- Aasith Villavicencio
- Division of Infectious Diseases, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Gray Kelsey
- University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Nicholas F. Nogueira
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Julia Zukerberg
- University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Ana S. Salazar
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Lucila Hernandez
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Patricia Raccamarich
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Maria Luisa Alcaide
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- * E-mail:
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Harry ML, Asche SE, Freitag LA, Sperl-Hillen JM, Saman DM, Ekstrom HL, Chrenka EA, Truitt AR, Allen CI, O'Connor PJ, Dehmer SP, Bianco JA, Elliott TE. Human Papillomavirus vaccination clinical decision support for young adults in an upper midwestern healthcare system: a clinic cluster-randomized control trial. Hum Vaccin Immunother 2022; 18:2040933. [PMID: 35302909 PMCID: PMC9009937 DOI: 10.1080/21645515.2022.2040933] [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: 12/13/2022] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) vaccination rates are low in young adults. Clinical decision support (CDS) in primary care may increase HPV vaccination. We tested the treatment effect of algorithm-driven, web-based, and electronic health record-linked CDS with or without shared decision-making tools (SDMT) on HPV vaccination rates compared to usual care (UC). METHODS In a clinic cluster-randomized control trial conducted in a healthcare system serving a largely rural population, we randomized 34 primary care clinic clusters (with three clinics sharing clinicians randomized together) to: CDS; CDS+SDMT; UC. The sample included young adults aged 18-26 due for HPV vaccination with a study index visit from 08/01/2018-03/15/2019 in a study clinic. Generalized linear mixed models tested differences in HPV vaccination status 12 months after index visits by study arm. RESULTS Among 10,253 patients, 6,876 (65.2%) were due for HPV vaccination, and 5,054 met study eligibility criteria. In adjusted analyses, the HPV vaccination series was completed by 12 months in 2.3% (95% CI: 1.6%-3.2%) of CDS, 1.6% (95% CI: 1.1%-2.3%) of CDS+SDMT, and 2.2% (95% CI: 1.6%-3.0%) of UC patients, and at least one HPV vaccine was received by 12 months in 13.1% (95% CI: 10.6%-16.1%) of CDS, 9.2% (95% CI: 7.3%-11.6%) of CDS+SDMT, and 11.2% (95% CI: 9.1%-13.7%) of UC patients. Differences were not significant between arms. Females, those with prior HPV vaccinations, and those seen at urban clinics had significantly higher odds of HPV vaccination in adjusted models. DISCUSSION CDS may require optimization for young adults to significantly impact HPV vaccination. TRIAL REGISTRATION clinicaltrials.gov NCT02986230, 12/6/2016.
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Chido-Amajuoyi OG, Talluri R, Jackson I, Shete SS, Fokom Domgue J, Shete S. The influence of parent-child gender on intentions to refuse HPV vaccination due to safety concerns/side effects, National Immunization Survey - Teen, 2010-2019. Hum Vaccin Immunother 2022; 18:2086762. [PMID: 35797721 PMCID: PMC9621054 DOI: 10.1080/21645515.2022.2086762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/01/2022] [Indexed: 12/20/2022] Open
Abstract
Amid subpar uptake of HPV vaccination in the United States, gender-generated disparities in HPV vaccination uptake have the potential to perpetuate existing disparities in HPV-associated cancers. Yet few studies have investigated the influence of parent-child gender on intentions to refuse HPV vaccination due to safety concerns/side effects. This study used nationally representative data, spanning 2010-2019, from the National Immunization Survey-Teen (NIS-Teen). NIS-Teen respondents are parents/guardians or primary caregivers of adolescents 13-17 years old living in the United States. Over the study period, intentions to refuse HPV vaccination due to safety concerns rose among all parent-child gender pairings but were highest among respondent mothers regarding their unvaccinated daughters. The results revealed a statistically significant increased likelihood of having intentions to refuse HPV vaccination due to safety concerns among all parent-child combinations compared with father-son pairs. These odds were consistently highest among mother-daughter pairs. In 2019, compared with father-son pairs, fathers were 1.94 (95% CI: 1.21-3.12) times more likely to report the intention to not vaccinate against HPV for their daughters, while mothers were 2.23 (95% CI: 1.57-3.17) and 2.87 (95% CI: 2.02-4.09) times more likely to report intentions to refuse HPV vaccination for their sons and daughters, respectively. These findings were persistent and constantly increased over the 10-year study period. Interventions aimed at correcting gender-based misperceptions and countering misinformation about the safety of the HPV vaccine are warranted.
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Affiliation(s)
| | - Rajesh Talluri
- Department of Data Science, The University of Mississippi Medical Center, Jackson, MS, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Inimfon Jackson
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Sahil S. Shete
- Department of Psychology and Counseling, The University of Texas at Tyler, Tyler, TX, USA
| | - Joël Fokom Domgue
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Harper DM, Rego R, Tariq M, Patel MR, Resnicow K, Sheinfeld Gorin S. HPV vaccination initiation among white, black and Middle East North African (MENA) males. Prev Med Rep 2022; 30:102029. [PMID: 36281349 PMCID: PMC9587522 DOI: 10.1016/j.pmedr.2022.102029] [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: 06/15/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives US males initiate HPV vaccination at older ages than females and currently have low population coverage. We aim to describe the prevalence and predictors of HPV vaccination initiation among males of White, Black, and Middle-Eastern/North-African (MENA) descent in southeast Michigan. Methods We conducted three community-based surveys in 2019 that provided primary data via self report. Using population weights and multivariate modeling, we measured the prevalence and predictors of HPV vaccine initiation in each race/ethnicity of men (age 18–34 years) analyzed. Results The vaccine initiation rates were 44.5 % (95 % CI: 44.4, 44.6) for White men, 46.2 % (46.0, 46.4) for Black men, and 23.2 % (22.8, 23.6) for MENA men, (p < 0.001). Being a student, compared to unemployed or disabled, was significantly associated with HPV vaccine initiation across all three races/ethnicities. Married men of any race/ethnicity were unlikely to be vaccinated. MENA men born in the US and having some college education were also more likely to initiate HPV vaccination. Conclusions White, Black, and MENA men are not vaccinated in accord with Healthy (Healthy People 2030, 2022) goals. Each race/ethnicity has different predictors of vaccination.
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Affiliation(s)
- Diane M. Harper
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States,Department of Obstetrics & Gynecology, University of Michigan School of Medicine, Ann Arbor, MI, United States,Department of Women's Studies, University of Michigan, College of Literature, Science and the Arts, Ann Arbor, MI, United States,Corresponding author at: Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States..
| | - Ryan Rego
- Center for Global Health Equity, University of Michigan School of Medicine, Ann Arbor, MI, United States
| | - Madiha Tariq
- Arab Community Center for Economic and Social Services (ACCESS), Dearborn, MI, United States
| | - Minal R. Patel
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Arbor, MI, United States
| | - Kenneth Resnicow
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Arbor, MI, United States,Outreach and Health Disparities Research, University of Michigan Rogel Cancer Center, Ann Arbor, MI, United States,Center for Health Communications Research, University of Michigan, School of Public Health, Ann Arbor, MI, United States
| | - Sherri Sheinfeld Gorin
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States,Department of Health Behavior & Health Education, University of Michigan School of Public Health, Arbor, MI, United States
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Kanmodi KK, Salami AA, Nwafor JN, Olomo CA, Nnyanzi LA. Trend Analysis of Global Web Searches (2004–2022) on Oral Cancer and Its Major Risk Factors. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1756479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background Oral cancer is the 15th leading cause of mortality globally. The Internet is an online source of information pertaining to oral cancer and its major risk factors. This study aims to analyze the trend of global online interest on oral cancer and its major risk factors through an analysis of web searches of oral cancer.
Materials and Methods This study analyzed the web searches conducted, from 2004 to January 2022, on oral cancer and its major risk factors (tobacco use, harmful alcohol use, and human papillomavirus [HPV] infection) using data obtained from Google Trends.
Results Within the time frame under study, oral cancer had multiple peak search periods, with the highest relative search volume index (SVI) for a period being 1; the peak search period for alcohol was March 2020 (SVI = 100); the peak search periods for tobacco were March to April 2004 (SVI = 17); and the peak search period of HPV was April 2004 (SVI = 1). Globally, alcohol was the most common searched term among these four terms (oral cancer, alcohol, tobacco, and HPV) except in Turkey where tobacco was the most common (55%) searched term. The top 25 search queries for oral cancer, HPV, tobacco, and alcohol had SVI ranges of 22 to 100, 12 to 100, 28 to 100, and 18 to 100, respectively. From these search queries, it was observed that people have interest in oral cancer symptomatology, and the adverse effects of tobacco, alcohol, and HPV.
Conclusion This study revealed an overall decline in the online interest on oral cancer and its major risk factors on a global scale.
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Affiliation(s)
- Kehinde Kazeem Kanmodi
- Oral Health Working Group (Health Students Research Network), School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
| | - Afeez Abolarinwa Salami
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria
| | - Jacob Njideka Nwafor
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Department of Medicine, Nottingham University Hospital NHS Trust, Nottingham, United Kingdom
| | - Charles Adetokunbo Olomo
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Department of Oral Pathology/Oral Medicine, University College Hospital, Ibadan, Nigeria
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Lawrence Achilles Nnyanzi
- Oral Health Working Group (Health Students Research Network), School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
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Castañeda-Avila MA, Oramas Sepúlveda CJ, Pérez CM, Ramos-Cartagena JM, Acosta Pagán K, Pérez-Santiago J, Godoy-Vitorino F, Ortiz AP. Sex and educational attainment differences in HPV knowledge and vaccination awareness among unvaccinated-sexually active adults in Puerto Rico. Hum Vaccin Immunother 2022; 18:2077065. [PMID: 35695750 PMCID: PMC9481100 DOI: 10.1080/21645515.2022.2077065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Human papillomavirus (HPV) knowledge and HPV vaccination uptake remain suboptimal. We assessed sex and educational attainment differences in HPV knowledge and vaccine awareness. Data from a cross-sectional study (2018–2021) in Puerto Rico among adults aged 21–49 was analyzed (n = 278). Adequate knowledge was defined as a score of ≥70% of correct responses on a 13-item knowledge scale. Multivariable logistic regression was used to assess the association of sex (men vs. women) and education (high school or less vs. more than high school) categories with adequate HPV knowledge and vaccine awareness. Adequate HPV knowledge was higher among women (53%) and men (46%) with more than high school and was lower among women (46%) and men (27%) with high school or less. For HPV vaccine awareness, similar results were observed. Women (OR = 3.0 ; 95%CI = 1.4–6.2) and men (OR = 2.3 , 95%CI = 1.1–4.8) with more than high school and women with high school or less (OR = 2.3 , 95%CI = 1.0–5.2) were more likely to have adequate HPV vaccine knowledge than men with high-school or less education. Heightened HPV vaccine awareness was also seen among more educated women and men and women with similar lower education when compared to men with ≤ high school. Men and individuals with lower educational attainment were more likely to have inadequate HPV knowledge and vaccine awareness. HPV vaccine-oriented educational interventions should target these high-risk groups.
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Affiliation(s)
- Maira A Castañeda-Avila
- Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Carla J Oramas Sepúlveda
- Division of Cancer Control and Population Sciences, Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Cynthia M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - Jeslie M Ramos-Cartagena
- University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research, University of Puerto Rico, San Juan, Puerto Rico
| | - Kimil Acosta Pagán
- Department of Microbiology and Medical Zoology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Josué Pérez-Santiago
- Division of Cancer Control and Population Sciences, Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Filipa Godoy-Vitorino
- Department of Microbiology and Medical Zoology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Ana P Ortiz
- Division of Cancer Control and Population Sciences, Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.,Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
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Trends in HPV and HPV Vaccine Awareness among Gay and Bisexual Males in the U.S. Vaccines (Basel) 2022; 10:vaccines10040604. [PMID: 35455355 PMCID: PMC9032332 DOI: 10.3390/vaccines10040604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/01/2023] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (US). It is often discussed within the context of women’s sexual health due to its association with cervical cancer. However, HPV is also associated with other cancers and conditions which affect men. Gay and bisexual males (GBM) in the US have higher risks of HPV infection and a higher incidence of HPV-associated anal cancer than heterosexual males. In addition, GBM in the US have a higher prevalence of some high-risk strains of HPV than in other regions. HPV vaccination is highly effective at preventing HPV-associated cancers and genital warts. Several resources have been directed towards improving HPV awareness in the US over the past couple of years to improve vaccination rates. Given the low rates of HPV vaccination among GBM in the US, this study aimed to assess the trends in HPV and HPV vaccine awareness using a nationally representative sample of GBM. We found an overall increase in HPV and HPV vaccine awareness between 2017 and 2020. However, the sociodemographic differences in awareness levels highlight the need for more interventions to improve vaccination rates, especially in this high-risk population.
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Abuduxike G, Asut O, Cali S, Vaizoglu S. Knowledge and Awareness of Parents Towards Human Papillomavirus (HPV) and HPV Vaccines, and Vaccine Acceptability in Northern Cyprus. JOURNAL OF PREVENTION (2022) 2022; 43:225-240. [PMID: 35286543 DOI: 10.1007/s10935-021-00657-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
The human papillomavirus (HPV) vaccine is one of the most cost-effective public health measures for preventing cervical cancer and other HPV-related diseases. However, the vaccine uptake in many countries remains suboptimal. This cross-sectional study aimed to assess the knowledge and awareness of parents towards HPV, related diseases, and HPV vaccines, as well as to examine the effect of brief educational information on parents' vaccine acceptability. We used a structured interviewer-administered questionnaire to collect information from 227 outpatient visitors to a healthcare center who had children under the age of 19 years. We asked parents again about their acceptance of HPV vaccines after being provided brief educational information. Of all the parents, 43% were aware of HPV and related diseases, and 59% of those had sufficient knowledge regarding HPV while 45% of them reported that they were aware of HPV vaccines. Being Northern Cypriot was a predictor of having good knowledge, whilst being a female, having a higher education level, being 35 years or older, and being employed were the significant predictors of having greater awareness of HPV and related diseases. The HPV vaccine acceptance of the parents increased substantially in all sociodemographic groups after the provision of the educational information. The findings demonstrated that the vaccination rates of children of parents who have insufficient knowledge and awareness of HPV and vaccines are also very low. Effective educational interventions based on the specific sociodemographic characteristics of the patients should be given a stronger focus to improve vaccine acceptability among this population.
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Affiliation(s)
- Gulifeiya Abuduxike
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus.
| | - Ozen Asut
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
| | - Sanda Cali
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
| | - Songul Vaizoglu
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
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Logel M, Laurie C, El-Zein M, Guichon J, Franco EL. A review of ethical and legal aspects of gender-neutral human papillomavirus vaccination. Cancer Epidemiol Biomarkers Prev 2022; 31:919-931. [PMID: 35247878 DOI: 10.1158/1055-9965.epi-21-1256] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/12/2022] [Accepted: 02/25/2022] [Indexed: 12/24/2022] Open
Abstract
While launching a campaign to eliminate cervical cancer, the World Health Organization called to halt human papillomavirus (HPV) gender-neutral vaccination (GNV) because of limited vaccine supply, raising ethical and legal questions about female-only vaccination versus GNV. We identified ethical and legal aspects of HPV GNV by searching MEDLINE for records up to February 19, 2021. We also provided an overview of HPV vaccines, the evolution of HPV vaccine recommendations in North America, and a timeline of male HPV vaccination introduction by searching PubMed, Google, and government websites. Four HPV vaccines are available: Cervarix®, Gardasil®, Gardasil®9, and Cecolin®. Vaccine recommendations in North America evolved from female only to eventually include males. Following the Food and Drug Administration's approval of the first HPV vaccine for males (2009), 35 countries began vaccinating males (2011-2020). Based on 56 eligible records out of 652, we identified the following constructs: lower male awareness of HPV and vaccination (n=13), limited economic resources (n=5), shared social responsibility (n=18), unprotected groups from female-only HPV vaccination (n=10), limited screening for HPV-associated noncervical cancers (n=6), consideration of ethical principles (n=17), and HPV vaccine mandates (n=5). Ethical and legal aspects must be considered when recommending vaccination for females only or GNV.
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Zhang X, Chen H, Zhou J, Huang Q, Feng XY, Li J. Impact of web-based health education on HPV vaccination uptake among college girl students in Western and Northern China: a follow-up study. BMC Womens Health 2022; 22:46. [PMID: 35197068 PMCID: PMC8864209 DOI: 10.1186/s12905-022-01625-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/08/2022] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate the effect of a web-based educational intervention on changing female college students’ willingness and uptake of human papillomavirus (HPV) vaccines, and factors associated with HPV vaccination acceptance in Western and Northern China. Methods A web-based cluster randomized controlled trial was conducted in Western and Northern China from February to May 2020. A total of 967 female freshmen were recruited from two universities through convenience sampling, stratified sampling (liberal arts or sciences), and cluster sampling. Eligible students were randomized into intervention and control group with a 1:1 allocation ratio. The intervention group received seven days of web-based health education regarding HPV and HPV vaccines, whereas the control group received non-HPV-related materials. All students were asked to complete a post-intervention questionnaire to measure their awareness, uptake, and willingness to receive HPV vaccination at 7-day and one-month intervals. The chi-square test and Student’s t-test were employed to examine the differences between the intervention and control groups for categorical and continuous data. Logistic regressions were used to analyze factors associated with vaccination intentions. Results Nine hundred forty-six female freshmen aged 18.99 ± 0.63 years were enrolled in the study, with 532 in the intervention group and 414 in the control group. Prior to the intervention, 63.8%, 66.3%, and 60.8% of students had heard of HPV, HPV-related diseases, and HPV vaccines, respectively. Only 2.2% of students reported being vaccinated, but 33.0% were willing to be vaccinated against HPV. After seven days of education, students in the intervention group exhibited higher awareness (p < 0.001) and knowledge scores (5.13 ± 1.23 vs. 3.10 ± 1.99, p < 0.001) than those in the control group. Similarly, in the intervention groups, willingness to be vaccinated against HPV was significantly higher than in the control groups (p < 0.001). The high cost (57.7%) and concerns about adverse events (56.0%) were the main reasons female college students did not accept HPV vaccines. School location in urban areas, parents’ higher education backgrounds, history of HPV vaccination counseling, history of sexual behavior, and having heard of HPV vaccines were associated with a higher willingness to be vaccinated. Conclusion Female college students’ HPV vaccination uptake is insufficient, and they have minimal detailed knowledge about HPV and its vaccines. Web-based health education on HPV vaccines is an easy, feasible, and effective way to improve the awareness and acceptance of HPV vaccination among female college students, but it has limited effect on HPV vaccination uptake. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01625-0.
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Affiliation(s)
- Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Hui Chen
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Jing Zhou
- Chenghua District Center for Disease Control and Prevention, Chengdu, 610057, China
| | - Qian Huang
- Student Affairs Department, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiao-Yu Feng
- Shanxi University of Finance and Economics, Taiyuan, 030006, China
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
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Chido-Amajuoyi OG, Talluri R, Shete SS, Shete S. Safety Concerns or Adverse Effects as the Main Reason for Human Papillomavirus Vaccine Refusal: National Immunization Survey-Teen, 2008 to 2019. JAMA Pediatr 2021; 175:1074-1076. [PMID: 34180965 PMCID: PMC8240004 DOI: 10.1001/jamapediatrics.2021.1585] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This secondary analysis assesses safety concerns and adverse effects as reported reasons for HPV vaccine refusal.
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Affiliation(s)
| | - Rajesh Talluri
- Department of Data Science, The University of Mississippi Medical Center, Jackson
| | - Sahil S. Shete
- Department of Psychology and Counseling, The University of Texas at Tyler
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston,Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston,Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
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Torabi SJ, Su-Velez BM, Kasle DA, Yarbrough WG, St John M, Judson BL. Assessing Human Papillomavirus Awareness and the Role of Oropharyngeal Squamous Cell Carcinoma Education on Improving Intention to Vaccinate. Laryngoscope 2021; 132:528-537. [PMID: 34383306 DOI: 10.1002/lary.29805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/27/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES/HYPOTHESIS The current state of the U.S. public's knowledge of the relationship between human papillomavirus (HPV) and HPV vaccinations to oropharyngeal squamous cell carcinoma (OPSCC) is unknown. Our objective was to 1) assess the general population's knowledge of human papillomavirus (HPV) and willingness to vaccinate, and 2) assess whether targeted education on HPV-related OPSCC can change intentions to vaccinate. STUDY DESIGN Online cross-sectional survey. METHODS An online, cross-sectional survey utilizing U.S. census-derived quotas to represent the U.S. population was distributed and analyzed to 517 adults in 2020. RESULTS Exactly 72.7% of participants stated that they had or would vaccinate their child against HPV and were designated as "vaccinators." In multivariate regression, Black individuals were less likely to be vaccinators (OR 0.51 [95% CI 0.27-0.94]), but those who were aware of HPV's role in OPSCC were more likely to vaccinate (OR 2.56 [95% CI 1.47-4.46]). Knowledge about vaccination side-effects, eligibility, and mechanisms of HPV spread was low. Only 30.6% of the sample reported understanding the role of HPV in OPSCC. Of these, 43.0% gained this knowledge exclusively from nonhealthcare professional sources, like television. When presented with four short HPV-OPSCC-centered facts (HPV's role in OPSCC etiology, prevalence of infection, clinically silent course, and vaccine preventative effects), 54.0% of "nonvaccinators" indicated a willingness to change their minds. CONCLUSIONS General knowledge about HPV, HPV's role in OPSCC, and the vaccine remains low in the general population. There are racial disparities in willingness to vaccinate within this sample, but these may be overcome by effective education on HPV-related OPSCC. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Sina J Torabi
- Department of Surgery (Section of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, U.S.A.,Depart of Otolaryngology - Head and Neck Surgery, University of California, Irvine, Orange, California, U.S.A
| | - Brooke M Su-Velez
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, California, U.S.A
| | - David A Kasle
- Department of Surgery (Section of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Wendell G Yarbrough
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A.,Department of Pathology, UNC School of Medicine, Chapel Hill, North Carolina, U.S.A.,Lineberger Comprehensive Cancer Center, UNC School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Maie St John
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, California, U.S.A.,UCLA Head and Neck Cancer Program, David Geffen School of Medicine at University of California, Los Angeles, California, U.S.A
| | - Benjamin L Judson
- Department of Surgery (Section of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, U.S.A.,Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, U.S.A
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Milecki T, Michalak M, Milecki J, Michalak M, Kadziszewski R, Kuncman Ł, Jarzemski P, Milecki P, Antczak A. Polish Medical Students' Knowledge Regarding Human Papillomavirus's Ways of Transmission, Risk of Cancer Development and Vaccination, and Their Intention to Recommend Vaccination. Vaccines (Basel) 2021; 9:vaccines9070776. [PMID: 34358192 PMCID: PMC8310167 DOI: 10.3390/vaccines9070776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: Human papillomavirus (HPV) is associated with six types of cancer in men and women. A vaccine against HPV, preferably administered before initial sexual intercourse, has been proven to be highly effective in preventing these cancers. An effective healthcare provider recommendation has significant influence on HPV vaccine uptake; therefore, it is critical that medical students receive comprehensive training in this area. Aim: The aim of the study was to assess the knowledge of medical students regarding Human Papillomavirus’s (HPV) ways of transmission, risk of cancer development, and vaccination against HPV. This study also investigated factors among medical students that would affect their intention to recommend HPV vaccination to others. Materials and Methods: The study was conducted among 1061 (678 women and 383 men) medical students who filled in our questionnaire. The medical students were divided into two subgroups: (1) pre-clinical medical students (MS pre-clinical; first-to third-year students; n = 683) and (2) clinical medical students (MS clinical; fourth-to six-year students; n = 378). Results: A total259 (24.41%) of the 1061 medical students were vaccinated against HPV. We found a significant improvement in the general level of knowledge in the later years of education (4–6) compared to the early years of education (1–3). However, it was demonstrated that, despite medical education advancements, there are still significant gaps of knowledge about the relationship between HPV infection and cancers other than cervical cancer, as well as in relation to the routes by which HPV is transmitted. Medical students’ intentions to recommend HPV vaccine to others were related to their own HPV-related knowledge and their own vaccination status. Conclusion: Medical students have gaps of knowledge regarding particular issues and aspects of HPV. It is necessary to further educate medical students in the field of prevention and in the treatment of lesions caused by HPV infection. Medical students’ intention to recommend the HPV vaccine can be improved by including them and members of their families in the HPV vaccination program.
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Affiliation(s)
- Tomasz Milecki
- Department of Urology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.); (J.M.); (R.K.); (A.A.)
- Correspondence:
| | - Maciej Michalak
- Department of Urology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.); (J.M.); (R.K.); (A.A.)
| | - Jakub Milecki
- Department of Urology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.); (J.M.); (R.K.); (A.A.)
| | - Michał Michalak
- Department of Computer Sciences and Statistics, University of Medical Sciences, 61-701 Poznan, Poland;
| | - Radosław Kadziszewski
- Department of Urology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.); (J.M.); (R.K.); (A.A.)
| | - Łukasz Kuncman
- Department of Radiotherapy, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Piotr Jarzemski
- Department of Urology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus Univeristy in Torun, 87-100 Torun, Poland;
| | - Piotr Milecki
- Department of Electro–Radiology, University of Medical Sciences, 61-701 Poznan, Poland;
- Radiotherapy Department, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Andrzej Antczak
- Department of Urology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.); (J.M.); (R.K.); (A.A.)
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Deshmukh AA, Suk R, Shiels MS, Damgacioglu H, Lin YY, Stier EA, Nyitray AG, Chiao EY, Nemutlu GS, Chhatwal J, Schmeler K, Sigel K, Sonawane K. Incidence Trends and Burden of Human Papillomavirus-Associated Cancers Among Women in the United States, 2001-2017. J Natl Cancer Inst 2021; 113:792-796. [PMID: 32833021 PMCID: PMC8168114 DOI: 10.1093/jnci/djaa128] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/03/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023] Open
Abstract
Human papillomavirus (HPV)-associated anal and oropharyngeal cancer incidence has increased in recent years among US women. However, trends in incidence and burden (annual number of cases) of noncervical HPV-associated cancers relative to cervical cancer remain unclear. Using the 2001-2017 US cancer statistics dataset, we evaluated contemporary incidence trends and burden (annual number of cases) of HPV-associated cancers among women by anatomic site, race or ethnicity, and age. Overall, cervical cancer incidence plateaued among White women but continued to decline among Black and Hispanic women. Anal cancer incidence surpassed cervical cancer incidence among White women aged 65-74 years of age (8.6 and 8.2 per 100 000 in 2015) and 75 years or older (6.2 and 6.0 per 100 000 in 2014). The noncervical cancer burden (n = 11 871) surpassed the cervical cancer burden (n = 11 527) in 2013. Development of efficacious screening strategies for noncervical cancers and continued improvement in cervical cancer prevention are needed to combat HPV-associated cancers among women.
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Affiliation(s)
- Ashish A Deshmukh
- Center for Health Services Research, Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, USA
| | - Ryan Suk
- Center for Health Services Research, Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, USA
| | - Meredith S Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Haluk Damgacioglu
- Center for Health Services Research, Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, USA
| | - Yueh-Yun Lin
- Center for Health Services Research, Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, USA
| | - Elizabeth A Stier
- Department of Obstetrics and Gynecology, Boston Medical Center/Boston University School of Medicine, Boston, MA, USA
| | - Alan G Nyitray
- Clinical Cancer Center/Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Elizabeth Y Chiao
- Department of General Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Gizem S Nemutlu
- Massachusetts General Hospital Institute for Technology Assessment, Harvard Medical School, Boston, MA, USA
| | - Jagpreet Chhatwal
- Massachusetts General Hospital Institute for Technology Assessment, Harvard Medical School, Boston, MA, USA
| | - Kathleen Schmeler
- Department of Gynecological Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Keith Sigel
- Department of General Internal Medicine, Mt. Sinai Icahn School of Medicine, New York, NY, USA
- Department of Medicine, Mt. Sinai Icahn School of Medicine, New York, NY, USA
| | - Kalyani Sonawane
- Center for Health Services Research, Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, USA
- Center for Healthcare Data, Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, USA
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Chido-Amajuoyi OG, Talluri R, Wonodi C, Shete S. Trends in HPV Vaccination Initiation and Completion Within Ages 9-12 Years: 2008-2018. Pediatrics 2021; 147:peds.2020-012765. [PMID: 33941585 PMCID: PMC8785751 DOI: 10.1542/peds.2020-012765] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Routine human papillomavirus (HPV) vaccination is recommended at ages 11 to 12 years and may be initiated as early as 9 years of age. METHODS Data were derived from the National Immunization Survey-Teen, spanning 2008-2018. Using health care provider-verified vaccination histories, we examined trends in human papillomavirus vaccination up-to-date (HPV-UTD) rates within ages 9 to 12 years. Furthermore, we assessed vaccination status by sociodemographic factors and US state of residence. RESULTS Overall, amid evidence of recent stagnation, HPV vaccination between ages 9 to 12 increased over the years. Initiation rates rose from 17.3% in 2008 to 62.8% in 2018, and HPV-UTD rates rose from 13.5% in 2011 to 32.8% in 2018. After the inception of gender-neutral HPV vaccination, HPV-UTD rates between 2011 and 2018 rose by 31.9% among boys and only 6.6% among girls. For most of the study period, non-Hispanic Black and Hispanic individuals had higher rates of initiation and HPV-UTD than non-Hispanic white individuals. In 2018, vaccination initiation rates exceeded 70% in several states; however, HPV-UTD rates in most US states were <50%, excluding Rhode Island (61.6%), Colorado (58.7%), Hawaii (53.5%), District of Columbia (53.2%), and Ohio (50%). CONCLUSIONS HPV vaccination within ages 9 to 12 years is suboptimal. To leverage the substantial benefits of HPV vaccination within this age range, it is imperative that conscious efforts are taken at the national and state levels to promote HPV vaccination for this age group.
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Affiliation(s)
| | - Rajesh Talluri
- Department of Data Science, University of Mississippi
Medical Center, Jackson, Mississippi; and,Contributed equally as co-first authors
| | - Chizoba Wonodi
- Department of International Health, Bloomberg School
of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sanjay Shete
- Departments of Epidemiology and .,Biostatistics and.,Division of Cancer Prevention and Population Sciences, The University of Texas and Maryland Anderson Cancer Center, Houston, Texas
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Boatman DD, Eason S, Conn ME, Kennedy-Rea SK. Human Papillomavirus Vaccine Messaging on TikTok: Social Media Content Analysis. Health Promot Pract 2021; 23:382-387. [PMID: 33969725 PMCID: PMC8578596 DOI: 10.1177/15248399211013002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The human papillomavirus (HPV) vaccine is viewed as a critical tool to protect against six HPV-related cancers. Vaccination is recommended from early adolescence through age 26 years. As young people have become increasingly involved in personal health-related decisions, there is a need to tailor HPV vaccine messaging and reach this priority population on social media and digital outlets. TikTok is a growing social media platform with approximately 70% of its users between the ages of 13 and 24 years. PURPOSE The aim of this study was to understand HPV vaccine messaging and interactions on TikTok as a needed first step to identifying effective strategies to reach young people with important health messaging. METHODS Content analysis was performed on 170 top TikToks focused on the HPV vaccine. TikToks were assessed for content, classification type, and number of interactions. RESULTS Most TikToks were provaccine, while antivaccine TikToks had more user interactions. Cancer and prevention were the main content areas of the analyzed provaccine TikToks, while the side effects were the primary focus of antivaccine messages. Approximately 30% of all top TikToks analyzed were developed by health professionals. TikToks without an explicit vaccine opinion primarily described personal experiences and mentioned side effects most often. IMPLICATIONS TikTok is a growing social media platform that can be used to reach young people and encourage HPV vaccine uptake. Health professionals need to consider the interest that users have in personal experiences and address antivaccine narratives related to side effects.
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Affiliation(s)
| | - Susan Eason
- West Virginia University Cancer Institute, Morgantown, WV, USA
| | - Mary Ellen Conn
- West Virginia University Cancer Institute, Morgantown, WV, USA
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Yin G, Zhang Y, Chen C, Ren H, Guo B, Zhang M. Have you ever heard of Human Papillomavirus (HPV) vaccine? The awareness of HPV vaccine for college students in China based on meta-analysis. Hum Vaccin Immunother 2021; 17:2736-2747. [PMID: 33787459 DOI: 10.1080/21645515.2021.1899731] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: To evaluate the awareness of College Students (CSs) of HPV vaccine in China and provide evidence-based recommendations for HPV vaccine's publicity and promotion.Methods: Web of Science, PubMed, Science of Direct, EBSCO, China National Knowledge Infrastructure and Wanfang Data were searched. A random effects meta-analysis was conducted to determine pooled estimates of Awareness Rate (AR) for HPV vaccine.Results: Of the 36 studies included, the estimated AR of HPV vaccine was 40.27% (95% CI: 30.86%, 50.06%) among Chinese CSs. The AR of HPV vaccine was stratified by factors as gender, major, area, city, survey time, and sampling method of the study. The pooled AR of HPV vaccine among CSs was as follows: 44.17% (95% CI: 31.65%, 57.09%) and 31.93% (95% CI: 13.25%, 54.30%) for females and males; 44.47% (95% CI: 29.90%, 59.55%) and 12.02% (95% CI: 7.69%, 17.15%) for medical-related and nonmedical majors; 44.47% (95% CI: 28.71-60.82%) and 41.16% (95% CI: 26.48-56.64%) for Eastern and Midwestern region; 48.86% (95% CI: 30.63-67.25%) and 33.19% (95% CI: 22.27-45.12%) for first-tier and second- and third-tier city; 29.67 (95% CI: 11.44-52.16%) and 38.81 (95% CI: 27.14-51.21%) for AR before and after HPV vaccine entered in China; 51.51% (95% CI: 32.21%, 70.53%) and 26.21% (95% CI: 17.41%, 36.10%) for nonrandom and random sampling.Conclusion: This review indicates that awareness of HPV vaccine among CSs remains relatively low in China compared with European countries. Our findings may provide useful information to better understand the HPV vaccine awareness status among Chinese CSs.
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Affiliation(s)
- Gang Yin
- Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yulin Zhang
- Department of Business Administration, School of Economics and Management, Wuchang Institute of Technology, Wuhan, China
| | - Chaoyi Chen
- Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huayu Ren
- Department of Ideological and Political Education, School of Marxism, Harbin Medical University, Harbin, China
| | - Botang Guo
- Department of Medical Psychology, School of Health Management, Harbin Medical University, Harbin, China
| | - Meng Zhang
- Department of Ideological and Political Education, School of Marxism, Harbin Medical University, Harbin, China
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Villa A, Chmieliauskaite M, Patton LL. Including vaccinations in the scope of dental practice: The time has come. J Am Dent Assoc 2021; 152:184-186. [PMID: 33436264 PMCID: PMC7796798 DOI: 10.1016/j.adaj.2020.09.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/15/2020] [Accepted: 09/19/2020] [Indexed: 11/27/2022]
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