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Wang Y, Chen Y, Bao S. The impact of exposure to HPV related information and injunctive norms on young women's intentions to receive the HPV vaccine in China: A structural equation model based on KAP theory. Front Public Health 2023; 10:1102590. [PMID: 36726620 PMCID: PMC9884697 DOI: 10.3389/fpubh.2022.1102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/29/2022] [Indexed: 01/18/2023] Open
Abstract
Background The HPV vaccination is a crucial line of defensing against cervical cancer. As a result of government support and positive publicity from the majority of media, a craze for HPV vaccination has occurred in China. Besides, the intentions to get the HPV vaccine among women of appropriate age is also influenced by families' and friends' attitudes and perceptions toward HPV vaccine. Therefore, the purpose of this study was to investigate how HPV related information exposure and injunctive norms affect young Chinese women's intentions to receive the HPV vaccine. Methods A structural equation model was developed based on KAP theory, and 567 effective questionnaires were collected through an online survey. We used SPSS 26.0 for the reliability and validity analysis and the differential testing of demographic characteristics, and Amos 26.0 for the goodness-of-fit analysis and paths testing of the model. Results Our findings showed that (1) intention to receive HPV vaccine differed significantly in age (P = 0.046), educational background (P = 0.001), and occupation (P = 0.004). (2) Exposure to HPV related information positively affected knowledge about HPV (β = 0.316, P < 0.001) and intention to receive HPV vaccine (β = 0.141, P < 0.001). (3) Knowledge about HPV positively affected attitude toward HPV vaccine (β=0.341, P < 0.001), but negatively affected intention to receive HPV vaccine (β = -0.148, P < 0.05), and attitude toward HPV vaccine positively affected intention to receive HPV vaccine (β = 0.594, P < 0.001). (4) Injunctive norms positively affected attitude toward HPV vaccine (β = 0.362, P < 0.001) and intention to receive HPV vaccine (β = 0.420, P < 0.001). Conclusions Exposure to HPV related information influenced young Chinese women's intentions to receive the HPV vaccine and related knowledge, that is, the more frequently they were exposed to HPV related information, the stronger their intentions to receive the vaccine and the higher their HPV knowledge. Also, the perception and support of HPV vaccination by people around them will further influence their attitudes and intentions to receive the HPV vaccine.
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Low Response to the COVID-19 Vaccine Among the Arab Population in Israel: Is It a Cultural Background, or a Systemic Failure, or Maybe Both? J Racial Ethn Health Disparities 2023; 10:296-305. [PMID: 34984653 PMCID: PMC8725966 DOI: 10.1007/s40615-021-01220-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/01/2021] [Accepted: 12/17/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION A low response to COVID-19 vaccination was observed among the Arab population in Israel. Efforts to improve this achieved moderate results. OBJECTIVES The aim of this study was to examine the extent to which demographic and cultural factors, the media, trust, perceptions, and government policies influence the willingness of Arabs to be vaccinated against COVID-19. METHODS A cross-sectional survey was conducted among Israeli Arabs (558 respondents). The questionnaire was distributed through social networks between January 16 and 26, 2021. The t-tests, Chi-square tests, Z tests, which were used to evaluate the significance of variables, and Pearson correlations calculated for the study variables were used for statistical analysis. Hierarchical logistic regression was calculated to assess the extent of background influence on the odds for vaccination, and mediation was examined using the Process procedure. RESULTS Moderate means were found for attitudes towards vaccination, vulnerability, vaccine effectiveness, and pandemic fatigue. A lower score was found for accessibility to medical services, social norms, and emotional barriers. Trust was highest in health-related authorities, whereas trust in government and the media was the lowest. Higher pandemic fatigue was associated with lower trust and lower odds for vaccination. DISCUSSION Lack of awareness of the specific needs of the Arab minority in Israel, lack of vaccination campaigns in Arabic language, long neglect of Arabs in the Israeli health system, mistrust of governmental authorities by the Arabs, and low socioeconomic background of Israeli Arabs might have led to lower trust levels and incompliance with governmental policies among Arabs. Addressing these issues may benefit the entire population. The authors believe that "A chain (in population health) is only as strong as its weakest link."
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Fish LJ, Harrison SE, McDonald JA, Yelverton V, Williams C, Walter EB, Vasudevan L. Key stakeholder perspectives on challenges and opportunities for rural HPV vaccination in North and South Carolina. Hum Vaccin Immunother 2022; 18:2058264. [PMID: 35439108 PMCID: PMC9248957 DOI: 10.1080/21645515.2022.2058264] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/16/2022] [Indexed: 11/08/2022] Open
Abstract
The objective of this study was to identify factors at the individual, provider, and systems levels that serve as challenges or opportunities for increasing adolescent vaccination-including Human Papillomavirus (HPV) vaccination-in rural communities in the southern United States (US). As part of a broader study to increase HPV vaccine uptake in the southern US, we conducted in-depth interviews with vaccination stakeholders representing public health and education agencies in North Carolina (NC) and South Carolina (SC). Fourteen key stakeholders were recruited using purposive sampling to obtain insights into challenges and solutions to rural-urban disparities in HPV vaccination coverage. Stakeholders were also queried about their experiences and attitudes toward school-based vaccination promotion programs and campaigns. We used a rapid qualitative approach to analyze the data. Stakeholders identified factors at the individual, provider, and systems levels that serve as challenges to vaccination in rural communities. Similar to previous studies, stakeholders mentioned challenges with healthcare access and vaccine-related misconceptions that pose barriers to HPV vaccination for rural residents. Systems-level challenges identified included limited access to high-speed internet in rural areas that may impact providers' ability to interface with state-level digital systems such as the vaccination registry. Stakeholders identified a number of opportunities to increase HPV vaccination coverage, including through school-based health promotion programs. Stakeholders strongly supported school-based programs and approaches to strengthen confidence and demand for HPV vaccination and to help address persistent social determinants and system level factors that pose challenges to HPV vaccination coverage in many rural areas.
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Affiliation(s)
- Laura J. Fish
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
| | - Sayward E Harrison
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
- South Carolina Smart State Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA
| | | | - Valerie Yelverton
- Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, USA
| | - Charnetta Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Emmanuel B. Walter
- Duke Human Vaccine Institute, Durham, NC, USA
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Lavanya Vasudevan
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
- Duke Human Vaccine Institute, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
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Vaccines. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Brandt HM, Vanderpool RC, Pilar M, Zubizarreta M, Stradtman LR. A narrative review of HPV vaccination interventions in rural U.S. communities. Prev Med 2021; 145:106407. [PMID: 33388323 PMCID: PMC10064483 DOI: 10.1016/j.ypmed.2020.106407] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/20/2020] [Accepted: 12/28/2020] [Indexed: 11/25/2022]
Abstract
Uptake of human papillomavirus (HPV) vaccine in the United States (U.S.) is far below the Healthy People 2020 goal of 80% coverage among adolescents. In rural communities, HPV vaccination coverage is low, yet incidence and mortality rates of HPV-associated cancer are high. Much of the research focused on HPV vaccination in rural U.S. communities has involved qualitative investigations, observations, survey research, and secondary data analysis with limited implementation of interventional study designs. The purpose of this narrative review was to examine intervention studies to increase HPV vaccination in rural settings and to summarize study characteristics and associated outcomes. PubMed, PsycINFO, CINAHL, and Web of Science were searched utilizing systematic narrative review methodology for studies describing implementation of HPV vaccination interventions in rural U.S. settings from January 2006-December 2019. Using specific search criteria, 991 studies were identified. After abstract review, 30 full-text articles were assessed for eligibility, and 15 met the inclusion criteria. The 15 articles - published from 2011 to 2019 - described HPV vaccination interventions in rural settings of six states, including communities, health clinics, and schools. A range of primary and secondary outcomes were reported, including HPV vaccine receipt (series initiation, continuation, and/or completion); HPV vaccine knowledge; and/or cervical cancer knowledge. Across the studies, there was an absence of the description of rural context. As compared to the broader HPV vaccination intervention literature, interventions in rural settings were limited. More interventional research is needed in rural communities given the elevated rates of HPV-related cancer and low rates of HPV vaccine uptake.
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Affiliation(s)
- Heather M Brandt
- University of South Carolina Arnold School of Public Health, Department of Health Promotion, Education, Behavior, Rural and Minority Health Research Center, 915 Greene Street, Columbia, SC 29208, United States.
| | - Robin C Vanderpool
- National Cancer Institute, Division of Cancer Control and Population Sciences, Health Communication and Informatics Research Branch, 9609 Medical Center Drive, 3E610, Rockville, MD 20850, United States.
| | - Meagan Pilar
- Washington University in St. Louis, Brown School of Social Work, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, United States.
| | - Maria Zubizarreta
- University of South Carolina Arnold School of Public Health, Core for Applied Research and Evaluation, 915 Greene Street, Columbia, SC 29208, United States.
| | - Lindsay R Stradtman
- University of Kentucky College of Public Health, Department of Health, Behavior & Society, 113 Washington Avenue, Lexington, KY 40506, United States
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Allington D, McAndrew S, Moxham-Hall VL, Duffy B. Media usage predicts intention to be vaccinated against SARS-CoV-2 in the US and the UK. Vaccine 2021; 39:2595-2603. [PMID: 33810905 DOI: 10.1016/j.vaccine.2021.02.054] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/11/2021] [Accepted: 02/23/2021] [Indexed: 12/21/2022]
Abstract
There is existing evidence of a relationship between media use and vaccine hesitancy. Four online questionnaires were completed by general population samples from the US and the UK in June 2020 (N = 1198, N = 3890, N = 1663, N = 2237). After controls, all four studies found a positive association between intention to be vaccinated and usage of broadcast and print media. The three studies which operationalised media usage in terms of frequency found no effect for social media. However, the study which operationalised media use in terms of informational reliance found a negative effect for social media. Youth, low household income, female gender, below degree-level of education, and membership of other than white ethnic groups were each also found to be associated with lower intentions to be vaccinated in at least two of the four studies. In all four studies, intention to be vaccinated was positively associated with having voted either for Hillary Clinton in the 2016 US presidential elections or for Labour Party candidates in the 2019 UK general election. Neither of the UK studies found an association with having voted for Conservative Party candidates, but both US studies found a negative association between intention to be vaccinated and having voted for Donald Trump. The consistent finding of greater intention to be vaccinated among users of legacy media but not among users of social media suggests that social media do not currently provide an adequate replacement for legacy media, at least in terms of public health communication. The finding of a negative association with social media in the study which measured informational reliance rather than frequency is consistent with the view that uncritical consumption of social media may be acting to promote vaccine hesitancy.
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Affiliation(s)
| | - Siobhan McAndrew
- School of Sociology, Politics, and International Studies, University of Bristol, UK
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Suo T, Lu Q. Parental Acceptability of HPV Vaccination for Adolescent Daughters and Associated Factors: A Cross-Sectional Survey in Bozhou, China. Res Theory Nurs Pract 2020; 34:340-357. [PMID: 33199407 DOI: 10.1891/rtnp-d-19-00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to investigate parents' acceptability of human papillomavirus (HPV) vaccination for their daughters and associated factors. METHODS This cross-sectional study was conducted in a city in China with a sample population of parents with a daughter in middle school. Participants' demographic characteristics, knowledge level regarding HPV and the HPV vaccine, perspectives on the health belief model (HBM) constructs, social norms, and acceptability of the HPV vaccine were determined through self-administered questionnaires. RESULTS Among the 523 parents who completed the questionnaire, 71.5% expressed willingness to have their daughters vaccinated against HPV infection and cervical cancer. Logistic regression analysis revealed higher acceptability in the participants with higher perceived severity of HPV infection (OR = 4.823, 95% CI = 2.683, 12.049), higher knowledge-assessment score (OR = 1.298, 95% CI = 1.055, 1.476), and higher perceived safety of the HPV vaccine (OR = 6.372, 95% CI = 3.856, 14.062). Parents influenced by social norms (OR = 4.959, 95% CI = 2.989, 14.386) and those who complied with physicians' recommendations (OR = 4.896, 95% CI = 1.936, 9.258) reported higher levels of acceptability. IMPLICATIONS Our results provide preliminary evidence on the need for health education programs and HPV vaccination campaigns. Future studies should focus on whether the factors associated with vaccination can increase parental acceptability of the HPV vaccine.
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Affiliation(s)
- Tonghui Suo
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui
| | - Qi Lu
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui .,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui
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The power of anticipated regret: Predictors of HPV vaccination and seasonal influenza vaccination acceptability among young Romanians. Vaccine 2020; 38:1572-1578. [DOI: 10.1016/j.vaccine.2019.11.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 10/27/2019] [Accepted: 11/11/2019] [Indexed: 11/18/2022]
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Depression and Its Relationship with Coping Strategies and Illness Perceptions during the COVID-19 Lockdown in Greece: A Cross-Sectional Survey of the Population. DEPRESSION RESEARCH AND TREATMENT 2020; 2020:3158954. [PMID: 32908697 PMCID: PMC7450302 DOI: 10.1155/2020/3158954] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/18/2020] [Accepted: 07/28/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The COVID-19 epidemic has shown a more benign course in Greece possibly due to the early lockdown measures. Mental health consequences of the lockdown however are unknown. In addition, illness perceptions and relevant strategies to cope with the stress of the epidemic may have played a role in complying with the restrictions. We conducted a survey of the Greek population with the aim to investigate the prevalence of anxiety and depression during the lockdown, the emotional impact of the epidemic, and the effect of coping strategies and illness perceptions in mental health. METHODS Adult persons were invited during the peak of the lockdown period through social media. Depressive and anxiety symptoms were assessed with the PHQ-9 and GAD-2 scales, respectively. Coping strategies were assessed with selected items of the Brief COPE questionnaire, while illness beliefs were assessed with items from the revised Illness Perception Questionnaire (IPQ-R). RESULTS A total of 3379 individuals took part. A strong emotional impact of the epidemic was more often in women and in those with severe financial difficulties. Levels of depressive and anxiety symptoms were high but similar to past assessments. Participants showed high levels of personal control and used more often positive strategies to cope with the stress of the epidemic. Depressive symptoms were higher in the younger, in students, in those with a stronger emotional impact, in those isolated due to symptoms, and those overexposed to media for COVID-19-related news. Lower levels of depression were seen in those using positive coping strategies and showing high levels of personal and treatment control. CONCLUSIONS The study shows that certain psychological and social determinants were associated with increased depressive symptoms during the lockdown warranting the development of public health guidelines to mitigate the effects of the epidemic to the mental health of the population.
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Fokom Domgue J, Chido-Amajuoyi OG, Yu RK, Shete S. Beliefs About HPV Vaccine's Success at Cervical Cancer Prevention Among Adult US Women. JNCI Cancer Spectr 2019; 3:pkz064. [PMID: 32280919 PMCID: PMC6901081 DOI: 10.1093/jncics/pkz064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/30/2019] [Accepted: 08/08/2019] [Indexed: 01/01/2023] Open
Abstract
Background Beliefs are known to be a key determinant in vaccines’ uptake. However, little is known about beliefs surrounding the success of the human papillomavirus (HPV) vaccine in preventing cervical cancer in the United States. Methods Data from the Health Information National Trends Survey 5 Cycle 1 (2017) were analyzed for 1851 female respondents aged 18 years and older. Weighted multinomial logistic regression was employed to determine predictors of beliefs in the success of the HPV vaccine in preventing cervical cancer. Results Overall, 29.8% of women believed that HPV vaccine is successful in preventing cervical cancer, 6.6% believed it is not successful, and 63.6% did not know if the HPV vaccine is successful. Non-Hispanic blacks (adjusted odds ratio [aOR] = 1.80, 95% confidence interval [CI] = 1.16 to 2.79), women with no more than 12 years of education (aOR = 2.05, 95% CI = 1.17 to 3.60), those who did not know if they were advised by a health-care provider to get an HPV shot within the last 12 months (aOR = 4.19, 95% CI = 1.39 to 12.60), and those unaware of a family cancer history (aOR = 5.17, 95% CI = 1.48 to 18.21) were more likely to not know whether the HPV vaccine prevents cervical cancer. Women younger than 65 years were more likely than elderly to believe that the HPV vaccine is not successful at preventing cervical cancer. Conclusions A substantial proportion of US women are uninformed about the HPV vaccine. To accelerate progress in the HPV vaccine’s uptake, future interventions should incorporate educational programs, particularly targeting Non-Hispanic blacks, women with a lower level of education, and those younger than 65 years. Health-care providers’ participation in promotion of patient education about HPV vaccination should also be increased.
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Affiliation(s)
| | | | - Robert K Yu
- See the Notes section for the full list of authors' affiliations
| | - Sanjay Shete
- See the Notes section for the full list of authors' affiliations
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Thomas TL, Caldera M, Maurer J. A short report: parents HPV vaccine knowledge in rural South Florida. Hum Vaccin Immunother 2019; 15:1666-1671. [PMID: 30994388 DOI: 10.1080/21645515.2019.1600986] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
An exploratory pilot descriptive research study was conducted in the rural counties of Hendry and Glades Florida exploring parental knowledge and hesitancy of HPV vaccination. Participants included parents/caregivers with children ages 9 to 13; using quantitative methods, we evaluated knowledge, feelings, and beliefs toward HPV vaccination including vaccination prevalence and correlates among participating parents/caregivers. Our measures included the Parental HPV Survey with a Cronbach's alpha of .96. Hesitancy-focused results revealed 26% of parents showed caution because of stigma around vaccination while attributing low levels of knowledge about HPV vaccination; 80% had a persistent belief HPV vaccination could leave their child sterile, perpetuating hesitancy. Participants with a high-school education or less (64%) and conservative religious affiliation, e.g., Baptist and Catholic (74%), did not decline HPV vaccination. Results are striking considering research indicating conservative religious views and lack of a college education leads to lower HPV vaccination rates. Numerous interventions to increase HPV vaccination have been studied including strong recommendations for increased provider communication but our data indicates increasing public education with community input and a focus on cultural norms in each specific rural community among parents and providers is needed to increase HPV vaccine knowledge and decrease HPV vaccine hesitancy.
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Affiliation(s)
- Tami L Thomas
- a Nicole Wertheim College of Nursing and Health Sciences, Florida International University , Miami , Florida , USA
| | - Michelle Caldera
- a Nicole Wertheim College of Nursing and Health Sciences, Florida International University , Miami , Florida , USA
| | - Jeffrey Maurer
- a Nicole Wertheim College of Nursing and Health Sciences, Florida International University , Miami , Florida , USA
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Bahena M, Carvajal-Suarez M, Soliman AS, Luo J, De Alba A. The influence of medical providers on HPV vaccination among children of Mexican mothers: a comparison between Mexico and the Midwest region of the United States. BMC Public Health 2019; 19:515. [PMID: 31060527 PMCID: PMC6501334 DOI: 10.1186/s12889-019-6718-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 03/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Among cervical cancer patients in the U.S., a disproportionate number are Hispanics/Latinos. Also, about a third of patients diagnosed with cervical cancer annually in Mexico die of the disease. Vaccines are available to protect against HPV, the cause of cervical cancer. METHODS A cross-sectional study was conducted with 200 mothers of Mexican origin in the U.S. Midwest and Xalapa, Veracruz, Mexico. Based on a validated bilingual questionnaire, this study elicited information about knowledge and attitudes regarding HPV vaccination and cervical cancer. RESULTS Mothers living in Mexico showed better knowledge about HPV and HPV vaccine (77.8%) than participants living in the U.S. (48%) p < .0001. Logistic regression revealed that receiving information about the HPV vaccine from medical providers was a significant predictor of mothers' willingness to vaccinate their children. CONCLUSIONS A need for increasing public health education of Mexican mothers in the Midwest on HPV/HPV vaccination, may lead to improving utilization of the vaccination and eventually a reduction of cervical cancer. HPV vaccination for boys is critical for reducing the risk of transmission to sexual partners and decreasing the risk of HPV- related diseases in the population. Therefore, we recommend increasing efforts to vaccine boys and increasing knowledge that boys must also be vaccinated, especially in Mexico.
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Affiliation(s)
- Mariela Bahena
- Department of Health Promotion, University of Nebraska Medical Center, College of Public Health, Omaha, NE USA
| | - Marcela Carvajal-Suarez
- Center for Reducing Health Disparities, University of Nebraska Medical Center, College of Public Health, Omaha, NE USA
| | - Amr S. Soliman
- Department of Community Health and Social Medicine, City University of New York, School of Medicine, New York City, NY USA
| | - Jiangtao Luo
- EVMS-Sentara Healthcare Analytics and Delivery Science Institute (HADSI), Eastern Virginia Medical School, Norfolk, VA USA
| | - Armando De Alba
- Department of Health Promotion, University of Nebraska Medical Center, College of Public Health, Omaha, NE USA
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Hispanic Mothers' Beliefs About Having Their Adolescent Sons Initiate the HPV Vaccine Series. J Immigr Minor Health 2018; 21:1356-1364. [PMID: 30542973 DOI: 10.1007/s10903-018-0847-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Rates of HPV vaccination among adolescent Hispanic males lag far behind the Healthy People 2020 80% goal. This study identified Hispanic mothers' salient beliefs regarding having their sons initiate the HPV vaccine series. Twenty-seven Hispanic mothers completed in-depth interviews. They responded to questions that elicited the salient behavioral, normative and control beliefs associated with initiating the HPV vaccine series. We content analyzed their responses. We found that, regarding having their sons initiate the HPV vaccine, mothers: (1) express mostly positive feelings; (2) believe that the vaccine has positive effects, with side effects as the main negative effect; (3) believe that their sons' father and doctor support vaccination while some friends do not; and (4) believe that vaccine affordability, transportation and the support of their sons' father facilitate vaccine initiation. Overall, mothers held positive salient beliefs about the HPV vaccine including that it protects their son's health, has minimal side effects and is recommended by physicians. We are more likely to increase vaccination rates among adolescent Hispanic males if we address mothers' salient beliefs, including reinforcing their positive beliefs.
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Warner EL, Fowler B, Martel L, Kepka D. Improving HPV Vaccination Through a Diverse Multi-state Coalition. J Community Health 2018; 42:911-920. [PMID: 28393294 DOI: 10.1007/s10900-017-0334-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Rural and highly religious Intermountain West states demonstrate low levels of HPV vaccination uptake. The Intermountain West HPV Vaccination Coalition (IWHVC) was formed to improve HPV vaccination by enhancing collaborations between cancer centers, health departments, health clinics, religious groups, and community organizations. Coalition members' perceptions and experiences are described within. METHODS A cross-sectional online survey was distributed to the IWHVC. N = 86 responded to the online survey. Six subsequent focus groups were conducted (N = 36). Participant demographics, barriers, and facilitators of HPV vaccination were summarized. The first three focus groups were coded in an iterative manner based on a coding scheme. The final three focus groups were selectively coded for content related to five themes: barriers and facilitators to HPV vaccination, how the coalition has been useful, future directions of the coalition, and how to engage religious communities. RESULTS Participants suggested that HPV vaccination should occur in a doctor's office (70.9%), public health clinic (64.0%), or at a community health fair (58.1%). Perceived barriers included a lack of education/low knowledge about the HPV vaccine (55.8%), concerns about sexuality/promiscuity (44.2%), and not knowing the vaccine is recommended for boys (38.4%). Participants stressed the importance of gaining buy-in from religious leaders, and felt the coalition helped them advocate for HPV vaccination through networking, idea and information sharing, and voicing their community's needs. Future goals emphasized targeted outreach, sustainable funding, expanded environmental scans, gaining religious support, and policy reforms. CONCLUSIONS Targeted coalition work builds community capacity and coordinates HPV vaccination efforts. A community driven coalition approach could help improve HPV vaccination in other rural and highly religious regions.
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Affiliation(s)
- Echo L Warner
- University of Utah College of Nursing, Salt Lake City, UT, 84112, USA.
- Jonas Center for Nursing and Veterans Healthcare, New York, NY, 10021, USA.
- Cancer Control and Population Sciences Department, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA.
| | - Brynn Fowler
- Cancer Control and Population Sciences Department, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
| | - Laura Martel
- Cancer Control and Population Sciences Department, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
| | - Deanna Kepka
- University of Utah College of Nursing, Salt Lake City, UT, 84112, USA
- Cancer Control and Population Sciences Department, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
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Wilson KL, White A, Rosen BL, Chiappone A, Pulczinski JC, Ory MG, Smith ML. Factors Associated with College Students' Intentions to Vaccinate Their Daughters Against HPV: Protecting the Next Generation. J Community Health 2018; 41:1078-89. [PMID: 27147417 DOI: 10.1007/s10900-016-0192-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Human papillomavirus (HPV) is a contemporary public health concern because of its association with cervical cancer. Despite evidence about HPV vaccination benefits, debate surrounds whether or not to vaccinate American youth. While no nationwide mandate exists, understanding the behaviors and intentions of future parents may provide insight about our ability to protect the next generation of school-aged youth. The purposes of this study were to examine factors associated with unmarried college students' intentions to: (1) vaccinate their daughters against HPV and (2) give their daughters the choice about whether or not to be vaccinated. Data were analyzed from 1606 college students aged 18-26 using an internet-delivered questionnaire. Two binary logistic regression analyses were performed identifying predictor variables associated with participants' intentions when having daughters in the future to vaccinate them against HPV and whether or not they would let their daughters decide to get the vaccination. Relative to those who did not intend to vaccinate their daughters against HPV, participants who were female (OR 1.55, P = 0.018), sexually active (OR 1.62, P = 0.001), diagnosed with HPV (OR 2.64, P < 0.001), received a flu shot in the past 12 months (OR 1.63, P = 0.002), perceived the HPV vaccine to be safe (OR 1.19, P < 0.001), and supported HPV vaccination mandates for school-aged youth (OR 2.58, P < 0.001) were more likely to report intentions of vaccinating their daughters against HPV. Participants who were sexually active (OR 1.45, P = 0.002) and perceived the HPV vaccine to be safe (OR 1.05, P = 0.012) were more likely to report they would allow their daughters to choose whether to be vaccinated against HPV. Until HPV vaccination mandates are enacted, parental support of vaccines are among the most effective way of increasing vaccine uptake. Identifying HPV vaccination support among future parents has potential to inform parent vaccination education programs related and advocacy for HPV vaccination policies.
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Affiliation(s)
- Kelly L Wilson
- Department of Health and Kinesiology, Texas A&M University, TAMU 4243, College Station, TX, 77843-4243, USA.
| | - Alice White
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA, USA
| | - Brittany L Rosen
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Alethea Chiappone
- Department of Health Promotion, Social & Behavioral Health, University of Nebraska Medical Center College of Public Health, Omaha, NE, USA
| | - Jairus C Pulczinski
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, College Station, TX, USA
| | - Marcia G Ory
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, College Station, TX, USA
| | - Matthew Lee Smith
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA, USA.,Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, College Station, TX, USA
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Turiho AK, Okello ES, Muhwezi WW, Katahoire AR. Perceptions of human papillomavirus vaccination of adolescent schoolgirls in western Uganda and their implications for acceptability of HPV vaccination: a qualitative study. BMC Res Notes 2017; 10:431. [PMID: 28854964 PMCID: PMC5577844 DOI: 10.1186/s13104-017-2749-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 08/23/2017] [Indexed: 11/10/2022] Open
Abstract
Background Human papillomavirus (HPV) vaccination has been perceived in diverse ways some of which encourage its uptake while others could potentially deter its acceptability. This study explored community member’s perceptions about HPV vaccination in Ibanda district and the implications of the perceptions for acceptability of HPV vaccination. The study was conducted following initial vaccination of adolescent schoolgirls in the district between 2008 and 2011. Methods This qualitative study employed focus group discussions (FGDs) and key informant interviews (KIIs). FGDs were conducted with schoolgirls and parents/guardians and KIIs were conducted with school teachers, health workers and community leaders. Transcripts from the FGDs and KIIs were coded and analyzed thematically using ATLAS.ti (v. 6). Results The HPV vaccination was understood to safely prevent cervical cancer, which was perceived to be a severe incurable disease. Vaccinations were perceived as protection against diseases like measles and polio that were known to kill children. These were major motivations for girls’ and parents’ acceptance of HPV vaccination. Parents’ increased awareness that HPV is sexually transmitted encouraged their support for vaccination of their adolescent daughters against HPV. There were reports however of some initial fears and misconceptions about HPV vaccination especially during its introduction. These initially discouraged some parents and girls but over the years with no major side effects reported, girls reported that they were willing to recommend the vaccination to others and parents also reported their willingness to get their daughters vaccinated without fear. Health workers and teachers interviewed however explained that, some concerns stilled lingered in the communities. Conclusions The perceived benefits and safety of HPV vaccination enhanced girls’ and parents’ acceptability of HPV vaccination. The initial rumors, fears and concerns about HPV vaccination that reportedly discouraged some girls and parents, seemed to have waned with time giving way to more favourable perceptions regarding HPV vaccination although the study still found that a few concerns still lingered on and these have implications for HPV vaccination acceptability.
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Loke AY, Chan ACO, Wong YT. Facilitators and barriers to the acceptance of human papillomavirus (HPV) vaccination among adolescent girls: a comparison between mothers and their adolescent daughters in Hong Kong. BMC Res Notes 2017; 10:390. [PMID: 28797277 PMCID: PMC5553777 DOI: 10.1186/s13104-017-2734-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 08/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study is to examine knowledge and attitude as facilitators and barriers to the acceptance of HPV vaccination for adolescent girls by mothers and adolescent girls. METHODS A cross-sectional survey conducted in Hong Kong in January 2010. Adolescent girls aged 12-18, together with their mothers, were recruited to complete two separate questionnaires with similar questions. RESULTS A total of 170 mother-adolescent girl dyads were recruited. When the daughters and mothers were compared, the mothers were found to be more aware of "the risk of becoming infected with HPV through early sexual intercourse," while more daughters than mothers knew that "the HPV virus cannot be cured with antibiotics." Significantly more daughters perceived that they had a "chance of being infected with HPV and getting cervical cancer without the vaccine," while more mothers were concerned that "vaccinating for HPV will cause a girl to be stigmatized as promiscuous" and thought that their "adolescent daughters are too young to receive the HPV vaccine." The major predictive factor for the acceptance of the HPV vaccine among mothers was "The HPV vaccine is safe" (OR = 10.126, 95% CI 2.47-41.54). Among daughters who accepted the vaccine, the predictive factor was "The HPV vaccine can prevent most HPV infections" (OR = 6.274, 95% CI 1.93-20.42). CONCLUSIONS The findings provide healthcare professionals with a better understanding of the differences between mothers and adolescent girls in knowledge, attitude, and potential factors associated with acceptance of the HPV vaccine. Health professionals should promote the early prevention of HPV infection and eliminate the stigma surrounding HPV vaccination to increase its acceptance. The government should provide financial support for adolescent girls to receive the vaccination in school.
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Affiliation(s)
- Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | | | - Yuen Ting Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Hastings TJ, Hohmann LA, McFarland SJ, Teeter BS, Westrick SC. Pharmacists' Attitudes and Perceived Barriers to Human Papillomavirus (HPV) Vaccination Services. PHARMACY 2017; 5:pharmacy5030045. [PMID: 28970457 PMCID: PMC5622357 DOI: 10.3390/pharmacy5030045] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/05/2017] [Accepted: 08/03/2017] [Indexed: 11/16/2022] Open
Abstract
Use of non-traditional settings such as community pharmacies has been suggested to increase human papillomavirus (HPV) vaccination uptake and completion rates. The objectives of this study were to explore HPV vaccination services and strategies employed by pharmacies to increase HPV vaccine uptake, pharmacists' attitudes towards the HPV vaccine, and pharmacists' perceived barriers to providing HPV vaccination services in community pharmacies. A pre-piloted mail survey was sent to 350 randomly selected community pharmacies in Alabama in 2014. Measures included types of vaccines administered and marketing/recommendation strategies, pharmacists' attitudes towards the HPV vaccine, and perceived system and parental barriers. Data analysis largely took the form of descriptive statistics. 154 pharmacists completed the survey (response rate = 44%). The majority believed vaccination is the best protection against cervical cancer (85.3%), HPV is a serious threat to health for girls (78.8%) and boys (55.6%), and children should not wait until they are sexually active to be vaccinated (80.1%). Perceived system barriers included insufficient patient demand (56.5%), insurance plans not covering vaccination cost (54.8%), and vaccine expiration before use (54.1%). Respondents also perceived parents to have inadequate education and understanding about HPV infection (86.6%) and vaccine safety (78.7%). Pharmacists have positive perceptions regarding the HPV vaccine. Barriers related to system factors and perceived parental concerns must be overcome to increase pharmacist involvement in HPV vaccinations.
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Affiliation(s)
- Tessa J Hastings
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Auburn, AL 36849, USA.
| | - Lindsey A Hohmann
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Auburn, AL 36849, USA.
| | - Stuart J McFarland
- College of Medicine, University of South Alabama, 307 N University Blvd, Mobile, AL 36688, USA.
| | - Benjamin S Teeter
- Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA.
| | - Salisa C Westrick
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Auburn, AL 36849, USA.
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Ojinnaka CO, McClellan DA, Weston C, Pekarek K, Helduser JW, Bolin JN. Determinants of HPV vaccine awareness and healthcare providers' discussion of HPV vaccine among females. Prev Med Rep 2017; 5:257-262. [PMID: 28133601 PMCID: PMC5262500 DOI: 10.1016/j.pmedr.2017.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/07/2016] [Accepted: 01/11/2017] [Indexed: 11/18/2022] Open
Abstract
Two human papillomavirus (HPV) vaccines are available and can prevent 98% of HPV 16 and 18 infections. This study aimed to explore determinants of 1) HPV vaccine awareness among a cohort of low-income women participating in a cancer prevention program in Central Texas and compare them to United States residents; 2) determinants of healthcare providers' discussion of HPV vaccine among female residents of the United States. Bivariate and multivariable analysis of HPV vaccine awareness using survey data (n = 359) collected between 2014 and 2016 in Central Texas, and the Health Information and Nutrition Survey (HINTS) data which is a nationally representative dataset (unweighted n = 1214) collected in 2013 were conducted. Bivariate and multivariable regression analyses of healthcare providers' discussion of the HPV vaccine using the HINTS survey data were also conducted. Compared to non-Hispanic Whites, there was a decreased likelihood of HPV vaccine awareness among non-Hispanic Blacks (OR = 0.50; 95% CI = 0.28–0.90) and Hispanics (OR = 0.55; 95% CI = 0.30–0.99) in the grant funded program, as well as non-Hispanic Blacks (OR = 0.28; 95% CI = 0.14–0.58) and Hispanics (OR = 0.22; 95% CI = 0.12–0.41) in the HINTS data. There was also a decreased likelihood of healthcare providers discussing the HPV vaccine with respondents who were 35–49 years (OR = 0.50; 95% CI = 0.30–0.84), 50–64 years (OR = 0.26; 95% CI = 0.14–0.49) or ≥ 65 years compared to those who were 18–34 years among the HINTS data respondents. Interventions to increase HPV awareness among non-Hispanic Blacks and Hispanics, as well as encourage healthcare providers' discussion of the HPV vaccination during patient encounters regardless of the patient's age are needed. African Americans and Hispanics were less likely to be aware of the HPV vaccine. Residence was not associated with HPV vaccine awareness. Age was associated with healthcare providers' discussion of HPV vaccine.
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Affiliation(s)
- Chinedum O. Ojinnaka
- Department of Health Policy and Management, Texas A&M Health School of Public Health, College Station, TX 77843-1266, USA
- Corresponding author.
| | - David A. McClellan
- Department of Clinical and Translational Medicine, College of Medicine, Texas A&M University, 2900 E.29th Street, Bryan, TX 77803, USA
- Texas A&M Physicians Family Residency, Texas A&M University, 2900 E.29th Street, Bryan, TX 77803, USA
| | - Cynthia Weston
- College of Nursing, Texas A&M University, 8447 State Highway 47, Bryan, TX 77807-1359, USA
| | - Katie Pekarek
- Department of Clinical and Translational Medicine, College of Medicine, Texas A&M University, 2900 E.29th Street, Bryan, TX 77803, USA
- Texas A&M Physicians Family Residency, Texas A&M University, 2900 E.29th Street, Bryan, TX 77803, USA
| | - Janet W. Helduser
- Department of Health Policy and Management, Texas A&M Health School of Public Health, College Station, TX 77843-1266, USA
| | - Jane N. Bolin
- Department of Health Policy and Management, Texas A&M Health School of Public Health, College Station, TX 77843-1266, USA
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Winer RL, Gonzales AA, Noonan CJ, Buchwald DS. A Cluster-Randomized Trial to Evaluate a Mother-Daughter Dyadic Educational Intervention for Increasing HPV Vaccination Coverage in American Indian Girls. J Community Health 2017; 41:274-81. [PMID: 26399648 DOI: 10.1007/s10900-015-0093-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We evaluated whether delivering educational presentations on human papillomavirus (HPV) to American Indian mothers affected HPV vaccination rates in their adolescent daughters. In March-April 2012, we recruited Hopi mothers or female guardians with daughters aged 9-12 years for a cluster-randomized intervention study on the Hopi Reservation. Participants attended mother-daughter dinners featuring educational presentations for mothers on either HPV (intervention) or juvenile diabetes (control) and completed baseline surveys. Eleven months later, we surveyed mothers on their daughters' HPV vaccine uptake. We also reviewed aggregated immunization reports from the Indian Health Service to assess community-level HPV vaccination coverage from 2007 to 2013. Ninety-seven mother-daughter dyads participated; nine mothers reported that their daughters completed the three-dose HPV vaccination series before recruitment. Among the remaining mothers, 63 % completed the follow-up survey. Adjusting for household income, the proportion of daughters completing vaccination within 11 months post-intervention was similar in the intervention and control groups (32 vs. 28 %, adjusted RR = 1.2, 95 % confidence interval (CI) 0.6-2.3). Among unvaccinated daughters, those whose mothers received HPV education were more likely to initiate vaccination (50 vs. 27 %, adjusted RR = 2.6, 95 % CI 1.4-4.9) and complete three doses (adjusted RR = 4.0, 95 % CI 1.2-13.1) than girls whose mothers received diabetes education. Community-level data showed that 80 % of girls aged 13-17 years and 20 % of girls aged 11-12 completed the vaccination series by 2013. HPV vaccine uptake in Hopi girls aged 13-17 years is significantly higher than the U.S. national average. Brief educational presentations on HPV delivered to American Indian mothers might increase HPV vaccination rates in daughters aged 9-12 years.
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Affiliation(s)
- Rachel L Winer
- Department of Epidemiology, University of Washington, Box 359933, 325 9th Ave., Seattle, WA, 98104, USA.
| | - Angela A Gonzales
- Department of Development Sociology, Cornell University, Ithaca, NY, USA
| | - Carolyn J Noonan
- Department of Epidemiology, The Center for Clinical and Epidemiologic Research, Partnerships for Native Health, University of Washington, Seattle, WA, USA
| | - Dedra S Buchwald
- Department of Epidemiology, The Center for Clinical and Epidemiologic Research, Partnerships for Native Health, University of Washington, Seattle, WA, USA
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Morales-Campos DY, Parra-Medina D. Predictors of Human Papillomavirus Vaccine Initiation and Completion Among Latino Mothers of 11- to 17-Year-Old Daughters Living Along the Texas-Mexico Border. FAMILY & COMMUNITY HEALTH 2017; 40:139-149. [PMID: 28207677 PMCID: PMC5402888 DOI: 10.1097/fch.0000000000000144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Few Texas Latino girls initiate and complete the human papillomavirus (HPV) vaccine series, but few studies have examined predictors of initiation and completion in this group. Mothers are crucial to vaccine uptake. Using self-reported data from mothers of unvaccinated girls (n = 317), we examined the association between predictors (HPV and HPV vaccine knowledge, vaccine self-efficacy) and outcomes (initiation and completion). Despite an increase in HPV and HPV vaccine knowledge from baseline to follow-up (n = 195), we found no association between the predictors and the outcomes. Findings showed that health insurance status and study group participation (Entre Madre e Hija program or brochure only) were associated with initiation and completion.
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Westrick SC, Hohmann LA, McFarland SJ, Teeter BS, White KK, Hastings TJ. Parental acceptance of human papillomavirus vaccinations and community pharmacies as vaccination settings: A qualitative study in Alabama. PAPILLOMAVIRUS RESEARCH 2016; 3:24-29. [PMID: 28720453 PMCID: PMC5883249 DOI: 10.1016/j.pvr.2016.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/10/2016] [Accepted: 12/21/2016] [Indexed: 11/19/2022]
Abstract
Purpose To determine parents’ knowledge and attitudes regarding human papillomavirus (HPV) vaccinations in their adolescent children and to describe parents’ perceptions of adolescent vaccinations in community pharmacies. Methods In-depth interviews were completed with parents or guardians of children ages 11–17 years from Alabama's Lee and Macon counties. One-hour long, open-ended telephonic or in-person interviews were conducted until the saturation point was reached. Using ATLAS.ti software and thematic analysis, interview transcripts were coded to identify themes. Results Twenty-six parents were interviewed, most of whom were female (80.8%) and white (50%). A total of 12 themes were identified. First, two themes emerged regarding elements facilitating children's HPV vaccination, the most common being positive perception of the HPV vaccine. Second, elements hindering children's vaccination contained seven themes, the top one being lack of correct or complete information about the HPV vaccine. The last topic involved acceptance/rejection of community pharmacies as vaccination settings, and the most frequently cited theme was concern about pharmacists’ clinical training. Conclusions Physician-to-parent vaccine education is important, and assurances of adequate pharmacy immunization training will ease parents’ fears and allow pharmacists to better serve adolescents, especially those who do not see physicians regularly. Physicians play a crucial role in parents’ HPV vaccination decisions. Parents are reluctant to use pharmacists as HPV vaccine providers. Parents are concerned about pharmacists’ training and pharmacy infrastructure. Community pharmacists must work in conjunction with physicians.
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Affiliation(s)
- Salisa C Westrick
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| | - Lindsey A Hohmann
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| | - Stuart J McFarland
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| | - Benjamin S Teeter
- University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA.
| | - Kara K White
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| | - Tessa J Hastings
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
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Perez S, Fedoruk C, Shapiro GK, Rosberger Z. Giving Boys a Shot: The HPV Vaccine's Portrayal in Canadian Newspapers. HEALTH COMMUNICATION 2016; 31:1527-1538. [PMID: 27123533 DOI: 10.1080/10410236.2015.1089466] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In January 2012, the National Advisory Committee on Immunization (NACI) of Canada recommended that males aged 9-26 years receive the human papillomavirus (HPV) vaccine to protect against genital warts and HPV-associated cancers. Estimated HPV vaccine uptake rates for Canadian males are extremely low. Using a content analysis of Canadian newspaper articles, this study investigated what information about the HPV vaccine was relayed to the public, and how this content was portrayed following the 2012 male HPV vaccine recommendation. A search was conducted using Proquest Canadian Newsstand Complete for newspaper articles published between January 1, 2012, and September 1, 2014. Researchers coded 232 articles on several relevant dimensions: article information; epidemiological information; public policy information; article topic; article and title tone; and informant testimony. The majority of articles (93%) mentioned that girls are eligible for the HPV vaccine, whereas only half (49%) mentioned male eligibility. While most articles associated HPV with cervical cancer (85%), fewer indicated its relation to other HPV-associated cancers (59%) or genital warts (52%). Most articles (60%) were positive or neutral (22%) in tone toward the HPV vaccine, while few had mixed messages (11%) or were negative (6%). Less than 5% of articles reported on issues of morality, suggesting that fears that the HPV vaccine causes promiscuity have largely subsided. Notably, article tone toward male vaccination became progressively more positive over time. However, half of the articles did not mention the vaccine's approval for males, and articles tended to report HPV's relation to cervical cancer over other HPV-associated cancers. The Canadian public may thus be unaware of male eligibility and the importance of HPV vaccine for males. The collaboration of researchers, health care providers, and policymakers with journalists is critical in order to disseminate complete and accurate HPV and HPV vaccine information.
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Affiliation(s)
- Samara Perez
- a Department of Psychology , McGill University
- b Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Claire Fedoruk
- a Department of Psychology , McGill University
- b Lady Davis Institute for Medical Research, Jewish General Hospital
- c Department of Anthropology , McGill University
| | - Gilla K Shapiro
- a Department of Psychology , McGill University
- b Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Zeev Rosberger
- a Department of Psychology , McGill University
- b Lady Davis Institute for Medical Research, Jewish General Hospital
- d Department of Psychiatry and Oncology , McGill University
- e Lady Davis Institute for Medical Research and Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital
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Roncancio AM, Vernon SW, Carmack CC, Ward KK, Muñoz BT, Cribbs FL. Identifying Hispanic mothers' salient beliefs about human papillomavirus vaccine initiation in their adolescent daughters. J Health Psychol 2016; 24:453-465. [PMID: 27852885 DOI: 10.1177/1359105316676627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Guided by the Integrative Model of Behavioral Prediction, we identify mothers' salient beliefs regarding their daughters' initiation of the human papillomavirus vaccine series. In all, 34 Hispanic mothers responded to elicitation questions. Salient beliefs included the following: (1) feeling secure, happy, relieved, concerned, and fear about vaccinating; (2) believing that vaccinating prevents and protects from human papillomavirus but may result in side effects and sexual disinhibition; (3) identifying the daughter, father, mother, aunt, friends, and grandmothers as supporters/non-supporters; and (4) affordability, transportation, clinic distance, and making appointments as facilitators/barriers. This study begins the process of building a model of human papillomavirus vaccine initiation for this population.
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Cunningham-Erves J, Talbott LL, O'Neal MR, Ivankova NV, Wallston KA. Development of a Theory-based, Sociocultural Instrument to Assess Black Maternal Intentions to Vaccinate Their Daughters Aged 9 to 12 Against HPV. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:514-521. [PMID: 26081311 DOI: 10.1007/s13187-015-0867-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The human papillomavirus (HPV) vaccine could assist in reducing the cervical cancer disparity existing between Black and White women. Understanding factors influencing Black maternal intentions to vaccinate their daughter is essential in improving vaccination uptake. However, existing instruments do not comprehensively assess factors (e.g., culture) influencing maternal intentions. This paper describes the development of the Human Papillomavirus Vaccination Survey for Black Mothers with Girls Aged 9 to 12 (HPVS-BM), the first instrument to measure knowledge, attitudes, subjective norms, and cultural beliefs relating to Black maternal intentions to vaccinate their daughters aged 9 to 12 years against HPV. The items and scales were refined using content review by experts, as well as cognitive interviews and pilot testing with target audience participants. The final version of the HPVS-BM was administered to 242 Black mothers with adolescent daughters. Internal reliability was determined using Cronbach's alpha. An a priori hypothetical model was developed to determine convergent and discriminant validity. All scales of the HPVS-BM had an acceptable internal reliability of 0.70 or higher. The intention scale of HPVS-BM was significantly correlated (p < .05) with perceived benefits, perceived barriers, and subjective norms, supporting strong convergent validity. Moderate discriminant construct validity was also demonstrated. Exhibiting good psychometrics, this instrument could be used by healthcare researchers and professionals to develop programs to increase HPV vaccination among Black adolescent females aimed at reducing the racial disparities in cervical cancer. Further psychometric testing of this survey tool for understanding factors influencing maternal intentions is warranted.
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Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Surgery and Office of Research, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Blvd., Nashville, TN, 37208-3599, USA.
| | - Laura L Talbott
- Department of Human Studies, School of Education, The University of Alabama at Birmingham, EB 255, 901 13th Street South Room 255, Birmingham, AL, 35294-1250, USA
| | - Marcia R O'Neal
- Department of Human Studies, School of Education, The University of Alabama at Birmingham, EB 233, 1720 2nd Ave. S, Birmingham, AL, 35294-1250, USA
| | - Nataliya V Ivankova
- School of Health Professions, The University of Alabama at Birmingham, SHPB 560, 1720 2nd Ave. S, Birmingham, AL, 35294-1212, USA
| | - Kenneth A Wallston
- School of Nursing, Vanderbilt University, 461 21st Ave. S, Nashville, TN, 37240, USA
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Gay and Bisexual Men's Willingness to Use a Self-Collected Anal Cancer Screening Test. J Low Genit Tract Dis 2016; 19:354-61. [PMID: 26083331 DOI: 10.1097/lgt.0000000000000118] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We investigated gay and bisexual men's willingness to self-administer an anal cancer screening test at home. METHODS We conducted 2 national, online cross-sectional surveys of self-identified gay and bisexual men: Study I in 2009 with men ages 20 to 59 (n = 306) and Study II in 2013 with men ages 18 to 26 (n = 428). We used multivariate logistic regression analyses to determine variables associated with willingness to self-administer the screening test. RESULTS Most men were willing to self-administer an anal cancer screening test (78% Study I; 67% Study II). In Study I, willingness was higher among men who trusted anal Paps to find treatable cancer (adjusted odds ratio [aOR] = 1.47; 95% CI, 1.04-2.09) and who believed that men who have sex with men should be screened for anal cancer between 1 and 3 years vs. other intervals (aOR = 2.19; 95% CI, 1.17-4.10). In Study II, willingness was higher among men who perceived greater likelihood of anal cancer (aOR = 1.57; 95% CI, 1.12-2.20). Their most common concerns were not performing the test correctly and inaccuracy of results. CONCLUSIONS Many gay and bisexual men were willing to self-administer anal cancer screening tests at home. If routine screening is warranted, self-collected home testing could improve participation.
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Bednarczyk RA, Figueroa-Downing D, Ault K. Why is it appropriate to recommend human papillomavirus vaccination as cervical cancer prevention? Am J Obstet Gynecol 2016; 214:490-493. [PMID: 26529369 DOI: 10.1016/j.ajog.2015.10.920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/22/2015] [Accepted: 10/27/2015] [Indexed: 10/22/2022]
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Li J, Kang LN, Li B, Pang Y, Huang R, Qiao YL. Effect of a group educational intervention on rural Chinese women's knowledge and attitudes about human papillomavirus (HPV) and HPV vaccines. BMC Cancer 2015; 15:691. [PMID: 26467534 PMCID: PMC4606881 DOI: 10.1186/s12885-015-1682-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 10/02/2015] [Indexed: 11/23/2022] Open
Abstract
Background Statistics regarding HPV prevalence and cervical cancer rates in rural China are high, however, low levels of HPV awareness and HPV-related knowledge pose a great challenge for cervical cancer control. Methods The authors conducted an educational intervention study, which was embedded in a cervical cancer screening project in Yangcheng county, Shanxi Province, China from October to December, 2011 and was designed to assess the short-term effectiveness of a hospital-based, brief, HPV-focused session on rural Chinese women’s knowledge and attitudes. Student’s t-test was used when comparing quantitative variables. Chi-squared test or Fisher’s exact tests was used when comparing qualitative variables. Results We found that following the intervention, significant increases were detected in awareness regarding HPV (5.9 % vs. 59 %, p < 0.001) and cervical cancer (63.0 % vs. 89.2 %, p < 0.001). Changes were also observed regarding women’s intention to vaccinate themselves (82.0 % vs. 89.0 %, p = 0.001) and their daughters (82.9 % vs. 88.0 %, p = 0.011), although the impact was more modest compared with the impact on change of awareness. Among women who were aware of HPV, 60.3 % knew that cervical cancer is related to HPV, while only 5.0 % knew the relationship between HPV and genital warts after the educational intervention. Conclusions Educational campaigns, particularly those targeting women with limited education and poor access to public media or other educational channels are needed to improve knowledge regarding HPV in the general population.
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Affiliation(s)
- Jing Li
- Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, 610041, China.
| | - Le-Ni Kang
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
| | - Bayi Li
- Department of Medical Services, Yangcheng Maternal and Child Health Hospital, Yangcheng, 048100, China.
| | - Yi Pang
- The prevention and control section for STD & AIDS, Center for disease control and prevention of Jinjiang, Chengdu, 610021, China.
| | - Rong Huang
- Department of Human Resource, The People's Hospital of Gansu Province, Lanzhou, 730060, China.
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China.
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Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health 2015; 30:1361-85. [DOI: 10.1080/08870446.2015.1070851] [Citation(s) in RCA: 282] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Alder S, Gustafsson S, Perinetti C, Mints M, Sundström K, Andersson S. Mothers' acceptance of human papillomavirus (HPV) vaccination for daughters in a country with a high prevalence of HPV. Oncol Rep 2015; 33:2521-8. [PMID: 25738832 DOI: 10.3892/or.2015.3817] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 01/05/2015] [Indexed: 11/05/2022] Open
Abstract
Cervical cancer is the second most common cancer among women in Argentina and the mortality rate is not declining despite opportunistic screening. Free-of-charge human papillomavirus (HPV) vaccination of 11-year-old girls was introduced in 2011. Parental acceptance of HPV vaccination is considered to be of great importance for HPV vaccine uptake. However, little is known regarding this factor in Argentina. The aim of the present study was to explore maternal HPV vaccination acceptance, willingness to pay for HPV vaccination and correlates of this willingness, awareness of HPV and HPV-associated disease and behaviors and attitudes associated with HPV vaccination acceptance. A total of 180 mothers of girls aged 9-15 years comprised this quantitative, cross-sectional, survey-based study, conducted at two hospitals in the Mendoza Province. Correlates of willingness to pay for HPV vaccination were obtained using multivariable logistic regression models. Maternal HPV vaccination acceptance was 90%, and 60% of mothers were willing to pay for HPV vaccination. Mothers who were gainfully employed and had a higher disposable household income were significantly more willing to pay for HPV vaccination [odds ratio (OR)=2.54, 95% confidence interval (CI) 1.01-6.38; OR=3.28, 95% CI 1.36-7.94, respectively], as were mothers who were aware of cervical cancer prior to the study (OR=3.22, 95% CI 1.02-10.14). Only one in 10 mothers were informed that HPV vaccination does not offer complete protection against cervical cancer. In conclusion, the present study showed high maternal HPV vaccination acceptance, although acceptance decreased when vaccination was not free-of-charge. Continuous public education campaigns are needed to improve knowledge of HPV, HPV vaccines and HPV-associated disease.
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Affiliation(s)
- Susanna Alder
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
| | - Sofia Gustafsson
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
| | - Claudia Perinetti
- Department of Obstetrics and Gynecology, Docent Extension National University of Cuyo, Regional Hospital Diego Paroissien, Godoy Cruz 475, Maipú, Mendoza, Argentina
| | - Miriam Mints
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
| | - Karin Sundström
- Department of Laboratory Medicine, Karolinska Institutet and Hospital, 141 83 Stockholm, Sweden
| | - Sonia Andersson
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
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Krawczyk A, Knäuper B, Gilca V, Dubé E, Perez S, Joyal-Desmarais K, Rosberger Z. Parents' decision-making about the human papillomavirus vaccine for their daughters: I. Quantitative results. Hum Vaccin Immunother 2015; 11:322-9. [PMID: 25692455 PMCID: PMC4514251 DOI: 10.1080/21645515.2014.1004030] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/14/2014] [Accepted: 10/24/2014] [Indexed: 10/23/2022] Open
Abstract
Vaccination against the human papillomavirus (HPV) is an effective primary prevention measure for HPV-related diseases. For children and young adolescents, the uptake of the vaccine is contingent on parental consent. This study sought to identify key differences between parents who obtain (acceptors) and parents who refuse (non-acceptors) the HPV vaccine for their daughters. In the context of a free, universal, school-based HPV vaccination program in Québec, 774 parents of 9-10 year-old girls completed and returned a questionnaire by mail. The questionnaire was based on the theoretical constructs of the Health Belief Model (HBM), along with constructs from other theoretical frameworks. Of the 774 parents, 88.2% reported their daughter having received the HPV vaccine. Perceived susceptibility of daughters to HPV infection, perceived benefits of the vaccine, perceived barriers (including safety of the vaccine), and cues to action significantly distinguished between parents whose daughters had received the HPV vaccine and those whose daughters had not. Other significant factors associated with daughter vaccine uptake were parents' general vaccination attitudes, anticipated regret, adherence to other routinely recommended vaccines, social norms, and positive media influence. The results of this study identify a number of important correlates related to parents' decisions to accept or refuse the HPV vaccine uptake for their daughters. Future work may benefit from targeting such factors and incorporating other health behavior theories in the design of effective HPV vaccine uptake interventions.
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Key Words
- CAIQ, Commission d’Accès à l’Information du Québec
- CI, Confidence Interval
- GW, Genital Warts
- HBM, Health Belief Model
- HL, Hosmer-Lemeshow
- HPV, Human Papillomavirus
- Human papillomavirus
- OR, Odds Ratio
- RAMQ, Régie de l’Assurance Maladie du Québec
- STI, Sexually Transmitted Infection
- US, United States
- cancer vaccine
- decision-making
- papillomavirus vaccine
- quantitative research
- social determinants of health
- vaccine attitudes
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Affiliation(s)
- Andrea Krawczyk
- Department of Psychology; McGill University; Montreal, QC, Canada
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal, QC, Canada
| | - Bärbel Knäuper
- Department of Psychology; McGill University; Montreal, QC, Canada
| | - Vladimir Gilca
- Institut national de santé publique du Québec; Québec City, QC, Canada
| | - Eve Dubé
- Institut national de santé publique du Québec; Québec City, QC, Canada
| | - Samara Perez
- Department of Psychology; McGill University; Montreal, QC, Canada
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal, QC, Canada
| | - Keven Joyal-Desmarais
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal, QC, Canada
| | - Zeev Rosberger
- Department of Psychology; McGill University; Montreal, QC, Canada
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal, QC, Canada
- Louise Granofsky Psychosocial Oncology Program; Segal Cancer Center; Jewish General Hospital; Montreal, QC, Canada
- Departments of Oncology & Psychiatry; McGill University; Montreal, QC, Canada
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Burke NJ, Do HH, Talbot J, Sos C, Ros S, Taylor VM. Protecting our Khmer daughters: ghosts of the past, uncertain futures, and the human papillomavirus vaccine. ETHNICITY & HEALTH 2015; 20:376-90. [PMID: 24905057 PMCID: PMC4258177 DOI: 10.1080/13557858.2014.921895] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVES The FDA approved the first human papillomavirus (HPV) vaccine in 2006. Research into parental decision-making and concerns about HPV vaccination highlights questions about parenting and parents' role in the crafting of their daughters' future sexuality. In contrast to much of this literature, we explore narratives from interviews with Cambodian mothers of HPV vaccine-age eligible daughters who experienced genocide and came to the USA as refugees. DESIGN We conducted in-depth, in-person interviews with 25 Cambodian mothers of HPV vaccine-age eligible daughters. Interviews were conducted in Khmer and translated into English for analysis. We followed standard qualitative analysis techniques including iterative data review, multiple coders, and 'member checking.' Five members of the research team reviewed all transcripts and two members independently coded each transcript for concepts and themes. RESULTS Interview narratives highlight the presence of the past alongside desires for protection from uncertain futures. We turn to Quesada and colleagues' concept structural vulnerability to outline the constraints posed by these women's positionalities as genocide survivors when faced with making decisions in an area with which they have little direct knowledge or background: cervical cancer prevention. CONCLUSION Our study sheds light on the prioritization of various protective health practices, including but not exclusive to HPV vaccination, for Khmer mothers, as well as the rationalities informing decision-making regarding their daughters' health.
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Affiliation(s)
- Nancy J. Burke
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco
| | - Huyen H. Do
- Division of Public Health Sciences, Fred Hutchison Cancer Research Center
| | - Jocelyn Talbot
- Division of Public Health Sciences, Fred Hutchison Cancer Research Center
| | - Channdara Sos
- Division of Public Health Sciences, Fred Hutchison Cancer Research Center
| | - Srey Ros
- Division of Public Health Sciences, Fred Hutchison Cancer Research Center
| | - Victoria M. Taylor
- Division of Public Health Sciences, Fred Hutchison Cancer Research Center
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Hanley SJB, Yoshioka E, Ito Y, Konno R, Sasaki Y, Kishi R, Sakuragi N. An exploratory study of Japanese fathers' knowledge of and attitudes towards HPV and HPV vaccination: does marital status matter? Asian Pac J Cancer Prev 2014; 15:1837-43. [PMID: 24641418 DOI: 10.7314/apjcp.2014.15.4.1837] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND No studies on male attitudes towards HPV and HPV vaccination have been conducted in Japan, and little is known globally whether attitudes of single fathers differ to those living with a female partner. This exploratory study assessed whether Japanese fathers were likely to have their daughter vaccinated against HPV in a publically funded program and whether any differences existed regarding attitudes and knowledge about HPV according to marital status. MATERIALS AND METHODS Subjects were 27 fathers (16 single; 11 married) who took part in a study on HPV vaccine acceptability aimed at primary caregivers of girls aged 11-14 yrs in three Japanese cities between July and December 2010. RESULTS Knowledge about HPV was extremely poor (mean score out of 13 being 2.74 ± 3.22) with only one (3.7%) participant believing he had been infected with HPV and most (81.4%) believing they had no or low future risk. No difference existed regarding knowledge or awareness of HPV according to marital status. Concerning perceived risk for daughters, single fathers were significantly more likely to believe their daughter was at risk for both HPV (87.5% versus 36.4%; p=0.01) and cervical cancer (75.0% versus 27.3%; p=0.02). Acceptability of free HPV vaccination was high at 92% with no difference according to marital status, however single fathers were significantly more likely (p=0.01) to pay when vaccination came at a cost. Concerns specific to single fathers included explaining the sexual nature of HPV and taking a daughter to a gynecologist to be vaccinated. CONCLUSIONS Knowledge about HPV among Japanese fathers is poor, but HPV vaccine acceptability is high and does not differ by marital status. Providing sexual health education in schools that addresses lack of knowledge about HPV as well as information preferences expressed by single fathers, may not only increase HPV vaccine acceptance, but also actively involve men in cervical cancer prevention strategies. However, further large-scale quantitative studies are needed.
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Hussain S, Nasare V, Kumari M, Sharma S, Khan MA, Das BC, Bharadwaj M. Perception of human papillomavirus infection, cervical cancer and HPV vaccination in North Indian population. PLoS One 2014; 9:e112861. [PMID: 25386964 PMCID: PMC4227878 DOI: 10.1371/journal.pone.0112861] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 10/20/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) -associated cervical cancer is the second-most common cancer in women worldwide but it is the most frequent gynaecological cancer and cancer associated death in India women. The objective of this study was to assess knowledge about cervical cancer, HPV, HPV vaccine, HPV vaccine acceptance among school and undergraduates students and their parent's perception about acceptance of HPV vaccine in Northern part of India (Delhi and NCR regions). MATERIALS AND METHODS A qualitative questionnaire based survey among 2500 urban/rural students aged 12-22 years was conducted. RESULTS Overall, a low frequency (15%) of HPV and cervical cancer awareness was observed in students and their parents. However, the awareness was much higher in females belonging to urban setup compared to boys with a perception that HPV causes cervical cancer in women only. Additionally, only (13%) participants who were aware of cervical cancer and HPV) were willing to accept HPV vaccination. Apparently, parents of female students were two times more willing to accept HPV vaccination for their ward than male students (p<0.001; OR 95%CI = 2.09 (1.58-2.76). CONCLUSION Cervical cancer and HPV awareness among school, undergraduate students and also to their parents was found to be very low in this part of India. The level of awareness and education appears to be insignificant determinants in rural compared to urban setup. Better health education will be needed to maximize public awareness for cervical cancer prevention.
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Affiliation(s)
- Showket Hussain
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Vilas Nasare
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Malasha Kumari
- Division of Clinical Oncology, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Shashi Sharma
- Division of Biostatistics & Epidemiology, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Mohammad Aijaz Khan
- Division of Behaviour Oncology, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
- * E-mail: (MB); (MAK)
| | - Bhudev C. Das
- Division of Molecular Oncology, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Mausumi Bharadwaj
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
- * E-mail: (MB); (MAK)
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Abstract
This study examined the determinants of Black parents' intention to have their daughters receive the HPV vaccine. Relationships between behavioral beliefs regarding the HPV vaccine, HPV vaccine attitudes, and HPV vaccine intentions among Black parents were explored. A descriptive correlational design and mediation model were used to explain the hypothesized relationships. HPV parental attitudes were significantly related to vaccine intention (r = .865, p < .001). A significant relationship between HPV vaccine behavioral beliefs and HPV vaccine attitudes was found among Black parents (r = .239, p < .001). Parental vaccine attitudes completely mediated the relationship between HPV vaccine behavioral beliefs and parental HPV vaccine intention. Understanding relevant factors associated with parental intent to have their daughters vaccinated are essential to reducing opposition to the HPV vaccine and increase vaccination rates among Black female adolescents.
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Parents' and sons' beliefs in sexual disinhibition after human papillomavirus vaccination. Sex Transm Dis 2014; 40:822-8. [PMID: 24275737 DOI: 10.1097/olq.0000000000000021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The concern that adolescent girls who receive human papillomavirus (HPV) vaccine may be more likely to have sex (ie, sexual disinhibition) has been commonplace in media coverage, but this belief is not held by many parents of adolescent girls. Because no studies have addressed this topic for adolescent boys, we examined parents' and their adolescent sons' beliefs in sexual disinhibition occurring after boys receive HPV vaccine. METHODS A national sample of parents of adolescent boys (n = 547) and their sons (aged 15-17 years; n = 176) completed online surveys in fall 2010. We used multi-item scales to measure parents' and sons' beliefs in sexual disinhibition after HPV vaccination. We used multivariate linear regression to identify correlates of beliefs in sexual disinhibition. RESULTS Less than a quarter of parents or sons agreed with statements suggesting that HPV vaccination leads to sexual disinhibition among adolescent boys (range, 20%-24%). Parents who had more liberal political affiliations (β = -0.11), had a daughter who had received HPV vaccine (β = -0.12), or had no daughter (β = -0.10) reported weaker beliefs in sexual disinhibition. Parents who reported higher anticipated regret if their sons got HPV vaccine and fainted (β = 0.18) indicated stronger beliefs in sexual disinhibition. Sons who perceived higher peer acceptance of HPV vaccination (β = 0.44) or were Hispanic (β = 0.21) had stronger beliefs in sexual disinhibition. CONCLUSIONS Most parents and sons did not believe that HPV vaccination leads to sexual disinhibition among boys. Understanding the characteristics of parents and sons who hold these beliefs may help inform efforts to increase HPV vaccine uptake among boys.
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Educational interventions to increase HPV vaccination acceptance: a systematic review. Vaccine 2014; 32:1901-20. [PMID: 24530401 DOI: 10.1016/j.vaccine.2014.01.091] [Citation(s) in RCA: 212] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/15/2014] [Accepted: 01/31/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND The Human papillomavirus (HPV) vaccine has been available for protection against HPV-associated cervical cancer and genital warts since 2006. Nonetheless, uptake has varied among countries and populations within countries. Studies have found that individuals' knowledge and attitudes toward the vaccine are associated with immunization uptake. The purpose of the current review is to summarize and evaluate the evidence for educational interventions to increase HPV vaccination acceptance. METHODS We searched the databases of PubMed and Web of Science for English-language articles describing educational interventions designed to improve HPV vaccination uptake, intention or attitude. RESULTS We identified 33 studies of HPV vaccination educational interventions: 7 tested the effectiveness of interventions with parents, 8 with adolescents or young adults, and 18 compared the effectiveness of different message frames in an educational intervention among adolescents, young adults or their parents. Most studies involved populations with higher educational attainment and most interventions required participants to be literate. The minority of studies used the outcome of HPV vaccine uptake. Well-designed studies adequately powered to detect change in vaccine uptake were rare and generally did not demonstrate effectiveness of the tested intervention. CONCLUSIONS There is not strong evidence to recommend any specific educational intervention for wide-spread implementation. Future studies are required to determine the effectiveness of culturally-competent interventions reaching diverse populations.
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Association between maternal preventive care utilization and adolescent vaccination: it's not just about Pap testing. J Pediatr Adolesc Gynecol 2014; 27:29-36. [PMID: 24315716 DOI: 10.1016/j.jpag.2013.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/22/2013] [Accepted: 08/23/2013] [Indexed: 12/11/2022]
Abstract
STUDY OBJECTIVE To examine the association between maternal preventive care utilization and human papillomavirus (HPV) vaccine uptake by their adolescent daughters. DESIGN A cross-sectional study using immunization records from administrative claims and the state health department's immunization information system from June 2006 through May 2011. PARTICIPANTS Commercially-insured Michigan females aged 13-17 in May 2011 and their mothers. Mothers were identified using relationship information on the insurance contract. MAIN OUTCOME MEASURES Using logistic regression, we investigated whether initiating and/or completing the HPV vaccine series were associated with maternal preventive care utilization (Papaniculou testing, mammograms, primary care office visits) independently and using a combined maternal preventive care utilization index. RESULTS Among 38,604 mother-daughter pairs, 36% of daughters initiated and 22% completed the HPV vaccine series. Maternal utilization of each recommended service was modestly associated with both daughter's initiation and completion of the HPV vaccine. Effect estimates for receipt of Papaniculou test on vaccine initiation (OR = 1.07, 95% CI = 1.06-1.08) were not any higher than for mammograms (OR = 1.10, 95% CI = 1.08-1.11) or primary care office visits (OR = 1.07, 95% CI = 1.06-1.09). Using a maternal preventive care utilization index, vaccine uptake increased with an increasing number of received services. CONCLUSIONS Maternal receipt of recommended preventive care, which may reflect general attitudes toward prevention, is as or more predictive of daughter's vaccination status than cervical cancer screening alone. Engaging women in broad routine preventive care practices may have additional positive effects on adolescent HPV vaccination beyond those achieved through cervical cancer prevention efforts alone.
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Ben-Natan M, Maor S. Factors related to Israeli lesbian women's intention to be vaccinated against human papillomavirus. Int J STD AIDS 2014; 25:800-5. [DOI: 10.1177/0956462414521167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Summary Lesbian women's susceptibility to human papillomavirus infection and, as a consequence, to cervical cancer, is similar to that of heterosexual women. However, little is known about factors related to lesbian women's intention to be vaccinated against human papillomavirus. The aim of the study was to identify factors related to Israeli lesbian women's intention to be vaccinated, using the Health Belief Model. The study has a cross-sectional design. A convenience sample of 207 lesbian women recruited at clubs in central Israel's lesbian community completed a questionnaire, based on the Health Belief Model. Thirty-two percent of the respondents reported having a high intention to be vaccinated. Perceived susceptibility to cervical cancer and perceived benefits of human papillomavirus vaccination were found to be related to intention to be vaccinated. The findings offer insights that can inform health care providers of strategies to promote vaccination against human papillomavirus in this unique population.
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Affiliation(s)
- Merav Ben-Natan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
- Department of Nursing, School of Health Professions, Tel Aviv University, Tel Aviv, Israel
| | - Shir Maor
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
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Kratzke C, Vilchis H, Amatya A. Breast cancer prevention knowledge, attitudes, and behaviors among college women and mother-daughter communication. J Community Health 2014; 38:560-8. [PMID: 23358794 DOI: 10.1007/s10900-013-9651-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Although breast cancer prevention targets mostly women ages 40 and older, little is known about breast cancer prevention for young women and mother's advice. The purpose of this study was to examine breast cancer prevention knowledge, attitudes, and behaviors among college women and mother-daughter communication. Hispanic and non-Hispanic students at a southwestern university completed a breast cancer prevention survey with items for mother's advice, breast self-awareness and risk reduction knowledge, self-efficacy, susceptibility, family history, provider breast self-exam (BSE) recommendation, peer norms, BSE practice, and demographics. An openended item was also used to elicit types of mother's advice. Logistic regression was used to assess predictors for receiving mother's advice for breast cancer prevention and BSE practice. Self-reported data using a survey were obtained from 546 college women with a mean age of 23.3 (SD = 7.75). Nearly 36 % received mothers' advice and 55 % conducted BSE. Predictors for receiving mother's advice were age, self-efficacy, and family history of breast cancer. Predictors for BSE practice were mother's advice, age, self-efficacy, and provider BSE recommendation. Family history of breast cancer and knowledge were not significant predictors for BSE practice. Findings support the need for clinicians, community health educators, and mothers to provide breast cancer prevention education targeting college women.
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Affiliation(s)
- Cynthia Kratzke
- Department of Public Health Sciences, MSC 3HLS, New Mexico State University, P.O. Box 30001, Las Cruces, NM 88003, USA.
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The Carolina HPV immunization attitudes and beliefs scale (CHIAS): scale development and associations with intentions to vaccinate. Sex Transm Dis 2013; 37:234-9. [PMID: 19940807 DOI: 10.1097/olq.0b013e3181c37e15] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND No standardized instruments, to our knowledge, exist to assess attitudes and beliefs about human papillomavirus (HPV) vaccination. METHODS We developed the Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS), using data collected on 783 parents who had not yet vaccinated their daughters against HPV. We conducted a principal components analysis of 16 HPV vaccine attitude and belief items, assessed the scale's psychometric properties, and used linear regression to examine the relationship of CHIAS factors and parents' vaccination intentions. RESULTS Analyses identified 4 CHIAS factors, all of which had acceptable scale alphas and 1-year test-retest reliability. In multivariate models, higher vaccination intentions were associated with: believing HPV vaccine is effective (β = 0.06) or has less harmful effects (β = -0.47), perceiving more barriers to access (β = 0.18), and having less uncertainty about the vaccine (β = -0.23) (all P < 0.05). CONCLUSIONS Findings suggest that parent attitudes about HPV vaccine are important to their intentions to vaccinate their adolescent daughters against HPV. The CHIAS offers researchers a compact, standardized measure of important HPV vaccine attitudes and beliefs.
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Katz IT, Nkala B, Dietrich J, Wallace M, Bekker LG, Pollenz K, Bogart LM, Wright AA, Tsai AC, Bangsberg DR, Gray GE. A qualitative analysis of factors influencing HPV vaccine uptake in Soweto, South Africa among adolescents and their caregivers. PLoS One 2013; 8:e72094. [PMID: 24023613 PMCID: PMC3758285 DOI: 10.1371/journal.pone.0072094] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 07/11/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In South Africa, the prevalence of oncogenic Human Papillomavirus (HPV) may be as high as 64%, and cervical cancer is the leading cause of cancer-related death among women. The development of efficacious prophylactic vaccines has provided an opportunity for primary prevention. Given the importance of psycho-social forces in vaccine uptake, we sought to elucidate factors influencing HPV vaccination among a sample of low-income South African adolescents receiving the vaccine for the first time in Soweto. METHODS The HPV vaccine was introduced to adolescents in low-income townships throughout South Africa as part of a nationwide trial to understand adolescent involvement in future vaccine research targeting human immunodeficiency virus (HIV). We performed in-depth semi-structured interviews with purposively-sampled adolescents and their care providers to understand what forces shaped HPV vaccine uptake. Interviews were recorded, transcribed, translated, and examined using thematic analysis. RESULTS Of 224 adolescents recruited, 201 initiated the vaccine; 192 (95.5%) received a second immunization; and 164 (81.6%) completed three doses. In our qualitative study of 39 adolescent-caregiver dyads, we found that factors driving vaccine uptake reflected a socio-cultural backdrop of high HIV endemnicity, sexual violence, poverty, and an abundance of female-headed households. Adolescents exercised a high level of autonomy and often initiated decision-making. Healthcare providers and peers provided support and guidance that was absent at home. The impact of the HIV epidemic on decision-making was substantial, leading participants to mistakenly conflate HPV and HIV. CONCLUSIONS In a setting of perceived rampant sexual violence and epidemic levels of HIV, adolescents and caregivers sought to decrease harm by seeking a vaccine targeting a sexually transmitted infection (STI). Despite careful consenting, there was confusion regarding the vaccine's target. Future interventions promoting STI vaccines will need to provide substantial information for participants, particularly adolescents who may exercise a significant level of autonomy in decision-making.
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Affiliation(s)
- Ingrid T. Katz
- Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts General Hospital Center for Global Health, Boston, Massachusetts, United States of America
| | - Busisiwe Nkala
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Janan Dietrich
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Melissa Wallace
- Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Kathryn Pollenz
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Laura M. Bogart
- Harvard Medical School, Boston, Massachusetts, United States of America
- Children’s Hospital Boston, Boston, Massachusetts, United States of America
| | - Alexi A. Wright
- Harvard Medical School, Boston, Massachusetts, United States of America
- Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Alexander C. Tsai
- Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts General Hospital Center for Global Health, Boston, Massachusetts, United States of America
| | - David R. Bangsberg
- Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts General Hospital Center for Global Health, Boston, Massachusetts, United States of America
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard, Boston, Massachusetts, United States of America
| | - Glenda E. Gray
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
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Head KJ, Vanderpool RC, Mills LA. Health care providers' perspectives on low HPV vaccine uptake and adherence in Appalachian Kentucky. Public Health Nurs 2013; 30:351-60. [PMID: 23808860 PMCID: PMC4753794 DOI: 10.1111/phn.12044] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Previous intervention research conducted in Appalachian Kentucky resulted in extremely low uptake and adherence to the human papillomavirus (HPV) vaccine among women ages 18-26, despite provision of free vaccine. Because of these findings, the purpose of this qualitative, follow-up study was to elicit health care providers' perspectives on barriers and facilitators to HPV vaccination and suggested strategies for improving vaccination rates. DESIGN AND SAMPLE Researchers conducted semi-structured qualitative interviews with a purposive sample of eight health care providers (seven nursing professionals, one physician) at the health clinic where the original HPV vaccination intervention took place. Interviews were audio-recorded and transcribed and authors used a constant-comparative method to analyze the data. RESULTS Significant themes emerged from the interviews, centering around two primary issues: vaccine uptake and vaccine adherence. Related to uptake, health care providers identified perceived patient barriers and inadequate HPV vaccine education. They also identified the vaccine schedule and clinic-centered communication deficiencies as adherence-related barriers. CONCLUSION These Appalachian Kentucky health care providers provided important insights into barriers and facilitators to HPV vaccine uptake and adherence that need to be readily addressed in this community. As informed by these providers, several suggestions for improving HPV vaccination, such as more targeted education efforts and patient-centered reminder systems, may be applicable to other nursing professionals working in rural and medically underserved communities.
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Affiliation(s)
- Katharine J. Head
- Department of Communication, University of Kentucky College of Communication and Information, Lexington, Kentucky
| | - Robin C. Vanderpool
- Department of Health Behavior, University of Kentucky College of Public Health, Lexington, Kentucky
| | - Laurel A. Mills
- Department of Health Promotion and Administration, Eastern Kentucky University, Richmond, Kentucky
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Reiter PL, McRee AL, Pepper JK, Gilkey MB, Galbraith KV, Brewer NT. Longitudinal predictors of human papillomavirus vaccination among a national sample of adolescent males. Am J Public Health 2013; 103:1419-27. [PMID: 23763402 DOI: 10.2105/ajph.2012.301189] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We conducted a longitudinal study to examine human papillomavirus (HPV) vaccine uptake among male adolescents and to identify vaccination predictors. METHODS In fall 2010 and 2011, a national sample of parents with sons aged 11 to 17 years (n = 327) and their sons (n = 228) completed online surveys. We used logistic regression to identify predictors of HPV vaccination that occurred between baseline and follow-up. RESULTS Only 2% of sons had received any doses of HPV vaccine at baseline, with an increase to 8% by follow-up. About 55% of parents who had ever received a doctor's recommendation to get their sons HPV vaccine did vaccinate between baseline and follow-up, compared with only 1% of parents without a recommendation. Fathers (odds ratio = 0.29; 95% confidence interval = 0.09, 0.80) and non-Hispanic White parents (odds ratio = 0.29; 95% confidence interval = 0.11, 0.76) were less likely to have vaccinated sons. Willingness to get sons HPV vaccine decreased from baseline to follow-up among parents (P < .001) and sons (P = .003). CONCLUSIONS Vaccination against HPV remained low in our study and willingness to vaccinate may be decreasing. Physician recommendation and education about HPV vaccine for males may be key strategies for improving vaccination.
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Affiliation(s)
- Paul L Reiter
- Division of Cancer Prevention and Control, The Ohio State University College of Medicine, 1590 North High St, Suite 525, Columbus, OH 43201, USA.
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Gerend MA, Shepherd JE. Predicting human papillomavirus vaccine uptake in young adult women: comparing the health belief model and theory of planned behavior. Ann Behav Med 2013; 44:171-80. [PMID: 22547155 DOI: 10.1007/s12160-012-9366-5] [Citation(s) in RCA: 252] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Although theories of health behavior have guided thousands of studies, relatively few studies have compared these theories against one another. PURPOSE The purpose of the current study was to compare two classic theories of health behavior-the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB)-in their prediction of human papillomavirus (HPV) vaccination. METHODS After watching a gain-framed, loss-framed, or control video, women (N = 739) ages 18-26 completed a survey assessing HBM and TPB constructs. HPV vaccine uptake was assessed 10 months later. RESULTS Although the message framing intervention had no effect on vaccine uptake, support was observed for both the TPB and HBM. Nevertheless, the TPB consistently outperformed the HBM. Key predictors of uptake included subjective norms, self-efficacy, and vaccine cost. CONCLUSIONS Despite the observed advantage of the TPB, findings revealed considerable overlap between the two theories and highlighted the importance of proximal versus distal predictors of health behavior.
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Affiliation(s)
- Mary A Gerend
- Department of Medical Humanities and Social Sciences, College of Medicine, Florida State University, Tallahassee, 32306-4300, USA.
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Bednarczyk RA, Davis R, Ault K, Orenstein W, Omer SB. Sexual activity-related outcomes after human papillomavirus vaccination of 11- to 12-year-olds. Pediatrics 2012; 130:798-805. [PMID: 23071201 DOI: 10.1542/peds.2012-1516] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Previous surveys on hypothesized sexual activity changes after human papillomavirus (HPV) vaccination may be subject to self-response biases. To date, no studies measured clinical markers of sexual activity after HPV vaccination. This study evaluated sexual activity-related clinical outcomes after adolescent vaccination. METHODS We conducted a retrospective cohort study utilizing longitudinal electronic data from a large managed care organization. Girls enrolled in the managed care organization, aged 11 through 12 years between July 2006 and December 2007, were classified by adolescent vaccine (HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed; quadrivalent meningococcal conjugate) receipt. Outcomes (pregnancy/sexually transmitted infection testing or diagnosis; contraceptive counseling) were assessed through December 31, 2010, providing up to 3 years of follow-up. Incidence rate ratios comparing vaccination categories were estimated with multivariate Poisson regression, adjusting for health care-seeking behavior and demographic characteristics. RESULTS The cohort included 1398 girls (493 HPV vaccine-exposed; 905 HPV vaccine-unexposed). Risk of the composite outcome (any pregnancy/sexually transmitted infection testing or diagnosis or contraceptive counseling) was not significantly elevated in HPV vaccine-exposed girls relative to HPV vaccine-unexposed girls (adjusted incidence rate ratio: 1.29, 95% confidence interval [CI]: 0.92 to 1.80; incidence rate difference: 1.6/100 person-years; 95% CI: -0.03 to 3.24). Incidence rate difference for Chlamydia infection (0.06/100 person-years [95% CI: -0.30 to 0.18]) and pregnancy diagnoses (0.07/100 person-years [95% CI: -0.20 to 0.35]), indicating little clinically meaningful absolute risk differences. CONCLUSIONS HPV vaccination in the recommended ages was not associated with increased sexual activity-related outcome rates.
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Affiliation(s)
- Robert A Bednarczyk
- Center for Health Research-Southeast, Kaiser Permanente, Atlanta, Georgia 30305, USA.
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Bartolini RM, Winkler JL, Penny ME, LaMontagne DS. Parental acceptance of HPV vaccine in Peru: a decision framework. PLoS One 2012; 7:e48017. [PMID: 23144719 PMCID: PMC3483308 DOI: 10.1371/journal.pone.0048017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 09/20/2012] [Indexed: 12/02/2022] Open
Abstract
Objective and Method Cervical cancer is the third most common cancer affecting women worldwide and it is an important cause of death, especially in developing countries. Cervical cancer is caused by human papillomavirus (HPV) and can be prevented by HPV vaccine. The challenge is to expand vaccine availability to countries where it is most needed. In 2008 Peru’s Ministry of Health implemented a demonstration project involving 5th grade girls in primary schools in the Piura region. We designed and conducted a qualitative study of the decision-making process among parents of girls, and developed a conceptual model describing the process of HPV vaccine acceptance. Results We found a nonlinear HPV decision-making process that evolved over time. Initially, the vaccine’s newness, the requirement of written consent, and provision of information were important. If information was sufficient and provided by credible sources, many parents accepted the vaccine. Later, after obtaining additional information from teachers, health personnel, and other trusted sources, more parents accepted vaccination. An understanding of the issues surrounding the vaccine developed, parents overcome fears and rumors, and engaged in family negotiations–including hearing the girl’s voice in the decision-making process. The concept of prevention (cancer as danger, future health, and trust in vaccines) combined with pragmatic factors (no cost, available at school) and the credibility of the offer (information in the media, recommendation of respected authority figure) were central to motivations that led parents to decide to vaccinate their daughters. A lack of confidence in the health system was the primary inhibitor of vaccine acceptance. Conclusions Health personnel and teachers are credible sources of information and can provide important support to HPV vaccination campaigns.
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Affiliation(s)
| | | | - Mary E. Penny
- Instituto de Investigación Nutricional, La Molina, Lima, Peru
| | - D. Scott LaMontagne
- PATH, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Harborview Medical Center, Seattle, Washington, United States of America
- * E-mail:
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Kilic A, Seven M, Guvenc G, Akyuz A, Ciftci S. Acceptance of Human Papillomavirus Vaccine by Adolescent Girls and Their Parents in Turkey. Asian Pac J Cancer Prev 2012; 13:4267-72. [DOI: 10.7314/apjcp.2012.13.9.4267] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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The females against cancer educational series: a qualitative evaluation of mother/daughter knowledge and perceptions of human papillomavirus and its related cancers. J Natl Med Assoc 2012; 104:194-8. [PMID: 22774387 DOI: 10.1016/s0027-9684(15)30137-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the knowledge, perceptions, and effectiveness of an human papillomavirus (HPV)/cervical cancer education/prevention program. METHODS Approximately 50 middle and high school girls and their mothers participated in the 7-part educational series. Qualitative pre-evaluations and postevaluations were completed for every session, followed by culminating focus groups with mothers and daughters separately. RESULTS Common themes included lack of basic knowledge about HPV and its related cancers. Additionally, mothers and daughters expressed difficulty in communicating with one another about healthy relationships; however, during the focus groups, both mothers and daughters discussed how they had utilized effective communication tools to discuss sensitive topics and make informed decisions together. CONCLUSIONS Despite recent HPV prevention campaigns, more innovative strategies must be implemented to educate more mothers and daughters of HPV and its dangers. Additionally, in educating communities about HPV and associated cancers, more innovative strategies should be mobilized to trigger discussions regarding protective behaviors against HPV.
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Cover JK, Nghi NQ, LaMontagne DS, Huyen DTT, Hien NT, Nga LT. Acceptance patterns and decision-making for human papillomavirus vaccination among parents in Vietnam: an in-depth qualitative study post-vaccination. BMC Public Health 2012; 12:629. [PMID: 22877158 PMCID: PMC3437216 DOI: 10.1186/1471-2458-12-629] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 08/03/2012] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The GAVI Alliance's decision in late 2011 to invite developing countries to apply for funding for human papillomavirus (HPV) vaccine introduction underscores the importance of understanding levels of HPV vaccine acceptance in developing country settings. In this paper, we present findings from qualitative research on parents' rationales for vaccinating or not vaccinating their daughters (vaccine acceptance) and their decision-making process in the context of an HPV vaccination demonstration project in Vietnam (2008-2009). METHODS We designed a descriptive qualitative study of HPV vaccine acceptability among parents of girls eligible for vaccination in four districts of two provinces in Vietnama. The study was implemented after each of two years of vaccinations was completed. In total, 133 parents participated in 16 focus group discussions and 27 semi-structured interviews. RESULTS Focus group discussions and in-depth interviews with parents of girls vaccinated revealed that they were generally very supportive of immunization for disease prevention and of vaccinating girls against HPV. The involvement of the National Expanded Program of Immunization in the demonstration project lent credibility to the HPV vaccine, contributing to high levels of acceptance. For parents who declined participation, concerns about side effects, the possibility that the vaccine was experimental, and the possible impact of the vaccine on future fertility rose to the surface. In terms of the decision-making process, many parents exhibited 'active decision-making,' reaching out to friends, family, and opinion leaders for guidance prior to making their decision. CONCLUSION Vietnam's HPV vaccination experience speaks to the importance of close collaboration with the government to make the most of high levels of trust, and to reduce suspicions about new vaccines that may arise in the context of vaccine introduction in developing country settings.
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Affiliation(s)
| | - Nguyen Quy Nghi
- PATH, Unit 01-02, Floor 2nd, Hanoi Towers, 49 Hai Ba Trung, Hoan Kiem District, Vietnam
| | | | - Dang Thi Thanh Huyen
- National Institute of Hygiene and Epidemiology, Ministry of Health, 1 Yersin St, Hanoi, Vietnam
| | - Nguyen Tran Hien
- National Institute of Hygiene and Epidemiology, Ministry of Health, 1 Yersin St, Hanoi, Vietnam
| | - Le Thi Nga
- PATH, Unit 01-02, Floor 2nd, Hanoi Towers, 49 Hai Ba Trung, Hoan Kiem District, Vietnam
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