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Magana K, Strand L, Love M, Moore T, Peña A, Ito Ford A, Vassar M. Health inequities in human papillomavirus prevention, diagnostics and clinical care in the USA: a scoping review. Sex Transm Infect 2023; 99:128-136. [PMID: 36396174 DOI: 10.1136/sextrans-2022-055587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) represents the most common STI in the USA. HPV inequities in prevention, diagnostics and clinical care persist. We define inequities as systematic, avoidable and unfair differences in health outcomes. OBJECTIVES The objectives of this scoping review are to chart existing data on HPV-related inequities, identify gaps in existing literature and guide future research to reduce these inequities. METHODS We completed a scoping review following guidelines from the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping reviews extension. We performed a literature search on PubMed and Ovid Embase in July 2022 for articles pertaining to HPV and evaluating populations within the USA. We included English language publications from 2018 to 2022 evaluating at least one health inequity outlined by the National Institutes of Health. General publication characteristics and health inequity data were charted in a masked, duplicate fashion using a pilot-tested Google Form. We analysed frequencies of health inequities and summarised main findings from included studies. RESULTS Our final sample included 170 publications. The most common inequities examined were race/ethnicity (140 studies), sex or gender (97 studies), and income (69 studies). Many historically marginalised racial/ethnic groups had lower rates of HPV-related knowledge, vaccination and worse overall outcomes related to HPV. Compared with women, men had lower rates of HPV vaccination and provider recommendation, and higher rates of HPV-infection. Results regarding income were largely conflicting. CONCLUSION Findings from our review demonstrate clear gaps in HPV-related inequity research. Vaccine completion, provider recommendation and intersectionality should continue to be evaluated to implement targeted interventions.
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Affiliation(s)
- Kimberly Magana
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Laura Strand
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Mitchell Love
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Ty Moore
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Andriana Peña
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Alicia Ito Ford
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Kolek CO, Opanga SA, Okalebo F, Birichi A, Kurdi A, Godman B, Meyer JC. Impact of Parental Knowledge and Beliefs on HPV Vaccine Hesitancy in Kenya-Findings and Implications. Vaccines (Basel) 2022; 10:vaccines10081185. [PMID: 35893833 PMCID: PMC9332201 DOI: 10.3390/vaccines10081185] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023] Open
Abstract
Cervical cancer can be prevented by human papillomavirus (HPV) vaccination. However, parents can have concerns about vaccinating their daughters. Consequently, there is a need to identify prevalence and risk factors for HPV vaccine hesitancy among parents in Kenya. A descriptive cross-sectional study was conducted among parents with children aged 9−14 years attending a leading referral hospital in Kenya. Data on sociodemographic traits, HPV knowledge, beliefs and vaccine hesitancy were collected. Out of 195 participants, 183 (93.5%) were aged >30 years. Thirty-four (46.4%) of males and 39 (35.1%) of females did not know that the vaccine is given to prevent HPV infection. Encouragingly, levels of vaccine acceptance were high (90%) although one-third (37.9%) had a negative perception about the effectiveness of the vaccine, with vaccine hesitancy attributed to safety concerns (76%) and feelings that the child was too young (48%). Positive beliefs and knowledge of the vaccine were positively associated with parental willingness to vaccinate their children. Low levels of parenteral education and a younger age among mothers were negatively associated with willingness to vaccinate. Most parents (59%) would consult their daughters before vaccination, and 77% (n = 150) recommended early sex education. Despite low knowledge levels, there was high parental willingness to have their children vaccinated.
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Affiliation(s)
| | - Sylvia A. Opanga
- Department of Pharmacy, University of Nairobi, Nairobi 00202, Kenya;
- Correspondence: (S.A.O.); or (B.G.)
| | - Faith Okalebo
- Department of Pharmacy, University of Nairobi, Nairobi 00202, Kenya;
| | - Alfred Birichi
- Directorate of Pharmaceutical Services, Kenyatta National Hospital, Nairobi 00202, Kenya;
| | - Amanj Kurdi
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK;
- Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil 44001, Iraq
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK;
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 13306, United Arab Emirates
- Correspondence: (S.A.O.); or (B.G.)
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
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Zhu A, Amith M, Tang L, Cunningham R, Xu A, Boom JA, Tao C. Experimenting with a Prototype Interactive Narrative Game to Improve Knowledge and Beliefs for the HPV Vaccine. HCI INTERNATIONAL 2021 -- LATE BREAKING PAPERS : HCI APPLICATIONS IN HEALTH, TRANSPORT, AND INDUSTRY : 23RD HCI INTERNATIONAL CONFERENCE, HCII 2021, VIRTUAL EVENT, JULY 24-29, 2021 PROCEEDINGS. INTERNATIONAL CONFERENCE ON HUMAN-COMPUTER... 2021; 13097:186-201. [PMID: 35083474 PMCID: PMC8788190 DOI: 10.1007/978-3-030-90966-6_14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Narratives can have a powerful impact on our health-related beliefs, attitudes, and behaviors. The human papillomavirus (HPV) vaccine can protect against human papillomavirus that leads to different types of cancers. However, HPV vaccination rates are low. This study explored the effectiveness of a narrative-based interactive game about the HPV vaccines as a method to communicate knowledge and perhaps create behavioral outcomes. We developed a serious storytelling game called Vaccination Vacation inspired by personal narratives of individuals who were impacted by the HPV. We tested the game using a randomized control study of 99 adult participants and compared the HPV knowledge and vaccine beliefs of the Gamer Group (who played the game, n = 44) and the Reader group (who read a vaccine information sheet, n = 55). We also evaluated the usability of the game. In addition to high usability, the interactive game slightly impacted the beliefs about the HPV vaccine over standard delivery of vaccine information, especially among those who never received the HPV vaccine. We also observed some gender-based differences in perception towards usability and the likelihood of frequently playing the game. A narrative-based game could bring positive changes to players' HPV-related health beliefs. The combination of more comprehensive HPV vaccine information with the narratives may produce a larger impact. Narrative-based games can be effectively used in other vaccine education interventions and warrant future research.
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Affiliation(s)
- Anna Zhu
- Southern Methodist University, Dallas, TX, USA
| | - Muhammad Amith
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lu Tang
- Department of Communication, Texas A&M University, College Station, TX, USA
| | | | - Angela Xu
- St. Johns High School, Houston, TX, USA
| | - Julie A Boom
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Cui Tao
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Rosalik K, Tarney C, Han J. Human Papilloma Virus Vaccination. Viruses 2021; 13:v13061091. [PMID: 34201028 PMCID: PMC8228159 DOI: 10.3390/v13061091] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 12/30/2022] Open
Abstract
Human papilloma virus (HPV) is the most common sexually transmitted infection worldwide causing a variety of benign and malignant conditions. A significant portion of the global population is infected with HPV, with the virus attributed to causing up to 5% of cancers worldwide. Bivalent, quadrivalent, and nine-valent vaccinations exist to aid in the prevention of these diseases and have been proven to be effective at preventing both benign and malignant disease. While vaccination is readily accessible in more developed countries, barriers exist to worldwide distribution and acceptance of vaccination. Vaccination and screening of HPV infection when used in combination are proven and predicted to decrease HPV related pathology. Improvements in vaccination formulations, for treatment as well as prevention, are actively being sought from a variety of mechanisms. Despite these advancements, and the data supporting their efficacy, there has been substantial delay in obtaining adequate vaccination coverage. In reviewing these challenges and looking forward to new vaccine development—especially within the current pandemic—it is clear from the challenges of HPV we require methods to more effectively encourage vaccination, ways to dispel vaccination myths as they occur, and implement better processes for vaccine distribution globally.
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Affiliation(s)
- Kendal Rosalik
- Madigan Army Medical Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 9040A Jackson Ave, Joint Base Lewis-McChord, WA 98431, USA;
- Correspondence:
| | - Christopher Tarney
- Madigan Army Medical Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 9040A Jackson Ave, Joint Base Lewis-McChord, WA 98431, USA;
| | - Jasmine Han
- General Leonard Wood Army Community Hospital, Department of Obstetrics and Gynecology, 4430 Missouri Ave, Ford Leonard Wood, MO 65473, USA;
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Chido-Amajuoyi OG, Talluri R, Wonodi C, Shete S. Trends in HPV Vaccination Initiation and Completion Within Ages 9-12 Years: 2008-2018. Pediatrics 2021; 147:peds.2020-012765. [PMID: 33941585 PMCID: PMC8785751 DOI: 10.1542/peds.2020-012765] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Routine human papillomavirus (HPV) vaccination is recommended at ages 11 to 12 years and may be initiated as early as 9 years of age. METHODS Data were derived from the National Immunization Survey-Teen, spanning 2008-2018. Using health care provider-verified vaccination histories, we examined trends in human papillomavirus vaccination up-to-date (HPV-UTD) rates within ages 9 to 12 years. Furthermore, we assessed vaccination status by sociodemographic factors and US state of residence. RESULTS Overall, amid evidence of recent stagnation, HPV vaccination between ages 9 to 12 increased over the years. Initiation rates rose from 17.3% in 2008 to 62.8% in 2018, and HPV-UTD rates rose from 13.5% in 2011 to 32.8% in 2018. After the inception of gender-neutral HPV vaccination, HPV-UTD rates between 2011 and 2018 rose by 31.9% among boys and only 6.6% among girls. For most of the study period, non-Hispanic Black and Hispanic individuals had higher rates of initiation and HPV-UTD than non-Hispanic white individuals. In 2018, vaccination initiation rates exceeded 70% in several states; however, HPV-UTD rates in most US states were <50%, excluding Rhode Island (61.6%), Colorado (58.7%), Hawaii (53.5%), District of Columbia (53.2%), and Ohio (50%). CONCLUSIONS HPV vaccination within ages 9 to 12 years is suboptimal. To leverage the substantial benefits of HPV vaccination within this age range, it is imperative that conscious efforts are taken at the national and state levels to promote HPV vaccination for this age group.
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Affiliation(s)
| | - Rajesh Talluri
- Department of Data Science, University of Mississippi
Medical Center, Jackson, Mississippi; and,Contributed equally as co-first authors
| | - Chizoba Wonodi
- Department of International Health, Bloomberg School
of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sanjay Shete
- Departments of Epidemiology and .,Biostatistics and.,Division of Cancer Prevention and Population Sciences, The University of Texas and Maryland Anderson Cancer Center, Houston, Texas
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Suryadevara M, Bonville CA, Cibula DA, Domachowske JB. Multi-component cancer prevention awareness program to improve adolescent HPV vaccine uptake. Hum Vaccin Immunother 2021; 17:1052-1058. [PMID: 33064046 DOI: 10.1080/21645515.2020.1812316] [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: 10/23/2022] Open
Abstract
OBJECTIVE We introduced a multi-component cancer prevention awareness program to primary care practices across New York State to evaluate its impact on adolescent human papillomavirus (HPV) vaccination rates. METHODS Eight pediatric and three family medicine practices were recruited to participate in this program. On-site training sessions were provided for all practice providers and staff to discuss the importance of HPV vaccine and cancer prevention and teach strategies for delivering a strong vaccine recommendation. Each practice received a study-specific booklet that included HPV vaccine information and other commonly provided cancer prevention guidance. These booklets were distributed to all adolescents and their parents during well visits over a one-year period. Practice specific and county-wide HPV vaccination rates were assessed before and 12 months after the program training session. RESULTS One year after program initiation, aggregate data show statistically higher vaccine series initiation rates among 11-12 and 13-18-year-olds and higher vaccine series completion rates among 13-18-year-olds. The greatest and most consistent improvements were seen in vaccine initiation rates for the 11-12-year-old cohort. Disparities in vaccine uptake were observed by gender and medical specialty. CONCLUSION Cancer prevention education targeting providers, office staff, patients, and parents, improved adolescent HPV vaccine series initiation rates.
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Affiliation(s)
- Manika Suryadevara
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Cynthia A Bonville
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Donald A Cibula
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
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Chido-Amajuoyi OG, Jackson I, Yu R, Shete S. Declining awareness of HPV and HPV vaccine within the general US population. Hum Vaccin Immunother 2020; 17:420-427. [PMID: 32692632 PMCID: PMC7899652 DOI: 10.1080/21645515.2020.1783952] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Programs aimed at boosting human papillomavirus (HPV)-related awareness are considered one of the most effective strategies for increasing vaccination uptake and eliminating HPV-associated cancers. Several US states have made strong commitments to this effort through legislation and dedicated funds. However, it is not known if these efforts have resulted in population-level increments in HPV awareness overtime. Using the Health Information National Trends Survey data, we examined the awareness of HPV and HPV vaccine in the US, between 2008 and 2018. Prevalence estimates and confidence intervals were calculated for HPV and HPV vaccine awareness. Further, we assessed awareness after stratifying by key sociodemographic characteristics. Overall, the awareness of HPV and HPV vaccine declined over time. The lowest awareness was among racial minorities, rural residents, male respondents, those aged 65 years and older, as well as those with the lowest educational and socioeconomic standing. Between 2013 and 2018, the awareness of HPV and HPV vaccine declined by almost 10% among males, those with a high school level of education or lower, and those who earned less than USD 35,000 per annum. In 2018, the awareness of HPV and HPV vaccine was highest among non-Hispanic whites (65.8% and 66.5%) and female adults (70.5% and 71.4%); however, these figures represented declines of about 5% from rates observed in 2008. Amidst a background of sub-optimal HPV vaccination uptake and a growing incidence of HPV-associated cancers in the US, HPV-related awareness within the general US population has declined over time. This calls for stricter enforcement of legislation aimed at boosting HPV awareness, as well as frequent evaluation of government-funded HPV awareness programs.
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Affiliation(s)
| | - Inimfon Jackson
- Department of Epidemiology, The University of Texas Health Science Center at Houston , Houston, TX, USA
| | - Robert Yu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA.,Department of Biostatistics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA.,Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center , Houston, TX, USA
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