1
|
Wong LP, Alias H, Seheli FN, Zimet GD, Hu Z, Lin Y. Human papillomavirus (HPV) vaccination intent and its associated factors: a study of ethnically diverse married women aged 27 to 45 in Malaysia, a Southeast Asian country. Hum Vaccin Immunother 2022; 18:2076525. [PMID: 35714272 PMCID: PMC9481129 DOI: 10.1080/21645515.2022.2076525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction This study aimed to investigate HPV vaccination intention among adult married women aged 27 to 45 years and its associated factors, and their spouse/partner’s influence on HPV vaccination decision-making. Methods This is a cross-sectional, questionnaire-based study. Study participants were recruited through simple random sampling of patients attending obstetrics and gynecology outpatient clinics in a university teaching hospital. Participants were selected based on a computer-generated list of a random list of patients attending the clinic. Results A total of 794 complete responses were received (response rate 88.2%). The mean age of the respondents was 32.2 years with a standard deviation (SD) of ±3.9 years.The vast majority (85.3%) would communicate with their spouse/partner with regard to HPV vaccination decision-making. Nearly 30% (over half were of the Malay ethnic group) perceived their spouse/partner would not consent to their HPV vaccination. Over half (54.9%) reported joint decision-making, and 9.1% (the majority of whom were Malay) reported that HPV vaccination was dependent on their spouse/partner’s decision. Intention to vaccinate against HPV was high (74.5%). Factors influencing HPV vaccination intention were spouse/partner’s consent to HPV vaccination (odds ratio [OR] = 4.51; 95% confidence interval [CI], 3.08–6.62), being a postgraduate student (OR = 4.55; 95% CI, 2.13–9.72 vs. unemployed/housewife), average household income MYR2000–4000 (OR = 2.09; 95%CI, 1.16–3.78 vs. below MYR2000), and an HPV-related knowledge score of 9–20 (OR = 1.60; 95% CI, 1.10–2.32 vs. score 0–8). Conclusion Findings highlight the importance of culture-centered interventions to enhance male partner’s awareness and support for the HPV vaccination of married women.
Collapse
Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.,Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Farhana Nishat Seheli
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Gregory D Zimet
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
| |
Collapse
|
2
|
Highet M, Jessiman-Perreault G, Hilton E, Law G, Allen-Scott L. Understanding the decision to immunize: insights into the information needs and priorities of people who have utilized an online human papillomavirus (HPV) vaccine decision aid tool. Canadian Journal of Public Health 2020; 112:191-198. [PMID: 33078333 PMCID: PMC7571294 DOI: 10.17269/s41997-020-00425-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/21/2020] [Indexed: 11/19/2022]
Abstract
Setting People in Alberta are more likely to seek information about cancer prevention online than they are to have this conversation with their primary care provider. As people turn to the internet to support health decision-making, it is critical that we improve the supportiveness of the virtual health setting for cancer prevention. Intervention In 2014, the Alberta Cancer Prevention Legacy Fund launched an online HPV Decision Aid Tool to support evidence-informed decision-making in response to suboptimal uptake of the HPV (human papillomavirus) vaccine. Google Analytics data from approximately 2000 recent interactions with this tool have yielded insights into the concerns that impact people’s decision-making about the vaccine. Outcomes Most users of this tool are adults interested in the vaccine for themselves (69%), rather than parents considering immunizing their children (31%). No differences were found in the information-seeking behaviour of parents of girls compared with parents of boys, suggesting that mental models among those who are considering the HPV vaccine may have shifted in recent years. Concerns differed by respondent; cost was the most important concern among adults (62.0%), while parents were most concerned about vaccine safety (61.5%). Only 23% of users asked “what is HPV”, suggesting that many people in Alberta now have basic knowledge about the virus. Implications Results provide a real-time “pulse” on knowledge and attitudes towards HPV immunization, which informs our approach to tailoring messaging with the aim of increasing vaccine uptake in Alberta. Outcomes will provide evidence needed to inform new interventions aimed at increasing HPV immunization rates.
Collapse
Affiliation(s)
- Megan Highet
- Alberta Cancer Prevention Legacy Fund, Alberta Health Services, Holy Cross Centre, 2210 2 Street S.W., Calgary, Alberta, T2S 3C3, Canada.
| | - Geneviève Jessiman-Perreault
- Alberta Cancer Prevention Legacy Fund, Alberta Health Services, Holy Cross Centre, 2210 2 Street S.W., Calgary, Alberta, T2S 3C3, Canada
| | | | - Greg Law
- Alberta Cancer Prevention Legacy Fund, Alberta Health Services, Holy Cross Centre, 2210 2 Street S.W., Calgary, Alberta, T2S 3C3, Canada
| | - Lisa Allen-Scott
- Alberta Cancer Prevention Legacy Fund, Alberta Health Services, Holy Cross Centre, 2210 2 Street S.W., Calgary, Alberta, T2S 3C3, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| |
Collapse
|
3
|
Abstract
BACKGROUND Social determinants of health explain most health inequities. Intermediate determinants dictate differences in the exposure and vulnerability of people based on social stratification. Vulnerable women (lower education level, older age, uninsured, etc.) have lower adherence to recommended Pap smear screening guidelines. However, a gap remains concerning the effect of social determinants on human papillomavirus (HPV) infection. OBJECTIVES The aim of this study was to analyze the association between the level of knowledge about HPV infection and HPV vaccines with education level and residential setting among a sample of Spanish women. METHODS A cross-sectional study at six primary care centers (Cantabria, Spain) was performed. All women >21 years consecutively attended by midwives for routine follow-up were invited to participate during the study period (2015-2016) until a convenience sample was recruited. Participants completed an anonymous questionnaire addressing sociodemographic variables (age, education level, and residential setting) and the level of knowledge regarding HPV infection, including general knowledge about infection and knowledge about the HPV vaccine. Associations between education level (primary, secondary, and university) and residential setting (urban, semiurban, and rural) with the level of knowledge of HPV infection and HPV vaccine were calculated using adjusted logistic regressions. Dose-response associations were estimated based on p-trend. RESULTS Compared to university women, a lower education level was associated with limited or no knowledge of either HPV infection or the HPV vaccine. Women living in rural areas poorly identified "promiscuity" as a risk factor of HPV infection and "the use of condoms" as a protective factor. Moreover, living in rural areas was associated with limited or no knowledge of HPV infection and HPV vaccine. There were significant dose-response trends; those who were more educated and living in more urban areas had more knowledge about either HPV infection or the vaccine. DISCUSSION In our sample, the level of knowledge of HPV infection and HPV vaccine was high. However, vulnerable women, defined by a lower education level and living in rural areas, presented a greater lack of knowledge regarding HPV infection and the HPV vaccine.
Collapse
|
4
|
Özdemir S, Akkaya R, Karaşahin KE. Analysis of community-based studies related with knowledge, awareness, attitude, and behaviors towards HPV and HPV vaccine published in Turkey:
A systematic review. J Turk Ger Gynecol Assoc 2020; 21:111-123. [PMID: 31397145 PMCID: PMC7294837 DOI: 10.4274/jtgga.galenos.2019.2019.0071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/29/2019] [Indexed: 01/16/2023] Open
Abstract
Human papilloma virus (HPV) vaccine is a proven method for preventing HPV-related cancers and genital warts, especially preventing cervical cancer. It is aimed to systematically review and synthesize conclusions in detail from community-based studies published in Turkey between 2009 and 2019, which evaluate the knowledge, awareness, attitude, and behaviors of individuals towards HPV and HPV vaccination. This systematic review is conducted based on the PRISMA reporting method and includes community-based, descriptive cross-sectional and cross-sectional studies published between 2009 and 2019. In this systematic review, 5132 studies from six databases were scanned in total. It was determined that there were 23 studies that met the eligibility criteria for this systematic review. In the reviewed studies, it was determined that the rate of “Hearing of HPV before” was 3.8% at the lowest and 57.0% at the highest, and the rate of “Hearing of HPV vaccine before” was 2.2% at the lowest and 74.7% at the highest. In the reviewed studies, it was reported that although parents’ willingness to have their daughters vaccinated with HPV vaccine varied between 14.4% and 68.0%, their willingness to have their sons vaccinated with HPV vaccine varied between 11.0% and 62.0%. In addition, it was reported that the lowest rate of vaccination with HPV vaccine among participants was 0.3% at the lowest and 6.0% at the highest. Consequently, it is considered that conducting common, systematic, and continuous health education programs aimed at both sexes and including both parents, which will increase the knowledge and awareness on HPV and its vaccine, would provide positive attitudes, and will be effective in protecting against HPV-related cancers.
Collapse
Affiliation(s)
- Serpil Özdemir
- Department of Public Health Nursing, University of Health Sciences Turkey, Gülhane Faculty of Nursing, Ankara, Turkey
| | - Rabia Akkaya
- Department of Public Health Nursing, University of Health Sciences Turkey, Gülhane Faculty of Nursing, Ankara, Turkey
| | - Kazım Emre Karaşahin
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Gülhane Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
5
|
Le XTT, Nguyen PTN, Do TTT, Nguyen TH, Le HT, Nguyen CT, Ha GH, Hoang CL, Tran BX, Latkin CA, Ho RC, Ho CS. Intention to Pay for HPV Vaccination among Women of Childbearing Age in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093144. [PMID: 32365964 PMCID: PMC7246945 DOI: 10.3390/ijerph17093144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022]
Abstract
The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in an urban and a rural district (Dong Da and Ba Vi) of Hanoi, Vietnam. The vast percentage of our respondents expressed a firm intention to vaccinate, especially women in rural areas (over 90.0%). However, on being informed of the current price of the HPV vaccine, their intention to vaccinate dropped to about one-fifth of overall respondents, i.e., only 4.4% of women in rural areas. It was also observed that the initial intention to get the HPV vaccination among women in the rural district was about ten times higher than that of women living in the metropolitan district. Those participants who had greater knowledge of cervical cancer and HPV vaccinations also had a significantly higher intention to vaccinate. Our findings underscore the need to develop a well-designed vaccination program in Vietnam and other countries in a similar situation to increase the adoption of HPV vaccination.
Collapse
Affiliation(s)
- Xuan Thi Thanh Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Phuong Thi Ngoc Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Toan Thi Thanh Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Thang Huu Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
- Correspondence: ; Tel.: +84-86-9548-561
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (C.L.H.); (R.C.M.H.)
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Roger C.M. Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (C.L.H.); (R.C.M.H.)
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
| | - Cyrus S.H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
| |
Collapse
|
6
|
Facilitators and barriers of human papillomavirus vaccine uptake in young females 18-26 years old in Singapore: A qualitative study. Vaccine 2019; 37:6030-6038. [PMID: 31473002 DOI: 10.1016/j.vaccine.2019.08.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Around 70% of cervical cancers are caused by Types 16 and 18 of human papillomavirus (HPV). Vaccines against HPV have been shown to be safe and effective in preventing HPV and cervical cancer. OBJECTIVE To explore the facilitators and barriers of HPV vaccination in young females aged 18-26 years in Singapore, and to describe their recommended strategies to improve the uptake of HPV vaccination. DESIGN Qualitative, descriptive design guided by the socio-ecological model. PARTICIPANTS Young women studying in National University of Singapore (NUS), aged 18-26 (N = 40). Purposive sampling was used to recruit participants from various socio-economic levels and faculties, both vaccinated against HPV and unvaccinated. METHODS In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with the participants. IDIs and FGDs were transcribed and coded using NVIVO software. Thematic data analysis was performed using an inductive approach. RESULTS Barriers to HPV vaccination included lack of awareness, lack of perceived risk for cervical cancer, cost, lack of parental support, inconvenience of getting the vaccination, stigma associated with connection with sexual activity, and concern regarding safety. Facilitators include parental encouragement, protection of one's health, lack of logistical barriers, and perceived safety and efficacy of the vaccine. Participants recommended increasing awareness of HPV vaccination and cervical cancer, reducing cost of vaccination and making the vaccine compulsory to increase vaccine uptake. CONCLUSION Barriers and facilitators exist at different levels to influence vaccine uptake. Public education on cervical cancer and the vaccine should be stepped up to increase public awareness. A school-based national vaccination programme was proposed by the target group to increase the rate of uptake of HPV vaccination in Singapore.
Collapse
|
7
|
Cooper S, Schmidt B, Ryan J, Leon N, Mavundza E, Burnett R, Tanywe AC, Wiysonge CS. Factors that influence acceptance of human papillomavirus (HPV) vaccination for adolescents: a qualitative evidence synthesis. Cochrane Database Syst Rev 2019; 2019:CD013430. [PMCID: PMC6754167 DOI: 10.1002/14651858.cd013430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/30/2023]
Abstract
This is a protocol for a Cochrane Review (Qualitative). The objectives are as follows: The objectives of the review are to: Identify, appraise, and synthesise qualitative studies exploring: parents’, caregivers’, or adolescents’ views, experiences, or decision‐making regarding HPV vaccination; or the factors influencing the acceptance of HPV vaccination arising from parents’, caregivers’, and adolescents’ accounts. Identify the factors influencing parents’, caregivers’ and adolescents’ acceptance of HPV vaccination. Explore how the findings of this review can enhance our understanding of the related intervention review (Abdullahi 2015 ).
Collapse
Affiliation(s)
- Sara Cooper
- South African Medical Research CouncilCochrane South AfricaFrancie van Zijl Drive, Parow ValleyCape TownSouth Africa7505
| | - Bey‐Marrié Schmidt
- South African Medical Research CouncilCochrane South AfricaFrancie van Zijl Drive, Parow ValleyCape TownSouth Africa7505
| | - Jill Ryan
- South African Medical Research CouncilCochrane South AfricaFrancie van Zijl Drive, Parow ValleyCape TownSouth Africa7505
| | - Natalie Leon
- South African Medical Research CouncilHealth Systems Research UnitCape TownSouth Africa
| | - Edison Mavundza
- South African Medical Research CouncilCochrane South AfricaFrancie van Zijl Drive, Parow ValleyCape TownSouth Africa7505
| | | | | | - Charles S Wiysonge
- South African Medical Research CouncilCochrane South AfricaFrancie van Zijl Drive, Parow ValleyCape TownSouth Africa7505
| |
Collapse
|
8
|
Foss HS, Oldervoll A, Fretheim A, Glenton C, Lewin S. Communication around HPV vaccination for adolescents in low- and middle-income countries: a systematic scoping overview of systematic reviews. Syst Rev 2019; 8:190. [PMID: 31370886 PMCID: PMC6670236 DOI: 10.1186/s13643-019-1100-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/05/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection causes cervical cancer. More than 80% of those diagnosed with cervical cancer live in low- and middle-income countries (LMICs). The World Health Organization recommends vaccination as a public health measure against cervical cancer. Communication interventions are able to change how people think about vaccination and are thus instrumental in addressing vaccine hesitancy. Our aim was to provide a broad scoping overview of the available evidence on communication with adolescents, parents, and other stakeholders around HPV vaccination for adolescents, with a specific focus on LMICs. METHODS We conducted a systematic scoping overview of systematic reviews addressing a range of questions regarding communication around HPV vaccination. We considered reviews published between 2007 and 2018 focusing on communication around HPV vaccination and that searched for qualitative or quantitative studies for inclusion. We searched the Epistemonikos database which includes reviews from multiple electronic databases. Two overview authors screened titles and abstracts and examined potentially eligible reviews in full text. Data extraction was performed by one overview author and verified by a second. We assessed the reliability of the included reviews using an adapted version of AMSTAR 2. RESULTS We included twelve reviews in our overview. Four reviews assessed the effectiveness of communication interventions. These interventions intended to inform or educate about HPV and HPV vaccination, such as videos and fact sheets, or to remind or recall, such as text message reminders. Eight reviews assessed factors associated with HPV vaccination uptake, including communication-related factors such as whether the vaccine was recommended by a physician and people's knowledge regarding the vaccine. Nine reviews searched for studies from LMICs, but most found only a small number of studies from these countries. CONCLUSIONS The small number of studies identified from LMICs is of concern as these countries face the largest burden of disease related to HPV. This scoping overview also found and excluded a number of reviews because of important methodological limitations, highlighting the need for future reviews to use appropriate methods. The overview indicates areas in which further primary studies are needed on HPV vaccination communication in LMICs. SYSTEMATIC REVIEW REGISTRATION Open Science Framework https://osf.io/agzb4/.
Collapse
Affiliation(s)
| | - Ann Oldervoll
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Atle Fretheim
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Claire Glenton
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Simon Lewin
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway.
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
| |
Collapse
|
9
|
Rodriguez AM, Do TQN, Goodman M, Schmeler KM, Kaul S, Kuo YF. Human Papillomavirus Vaccine Interventions in the U.S.: A Systematic Review and Meta-analysis. Am J Prev Med 2019; 56:591-602. [PMID: 30773231 DOI: 10.1016/j.amepre.2018.10.033] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 10/28/2018] [Accepted: 10/29/2018] [Indexed: 12/13/2022]
Abstract
CONTEXT Despite current recommendations, human papillomavirus vaccine uptake remains low. A systematic review and meta-analysis assessed the effectiveness of interventions targeting human papillomavirus vaccine initiation and completion among children, adolescents, and young adults aged 9-26 years. EVIDENCE ACQUISITION Three electronic databases (CINAHL, OVID, and Web of Science) were searched for articles published in English peer-reviewed journals between January 2006 and January 2017 of U.S. studies that evaluated intervention strategies and reported post-intervention human papillomavirus vaccine initiation or completion rates among individuals aged 9-26 years. Study characteristics and outcomes were extracted. Data were collected in 2016 and analyzed in 2017. EVIDENCE SYNTHESIS Reviewers screened 983 unique titles and abstracts, read 241 full-text articles, and extracted data from 30 articles meeting the inclusion criteria (12 behavioral, ten environmental, four informational, and four combination strategies). Published EQUATOR (Enhancing the Quality and Transparency of Health Research) guidelines were used to assess study quality. Random effects meta-analyses were conducted. The meta-analyses included 17 RCTs and quasi-experiments involving 68,623 children, adolescents, and young adults. The pooled relative incidence estimates were 1.84 (95% CI=1.36, 2.48) for human papillomavirus vaccine initiation and 1.50 (95% CI=1.23, 1.83) for completion. Behavioral and informational interventions doubled human papillomavirus vaccine initiation (relative incidence estimate=2.04, 95% CI=1.36, 3.06 and relative incidence estimate=1.92, 95% CI=1.27, 2.91, respectively). Behavioral interventions increased completion by 68% (relative incidence estimate=1.68, 95% CI=1.25, 2.27). CONCLUSIONS Evidence supports behavioral interventions for increasing human papillomavirus vaccine initiation and completion. Future studies are needed to assess the effectiveness of interventions in reaching diverse populations and reducing missed opportunities for human papillomavirus vaccination.
Collapse
Affiliation(s)
- Ana M Rodriguez
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas; Sealy Institute for Vaccine Sciences, University of Texas Medical Branch at Galveston, Galveston, Texas.
| | - Thuy Quynh N Do
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Michael Goodman
- Department of Epidemiology, Emory University, Atlanta, Georgia
| | - Kathleen M Schmeler
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sapna Kaul
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Yong-Fang Kuo
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, Texas
| |
Collapse
|
10
|
McComb E, Ramsden V, Olatunbosun O, Williams-Roberts H. Knowledge, Attitudes and Barriers to Human Papillomavirus (HPV) Vaccine Uptake Among an Immigrant and Refugee Catch-Up Group in a Western Canadian Province. J Immigr Minor Health 2019; 20:1424-1428. [PMID: 29445898 DOI: 10.1007/s10903-018-0709-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Vaccination is a key strategy to prevent cervical cancer in developed countries. Lower uptake of human papillomavirus (HPV) vaccine among new immigrants and refugees has been documented, although exploration of underlying reasons remains an understudied area. Semi-structured interviews with eleven immigrant women (ages 18-26 years) were conducted to understand their knowledge, attitudes and barriers regarding HPV vaccination in a western Canadian province. Participants had limited knowledge about HPV and the vaccine. Most women perceived that their risk of HPV was low, however expressed willingness to receive the vaccine if it were recommended by their physician. Greater efforts are needed to increase knowledge about HPV among immigrant and refugee women and support for physicians to discuss and offer vaccination to this underserved population.
Collapse
Affiliation(s)
- Erin McComb
- Department of Obstetrics, Gynecology and Reproductive Sciences, College of Medicine, University of Saskatchewan, 107 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.
| | - Vivian Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Olufemi Olatunbosun
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Saskatchewan, Saskatoon, SK, Canada
| | - Hazel Williams-Roberts
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| |
Collapse
|
11
|
Baldovin T, Bertoncello C, Cocchio S, Fonzo M, Gazzani D, Buja A, Majori S, Baldo V. Perception and knowledge of HPV-related and vaccine-related conditions among a large cohort of university students in Italy. Hum Vaccin Immunother 2019; 15:1641-1649. [PMID: 30689506 PMCID: PMC6746475 DOI: 10.1080/21645515.2018.1564432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/06/2018] [Accepted: 12/24/2018] [Indexed: 10/27/2022] Open
Abstract
HPV is involved in cervical, anal, penile, vulvar and oropharyngeal cancers, as well as genital warts. It is important to investigate knowledge and attitudes among university students, considering in this age a shift in healthcare decision-making from parents to students themselves. The aim of this study was to estimate knowledge and perception of HPV in terms of potential shame for HPV-related conditions, trust in vaccine efficacy and worry for potential side effects. The study involved students (18-25 years old) from the Universities of Padua and Verona, Italy. Socio-demographic and behavioural characteristics were collected with a questionnaire (n = 9988). Female gender and older age were positively associated with higher knowledge. The adjusted logistic regression showed an association between the set of perceptions investigated and the vaccination status, while a direct connection with knowledge was not found. However, another adjusted linear regression showed that a good set of perceptions could be partially explained by a high level of knowledge. Perceptions seem to fill an intermediate position between the knowledge and the decision to get vaccinated. The potential shame deriving from asking for HPV-vaccination was not identified as a relevant barrier. Having received information from healthcare workers, family and school showed to be positively associated with the adhesion to the vaccination policy. This study identifies university students as a possible target for HPV vaccination and pinpoints specific areas that might be targeted as first to encourage vaccine uptake. Primary prevention together with screening programmes remains essential in further reducing the burden of HPV-related diseases.
Collapse
Affiliation(s)
- T. Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - C. Bertoncello
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - S. Cocchio
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - M. Fonzo
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - D. Gazzani
- Department of Public Health and Community Medicine, Hygiene and Environmental, Occupational and Preventive Medicine Division, University of Verona, Verona, Italy
| | - A. Buja
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - S. Majori
- Department of Public Health and Community Medicine, Hygiene and Environmental, Occupational and Preventive Medicine Division, University of Verona, Verona, Italy
| | - V. Baldo
- Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| |
Collapse
|
12
|
Perez S, Zimet GD, Tatar O, Stupiansky NW, Fisher WA, Rosberger Z. Human Papillomavirus Vaccines: Successes and Future Challenges. Drugs 2018; 78:1385-1396. [DOI: 10.1007/s40265-018-0975-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
13
|
Identification of determinants associated with uptake of the first dose of the human papillomavirus vaccine in Denmark. Vaccine 2018; 36:5747-5753. [DOI: 10.1016/j.vaccine.2018.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 11/18/2022]
|
14
|
Patel H, Austin-Smith K, Sherman SM, Tincello D, Moss EL. Knowledge, attitudes and awareness of the human papillomavirus amongst primary care practice nurses: an evaluation of current training in England. J Public Health (Oxf) 2018; 39:601-608. [PMID: 27412177 DOI: 10.1093/pubmed/fdw063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 05/23/2016] [Indexed: 11/13/2022] Open
Abstract
Background The incorporation of Human papillomavirus (HPV) testing into the English cervical screening programme has been met with fear and anxiety. Healthcare professionals need to be adequately informed about HPV to help alleviate patient concerns. The aim of this study was to evaluate the HPV training provided to practice nurses (PNs) and determine their level of HPV knowledge. Method A web-based survey was distributed to 147 General Practice surgeries in the Leicester, Leicestershire and Rutland regions, between May and July 2015. The survey explored four broad areas; demographics/level of experience, HPV knowledge, attitudes towards the HPV vaccine and self-perceived adequacy of HPV knowledge. Results A total of 128 surveys were completed, with 94 complete responses. Overall awareness of basic HPV facts was adequate; however, detailed, and in some cases basic, knowledge was lacking. 9.6% failed to identify that HPV can cause cervical cancer and 62.8% believed that HPV requires treatment. Not all PNs felt adequately informed about HPV and a need to improve the provision of training was identified. Conclusion PNs play a key role in increasing public awareness of HPV and implementing cervical cancer screening. The provision of education to PNs needs to be a priority and current methods of training need to be re-evaluated.
Collapse
Affiliation(s)
- H Patel
- Department of Gynaecology, University Hospitals Leicester, Gwendolen Road, Leicester LE5 4PW, UK
| | - K Austin-Smith
- Department of Gynaecology, Kettering General Hospital, Rothwell Road, KetteringNN16 8UZ, UK
| | | | - D Tincello
- University of Leicester, Centre for Medicine, Leicester LE1 7RH, UK
| | - E L Moss
- University Hospitals Leicester, Gwendolen Road, Leicester LE5 4PW, UK
| |
Collapse
|
15
|
Bhuiyan A, Sultana F, Islam JY, Chowdhury MAK, Nahar Q. Knowledge and Acceptance of Human Papillomavirus Vaccine for Cervical Cancer Prevention Among Urban Professional Women in Bangladesh: A Mixed Method Study. Biores Open Access 2018; 7:63-72. [PMID: 29844948 PMCID: PMC5970545 DOI: 10.1089/biores.2018.0007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Prophylactic human papillomavirus (HPV) vaccination is the most effective preventive method against invasive cervical cancer, the second leading cause of cancer-related deaths among women in Bangladesh. Evidence on women's knowledge and perception about cervical cancer and HPV vaccination are needed for effective implementation of national cervical cancer prevention programs. The objective of this study was to assess the knowledge, attitude, and acceptance of cervical cancer, HPV, and HPV vaccination among urban professional women in Bangladesh. We recruited 160 female professionals employed at selected private banks in Bangladesh. Participants were selected using nonprobability-based convenience sampling for interviews through a self-administered questionnaire. Later, in-depth interviews were conducted with nine of these women. Quantitative data were analyzed utilizing descriptive statistics, whereas qualitative data were analyzed using a thematic approach. Ninety-eight percent of participants reported that they had previously heard of cervical cancer, however, only half (51%) reported to have heard of HPV as a cause of the disease. Less than 1% of the 160 participants had previously undergone a pap smear, and only 2% were vaccinated with at least one dose of HPV vaccination. Although knowledge was low, intention for acceptance of vaccination was moderate for women and high for their children. Although the majority of women had heard of cervical cancer, few women had in-depth knowledge of HPV and the etiology of invasive disease. This study draws attention to the urgent need of educational interventions on cervical cancer and its prevention to improve uptake of available HPV vaccination in Bangladesh.
Collapse
Affiliation(s)
- Afsana Bhuiyan
- London Northwest Healthcare Trust, Harrow, United Kingdom
| | - Farhana Sultana
- Victorian Cytology Services Registries, East Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Jessica Yasmine Islam
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Quamrun Nahar
- International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| |
Collapse
|
16
|
Maisonneuve AR, Witteman HO, Brehaut J, Dubé È, Wilson K. Educating children and adolescents about vaccines: a review of current literature. Expert Rev Vaccines 2018; 17:311-321. [PMID: 29569498 DOI: 10.1080/14760584.2018.1456921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Until recently, research on vaccine hesitancy has focused primarily on parent populations. Although adolescent knowledge and views are gaining momentum within the literature, particularly with regards to the human papillomavirus and influenza, children remain a virtually unstudied population with regards to vaccine hesitancy. AREAS COVERED This review focuses on the lack of literature in this area and argues for more vaccine hesitancy research involving child and adolescent populations. It also outlines special issues to consider when framing health promotion messages for children and adolescents. Finally, we explore the use of new and existing technologies as delivery mechanisms for education on vaccines and immunizations in populations of children and adolescents. EXPERT COMMENTARY Children undergo cognitive development and experiences with vaccines (e.g. pain or education) have the potential to create future attitudes toward vaccines. This can influence future vaccine behaviour, including their participation in decision-making around adolescent vaccines, their decisions to vaccinate themselves when they are adults, and their decisions to vaccinate their own children. Interventions aimed at children, such as education, can create positive attitudes toward vaccines. These can also potentially influence parental attitudes toward vaccines as children convey this knowledge to them. Both of these impacts require further study.
Collapse
Affiliation(s)
| | - Holly O Witteman
- b Department of Family and Emergency Medicine , Université Laval , Québec , QC , Canada
| | - Jamie Brehaut
- c Ottawa Hospital Research Institute , Ottawa , ON , Canada
| | - Ève Dubé
- d Institut national de santé publique du Québec , Québec , QC , Canada
| | - Kumanan Wilson
- c Ottawa Hospital Research Institute , Ottawa , ON , Canada
| |
Collapse
|
17
|
Islam JY, Khatun F, Alam A, Sultana F, Bhuiyan A, Alam N, Reichenbach L, Marions L, Rahman M, Nahar Q. Knowledge of cervical cancer and HPV vaccine in Bangladeshi women: a population based, cross-sectional study. BMC WOMENS HEALTH 2018; 18:15. [PMID: 29325530 PMCID: PMC5765714 DOI: 10.1186/s12905-018-0510-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 01/03/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The objective of this study was to assess the level of knowledge of cervical cancer among Bangladeshi women and to assess their willingness to receive the human papillomavirus (HPV) vaccine. METHODS A population-based, cross-sectional survey was conducted from July to December 2011 in one urban and one rural area of Bangladesh. A total of 2037 ever-married women, aged 14 to 64 years, were interviewed using a structured questionnaire. Data on socio-demographic characteristics and knowledge of cervical cancer were collected. Willingness to receive the HPV vaccine was assessed. Univariate analyses were completed using quantitative data collected. Multivariable logistic regression models were developed to identify factors associated with having heard of cervical cancer and the HPV vaccine. RESULTS The majority of study participants reported to have heard of cervical cancer (urban: 89.7%, rural 93.4%; P = 0.003). The odds of having heard of cervical cancer were significantly higher in urban women aged 35-44 years (aOR: 2.92 (1.34-6.33) and rural women aged 25-34 years (aOR: 2.90 (1.24-6.73) compared to those aged less than 24 years. Very few women reported to have detailed knowledge on risk factors (urban:9.1%, rural: 8.8%) and prevention (urban: 6.4%, rural: 4.4%) of cervical cancer. In our sample, one in five urban women and one in twenty rural women heard about a vaccine that can prevent cervical cancer. Among urban women, secondary education or higher (aOR: 3.48, 95% CI: 1.67-7.25), age of 20 years and above at marriage (aOR: 2.83, 95% CI: 1.61-5.00), and high socioeconomic status (aOR: 2.25, 95% CI: 1.28-3.95) were factors associated with having heard of the HPV vaccine. Willingness to receive the HPV vaccine among study participants either for themselves (urban: 93.9%, rural: 99.4%) or for their daughters (urban: 91.8%, rural: 99.2%) was high. CONCLUSIONS Detailed knowledge of cervical cancer among Bangladeshi women was found to be poor. Education on cervical cancer must include information on symptoms, risk factors, and preventive methods. Despite poor knowledge, the study population was willing to receive the HPV vaccine.
Collapse
Affiliation(s)
- Jessica Yasmine Islam
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Fatema Khatun
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Anadil Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Farhana Sultana
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Parkville, VIC, 3010, Australia.,Registries and Research, Victorian Cytology Service Registries, Level 6, 176 Wellington Parade, East Melbourne, VIC, 3002, Australia
| | | | - Nazmul Alam
- University of Montreal Hospital Research Centre (CR-CHUM), Montreal, QC, Canada
| | | | - Lena Marions
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Mustafizur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Quamrun Nahar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh.
| |
Collapse
|
18
|
Impact of an HPV Education and Vaccination Campaign among Canadian University Students. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 40:440-446. [PMID: 29102218 DOI: 10.1016/j.jogc.2017.07.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/26/2017] [Accepted: 07/26/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Uptake of HPV vaccination among university students remains low despite risky sexual practices and increased prevalence of high-risk HPV genotypes. The study objective was to determine the level of knowledge related to HPV and cervical cancer among university students and to subsequently develop a targeted education and vaccination campaign to increase uptake. METHODS Phase I was a pilot project in which participants were recruited as part of Cervical Cancer Awareness Week 2015 at two universities, one site immediately offering vaccination and the other not. A self-administered questionnaire was used to collect demographic information from participants and evaluate their baseline knowledge related to HPV and the risks of cervical cancer, in addition to determining barriers to vaccination and future willingness to be vaccinated. Data was compiled and analyzed using descriptive statistics of means and percentages. In phase II, which followed 1 year after, a targeted education and vaccination campaign was designed based on lessons learned from phase I, and vaccination uptake was reevaluated after 1 year. RESULTS In phase I, 56 participants responded to a questionnaire related to HPV knowledge and cervical cancer. Among these, 29 students were vaccinated in a 2-day resident-run clinic. Overall, 63% felt they were not at risk of cervical cancer, though 88% knew HPV was the cause of cervical cancer. The three barriers identified to previous vaccination were lack of access to a doctor or a nurse (25%), financial reasons (25%), and low self-perceived risk (7%). There was a 50% three-dose completion rate in phase I. Based on this information, the education campaign in phase II was expanded in the subsequent year through social media, email communication, information booths, and individual solicitation. A total of 151 students were approached for individual solicitation and education. Among these, 64 students were vaccinated on site, including five men. Most importantly, there were 18 walk-ins resulting directly from the education initiatives and person-to-person solicitation. Subsequently, in 2016, 502 students were vaccinated at the McGill student health clinic and 455 at Concordia University. CONCLUSION HPV vaccination rates in university students are readily increased through educational campaigns, of which person-to-person solicitation proved to be the most fruitful in this study. Identifying barriers to vaccination can guide future initiatives to maximize impact.
Collapse
|
19
|
Sherman KA, Kilby CJ, Moore DM, Shaw LK. The importance of coherently understanding cervical cancer vaccination: factors associated with young Australian women’s uptake of the HPV vaccine. Health Psychol Behav Med 2017. [DOI: 10.1080/21642850.2017.1381023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Kerry A. Sherman
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia
| | - Christopher J. Kilby
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia
| | - Danielle M. Moore
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Laura-Kate Shaw
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia
| |
Collapse
|
20
|
Fernández-Feito A, Antón-Fernández R, Paz-Zulueta M. [Sexual risk behaviours and PAP testing in university women vaccinated against human papillomavirus]. Aten Primaria 2017; 50:291-298. [PMID: 28867156 PMCID: PMC6836978 DOI: 10.1016/j.aprim.2017.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/05/2017] [Accepted: 05/14/2017] [Indexed: 11/24/2022] Open
Abstract
Objetivo Estimar la asociación entre la vacunación frente al virus papiloma humano (VPH) y las conductas sexuales de riesgo, así como la participación en el Programa de Detección Precoz de Cáncer de Cuello Uterino (PDPCCU). Diseño Estudio descriptivo transversal. Emplazamiento Facultad de Medicina y Ciencias de la Salud, Facultad de Derecho y Facultad de Economía y Empresa (Universidad de Oviedo). Participantes Estudiantes universitarias. Mediciones principales Se recogió información sobre métodos anticonceptivos, conducta sexual, conocimientos sobre VPH y participación en el PDPCCU. Se estimaron proporciones y odds ratio (OR) con sus correspondientes intervalos de confianza al 95% (IC 95%). Resultados El 67,7% de la muestra estaban vacunadas frente al VPH. Un total de 216 mujeres (65,3%) eran sexualmente activas. El 67,6% utilizaba un método de barrera en la relación actual, siendo menos frecuente entre las mujeres no vacunadas (54,9% frente al 75,4% en estudiantes vacunadas) (p = 0,002). El riesgo de mantener al menos una conducta sexual de riesgo era mayor entre las mujeres no vacunadas: OR 2,29 (IC 95%: 1,29-4,07). La probabilidad de realizar una citología dentro del PDPCCU fue mayor entre las mujeres no vacunadas: OR 2,18 (IC 95%: 1,07-4,47). Conclusiones La prevalencia de conductas sexuales de riesgo en mujeres no vacunadas es elevada y se relaciona con la no utilización de métodos de barrera. La vacunación frente al VPH puede influir en la conducta sexual y en la participación en PDPCCU. Se debería reforzar la información que reciben los jóvenes sobre anticoncepción, enfermedades de transmisión sexual y prevención del cáncer.
Collapse
Affiliation(s)
- Ana Fernández-Feito
- Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España.
| | | | - María Paz-Zulueta
- Departamento de Enfermería, Escuela Universitaria de Enfermería, Universidad de Cantabria, Santander, España
| |
Collapse
|
21
|
Vielot NA, Butler AM, Brookhart MA, Becker-Dreps S, Smith JS. Patterns of Use of Human Papillomavirus and Other Adolescent Vaccines in the United States. J Adolesc Health 2017; 61:281-287. [PMID: 28739327 PMCID: PMC10530656 DOI: 10.1016/j.jadohealth.2017.05.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/08/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of the study was to describe the patterns of use of universally recommended adolescent vaccines in the United States. METHODS We identified 11-year-olds using the MarketScan insurance claims database (2009-2014). Human papillomavirus (HPV), tetanus-diphtheria-acellular pertussis (Tdap), and meningococcal (MenACWY) vaccination claims were identified using diagnosis and procedure codes. Generalized linear models estimated vaccination incidence rates and correlates of adolescent vaccination and timely vaccination. RESULTS Among 1,691,223 adolescents, receipt of Tdap (52.1%) and MenACWY (45.8%) vaccinations exceeded receipt of HPV vaccination (18.4%). While both sexes had similar Tdap and MenACWY vaccination proportions, girls received HPV vaccination more frequently than boys (21.9% vs. 15.1%). Adolescents received HPV vaccination later (mean age: 11.8 years) than Tdap or MenACWY vaccination (mean age: 11.2 years for both). Half of vaccinated adolescents received Tdap and MenACWY vaccination only; however, coadministration with HPV vaccine increased with birth cohort. Western adolescents had the highest incidence rates of HPV vaccination, and Southern adolescents had the lowest. Rural adolescents were less likely than urban adolescents to receive each vaccination except in the Northeast, where they were more likely to receive HPV vaccination (incidence rate ratio: 1.09, 95% confidence interval: 1.2005-1.13). Timely HPV vaccination was associated with female sex, urbanicity, Western residence, and later birth cohort. CONCLUSIONS HPV vaccination occurred later than Tdap or MenACWY vaccination and was less frequent in boys and rural adolescents. Girls, Western and urban residents, and younger birth cohorts were more likely to receive timely HPV vaccination. Vaccine coadministration increased over time and may encourage timely and complete vaccination coverage.
Collapse
Affiliation(s)
- Nadja A Vielot
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Anne M Butler
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - M Alan Brookhart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sylvia Becker-Dreps
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
22
|
Perez S, Tatar O, Gilca V, Shapiro GK, Ogilvie G, Guichon J, Naz A, Rosberger Z. Untangling the psychosocial predictors of HPV vaccination decision-making among parents of boys. Vaccine 2017; 35:4713-4721. [DOI: 10.1016/j.vaccine.2017.07.043] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 07/05/2017] [Accepted: 07/13/2017] [Indexed: 01/27/2023]
|
23
|
|
24
|
Sathian B, Babu MGR, van Teijlingen ER, Banerjee I, Roy B, Subramanya SH, Rajesh E, Devkota S. Ethnic Variations in Perception of Human Papillomavirus and its Vaccination among Young Women in Nepal . Nepal J Epidemiol 2017; 7:647-658. [PMID: 28970947 PMCID: PMC5607446 DOI: 10.3126/nje.v7i1.17757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The Human Papillomavirus (HPV) is strongly associated with cervical and other cancers. In women, cervical cancer is the third most common cancer. HPV infection can be largely prevented through vaccination of (adolescent) girls. At the same time, Nepal is a low-income country experiencing a cultural change in attitudes towards sex and sexual behaviour. However, in the adolescent population knowledge about HPV, factors associated with an increased risk of HPV and the existence of the vaccination is often low. MATERIALS AND METHODS This was a cross-sectional study with female students enrolled in health and non-health science courses in Pokhara, Nepal. The questionnaire included demographic details, knowledge and attitude questions related to HPV, associated risk behaviour and its vaccination. Descriptive statistics, including Chi-Square test, were used to identify statistically significant relationships. Ethical approval was granted by the relevant authority in Nepal. RESULTS Hindu religion (75.0 %; 95% CI: 70.9, 78.6) and Newari caste (75.5%; CI: 61.1, 86.7) were more aware about HPV, HPV vaccination. Hindus religion (55.6%; 95% CI: 51.2, 60.0) and Dalit caste (61.6%, 95% CI: 53.3, 69.4) more willing to be vaccinated than other religions and other castes, respectively. Not unsurprisingly, students on health-related courses had a greater awareness of HPV, HPV vaccination and were more willing to be vaccinated than students on other courses. Similar patterns of association arose for knowledge related to those sexually active at an early age; HPV risk and multiple sex partners; and fact that condoms cannot fully prevent the transmission of HPV. CONCLUSION Knowledge about the link between HPV and (a) early sexual initiation, (b) having multiple sexual partners, and (c) the limited protection of condoms and other birth control measures was poor in our study compared to similar research conducted in other parts of the world. One key implication is the need for education campaigns in Nepal to educate young women and their parents about HPV, its risk factors and the benefits of vaccination. .
Collapse
Affiliation(s)
- Brijesh Sathian
- Assistant Professor, Department of Community Medicine, Manipal College of Medical Sciences Pokhara, Nepal
| | - M G Ramesh Babu
- Senior Lecturer, Department of Physiology, Melaka Manipal Medical College Manipal University, India
| | | | - Indrajit Banerjee
- Associate Professor, Department of Pharmacology, Chitwan Medical College and Teaching Hospital Chitwan, Nepal
| | - Bedanta Roy
- Assistant Professor, Department of Physiology, Manipal College of Medical Sciences Pokhara, Nepal.
| | - Supram Hosuru Subramanya
- Assistant Professor, Department of Microbiology, Manipal College of Medical Sciences Pokhara, Nepal.
| | - Elayedath Rajesh
- Assistant Professor, School of Behavioural Sciences, Mahatma Gandhi University India.
| | - Suresh Devkota
- Lecturer, Department of Community Medicine, Manipal College of Medical Sciences Pokhara, Nepal.
| |
Collapse
|
25
|
GRDADOLNIK U, SOČAN M. The Impact of Socio-Economic Determinants on the Vaccination Rates with Rotavirus and Human Papiloma Virus Vaccine. Zdr Varst 2016; 55:43-52. [PMID: 27647088 PMCID: PMC4820181 DOI: 10.1515/sjph-2016-0007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 09/21/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Socio-economic inequalities may have an impact on the uptake of selfpaid vaccines. The aim of the study was to identify the effect of some socio economic determinants on vaccination rates with self-paid human papilloma virus (HPV) and rotavirus (RV) vaccines. METHODS Vaccination coverage data, available in electronic database cepljenje.net (administered by the National Institute of Public Health), were collected at administrative unit level. The socio-economic determinants (the average gross pay in euros, the unemployment rate, the educational and households structure, the population density, the number of inhabitants, the number of children aged from 0 to 4, the number of women aged from 15 to 30) were extracted from Statistical Office of the Republic of Slovenia web page. The strength of the correlation between socioeconomic variables and self-paid HPV and RV vaccination rates was determined. RESULTS Rotavirus vaccination rates show a slight negative correlation with the number of residents per administrative unit (ρ=-0.29, p=0.04), and no correlation with other socio-economic variables. Likewise, no correlation has been found between HPV vaccination rates and the selected socio-economic variables. CONCLUSION Ecological study did not reveal any correlations between socio economic variables and vaccination rates with RV and HPV self-paid vaccines on administrative unit level.
Collapse
Affiliation(s)
- Urška GRDADOLNIK
- University Medical Center Ljubljana, Division of Internal Medicine, Zaloška cesta 2, 1000 Ljubljana, Slovenia
| | - Maja SOČAN
- National Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia
| |
Collapse
|
26
|
Patel H, Jeve YB, Sherman SM, Moss EL. Knowledge of human papillomavirus and the human papillomavirus vaccine in European adolescents: a systematic review. Sex Transm Infect 2016; 92:474-9. [DOI: 10.1136/sextrans-2015-052341] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 12/28/2015] [Indexed: 11/04/2022] Open
|
27
|
La Vincente SF, Mielnik D, Jenkins K, Bingwor F, Volavola L, Marshall H, Druavesi P, Russell FM, Lokuge K, Mulholland EK. Implementation of a national school-based Human Papillomavirus (HPV) vaccine campaign in Fiji: knowledge, vaccine acceptability and information needs of parents. BMC Public Health 2015; 15:1257. [PMID: 26684658 PMCID: PMC4684606 DOI: 10.1186/s12889-015-2579-3] [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: 03/24/2015] [Accepted: 12/08/2015] [Indexed: 11/18/2022] Open
Abstract
Background In 2008 Fiji implemented a nationwide Human Papillomavirus (HPV) vaccine campaign targeting all girls aged 9–12 years through the existing school-based immunisation program. Parents of vaccine-eligible girls were asked to provide written consent for vaccination. The purpose of this study was to describe parents’ knowledge, experiences and satisfaction with the campaign, the extent to which information needs for vaccine decision-making were met, and what factors were associated with vaccine consent. Methods Following vaccine introduction, a cross-sectional telephone survey was conducted with parents of vaccine-eligible girls from randomly selected schools, stratified by educational district. Factors related to vaccine consent were explored using Generalised Estimating Equations. Results There were 560 vaccine-eligible girls attending the participating 19 schools at the time of the campaign. Among these, 313 parents could be contacted, with 293 agreeing to participate (93.6 %). Almost 80 % of participants reported having consented to HPV vaccination (230/293, 78.5 %). Reported knowledge of cervical cancer and HPV prior to the campaign was very low. Most respondents reported that they were satisfied with their access to information to make an informed decision about HPV vaccination (196/293, 66.9 %). and this was very strongly associated with provision of consent. Despite their young age, the vaccine-eligible girls were often involved in the discussion and decision-making. Most consenting parents were satisfied with the campaign and their decision to vaccinate, with almost 90 % indicating they would consent to future HPV vaccination. However, negative media reports about the vaccine campaign created confusion and concern. Local health staff were cited as a trusted source of information to guide decision-making. Just over half of the participants who withheld consent cited vaccine safety fears as the primary reason (23/44, 52.3 %). Conclusion This is the first reported experience of HPV introduction in a Pacific Island nation. In a challenging environment with limited community knowledge of HPV and cervical cancer, media controversy and a short lead-time for community education, Fiji has implemented an HPV vaccine campaign that was largely acceptable to the community and achieved a high level of participation. Community sensitisation and education is critical and should include a focus on the local health workforce and the vaccine target group.
Collapse
Affiliation(s)
- S F La Vincente
- Centre for International Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia. .,Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, VIC, Australia.
| | - D Mielnik
- Centre for International Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia. .,National Centre for Epidemiology and Population Health, Australian National University, Building 62, Cnr Eggleston and Mills Roads, Canberra, ACT, Australia.
| | - K Jenkins
- Fiji Health Sector Support Programme, Namosi House, Amy St, Suva, Fiji.
| | - F Bingwor
- Ministry of Health, Dinem House, 88 Amy St, Suva, Fiji.
| | - L Volavola
- Ministry of Health, Dinem House, 88 Amy St, Suva, Fiji.
| | - H Marshall
- Women's and Children's Hospital, 72 King William Rd, North Adelaide, SA, Australia. .,School of Medicine and Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, 55 King William Road, North Adelaide, SA, Australia. .,School of Population Health, University of Adelaide, 178 North Terrace, Adelaide, SA, Australia.
| | - P Druavesi
- Ministry of Health, Dinem House, 88 Amy St, Suva, Fiji.
| | - F M Russell
- Centre for International Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia. .,Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, VIC, Australia.
| | - K Lokuge
- National Centre for Epidemiology and Population Health, Australian National University, Building 62, Cnr Eggleston and Mills Roads, Canberra, ACT, Australia.
| | - E K Mulholland
- Centre for International Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia. .,London School of Hygiene and Tropical Medicine, Keppel St, London, UK.
| |
Collapse
|
28
|
Ngorsuraches S, Nawanukool K, Petcharamanee K, Poopantrakool U. Parents' preferences and willingness-to-pay for human papilloma virus vaccines in Thailand. J Pharm Policy Pract 2015. [PMID: 26199734 PMCID: PMC4509725 DOI: 10.1186/s40545-015-0040-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective To examine parents’ preferences and willingness-to-pay (WTP) for HPV vaccines. Methods A discrete choice experiment (DCE) was used. Parents with at least one daughter aged 9–13 years residing in Songkhla province were asked to choose one alternative from each DCE choice set describing HPV vaccines by four attributes, including cervical cancer risk reduction, genital warts risk reduction, common side effects, and cost. Multinomial logit model was used for data analyses. Results Parents preferred higher risk reductions for cervical cancer and genital warts, and lower common side effects. They valued the quadrivalent and bivalent HPV vaccines at 21,189.9 and 10,479.9 Baht, respectively. Results also showed that mothers valued both vaccines more than fathers did. Conclusions Parents valued net benefits for both quadrivalent and bivalent HPV vaccines, but they were willing to pay for the quadrivalent vaccine more than for the bivalent vaccine.
Collapse
Affiliation(s)
- Surachat Ngorsuraches
- Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla 90112 Thailand ; Department of Pharmacy Practice, College of Pharmacy, South Dakota State University, Brookings, SD 57007 US
| | - Kornwan Nawanukool
- Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla 90112 Thailand
| | - Krittin Petcharamanee
- Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla 90112 Thailand
| | - Ungkanit Poopantrakool
- Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla 90112 Thailand
| |
Collapse
|
29
|
Abstract
Purpose
– The purpose of this paper is to present a three-part framework of information engagement for situated gynecological cancers. These particular cancers intertwine with medicalization of sexuality and gender power dynamics, situating information behaviors and interactions in women’s socio-health perceptions. Using Kavanagh and Broom’s feminist risk framework, the framework establishes functional and temporal parameters for sense-making and information engagement.
Design/methodology/approach
– This paper employs a structured, reiterative literature review with emergent thematic analysis. Nine indices from medicine, information studies, and sociology were searched using combinations of five terms on cervical cancer (CC) and 14 terms on information engagement in the title, abstract, and subject fields. Results were examined on a reiterative basis to identify emergent themes pertaining to knowledge development and information interactions.
Findings
– Environmentally, social stigma and gender roles inhibit information seeking; normalizing CC helps integrate medical, moral, and sexual information. Internally, living with the dichotomy between “having” a body and “being” a body requires high-trust information resources that are presented gradually. Actively, choosing to make or cede medical decision-making requires personally relevant information delivered in the form of concrete facts and explanations.
Research limitations/implications
– The study covers only one country.
Originality/value
– This study’s information framework and suggestions for future research encourage consideration of gender power dynamics, medicalization of sexuality, and autonomy in women’s health information interactions.
Collapse
|
30
|
Lai CY, Wu WW, Tsai SY, Cheng SF, Lin KC, Liang SY. The Effectiveness of a Facebook-Assisted Teaching Method on Knowledge and Attitudes About Cervical Cancer Prevention and HPV Vaccination Intention Among Female Adolescent Students in Taiwan. HEALTH EDUCATION & BEHAVIOR 2015. [DOI: 10.1177/1090198114558591 10.1177/1090198114558591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Lack of education is a known barrier to vaccination, but data on the design and effectiveness of interventions remain limited. Objective. This study aims to identify the effectiveness of a Facebook-assisted teaching method on female adolescents’ knowledge and attitudes about cervical cancer prevention and on their human papillomavirus vaccination intention. Method. A quasi-experimental time series research design was used. Two hundred female adolescents at a senior high school in Taipei were recruited into two groups. Following a classroom lecture, one group was provided a Facebook-assisted online discussion, and the other group was provided an in-person discussion forum. A demographic questionnaire and cervical cancer prevention questionnaire were distributed. Data were analyzed for descriptive statistics and generalized estimation equations. Results. Improvement from T0 to T2 in knowledge and attitude scores was 4.204 and 4.496 points, respectively. The Facebook group’s improvement in vaccination intention from T0 to T2 was 2.310 times greater than the control group’s improvement under conditions of out-of-pocket expenses and 2.368 times greater under conditions of free vaccination. Conclusions. School-based cervical cancer prevention education can be effective. The Facebook-assisted discussion method was more effective than the in-person discussion. Providing the human papillomavirus vaccine free of charge would increase female adolescents’ intention to be vaccinated.
Collapse
Affiliation(s)
- Ching-Yi Lai
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wei-Wen Wu
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Su-Fen Cheng
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kuan-Chia Lin
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Yuan Liang
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
31
|
|
32
|
Lai CY, Wu WW, Tsai SY, Cheng SF, Lin KC, Liang SY. The Effectiveness of a Facebook-Assisted Teaching Method on Knowledge and Attitudes About Cervical Cancer Prevention and HPV Vaccination Intention Among Female Adolescent Students in Taiwan. HEALTH EDUCATION & BEHAVIOR 2014; 42:352-60. [PMID: 25512072 DOI: 10.1177/1090198114558591] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lack of education is a known barrier to vaccination, but data on the design and effectiveness of interventions remain limited. OBJECTIVE This study aims to identify the effectiveness of a Facebook-assisted teaching method on female adolescents' knowledge and attitudes about cervical cancer prevention and on their human papillomavirus vaccination intention. METHOD A quasi-experimental time series research design was used. Two hundred female adolescents at a senior high school in Taipei were recruited into two groups. Following a classroom lecture, one group was provided a Facebook-assisted online discussion, and the other group was provided an in-person discussion forum. A demographic questionnaire and cervical cancer prevention questionnaire were distributed. Data were analyzed for descriptive statistics and generalized estimation equations. RESULTS Improvement from T0 to T2 in knowledge and attitude scores was 4.204 and 4.496 points, respectively. The Facebook group's improvement in vaccination intention from T0 to T2 was 2.310 times greater than the control group's improvement under conditions of out-of-pocket expenses and 2.368 times greater under conditions of free vaccination. CONCLUSIONS School-based cervical cancer prevention education can be effective. The Facebook-assisted discussion method was more effective than the in-person discussion. Providing the human papillomavirus vaccine free of charge would increase female adolescents' intention to be vaccinated.
Collapse
Affiliation(s)
- Ching-Yi Lai
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wei-Wen Wu
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Su-Fen Cheng
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kuan-Chia Lin
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Yuan Liang
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
33
|
Wie wirken sich Informationen zur HPV-Impfung auf den Impfentscheid junger Frauen aus? PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2014. [DOI: 10.1007/s11553-014-0479-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Remschmidt C, Walter D, Schmich P, Wetzstein M, Deleré Y, Wichmann O. Knowledge, attitude, and uptake related to human papillomavirus vaccination among young women in Germany recruited via a social media site. Hum Vaccin Immunother 2014; 10:2527-35. [PMID: 25483492 DOI: 10.4161/21645515.2014.970920] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Many industrialized countries have introduced human papillomavirus (HPV) vaccination of young women, but vaccine uptake often remains suboptimal. This study aimed to investigate whether a social media site like Facebook is an appropriate tool to assess knowledge, attitude and uptake related to HPV vaccination in young women in Germany. METHODS Between December 2012 and January 2013 two different targeting strategies were implemented on Facebook, providing a link to an online questionnaire. Advertisements were displayed to female Facebook users aged 18-25 years living in Germany. During the simple targeting strategy, advertisements comprised health-related images along with various short titles and text messages. During the focused strategy, advertisements were targeted to users who in addition had certain fashion brands or pop stars listed on their profiles. The targeting strategies were compared with respect to participant characteristics. Univariate and multivariate analyses were used to identify factors associated with HPV vaccine uptake. RESULTS A total of 1161 women participated. The two targeting strategies resulted in significant differences regarding educational status and migrant background. Overall, awareness of HPV was high, but only 53% received at least one vaccine dose. In multivariate analysis, HPV vaccine uptake was independently associated with a physician's recommendation and trust in vaccine effectiveness. Concerns of adverse effects were negatively associated with vaccine uptake. DISCUSSION Social network recruitment permits fast and convenient access to young people. Sample characteristics can be manipulated by adjusting targeting strategies. There is further need for promoting knowledge of HPV vaccination among young women. Physicians have a major role in the vaccination decision-making process of young women.
Collapse
|
35
|
Bermedo-Carrasco S, Feng CX, Peña-Sánchez JN, Lepnurm R. Predictors of having heard about human papillomavirus vaccination: Critical aspects for cervical cancer prevention among Colombian women. GACETA SANITARIA 2014; 29:112-7. [PMID: 25444387 DOI: 10.1016/j.gaceta.2014.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/10/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine whether the probability of having heard about human papillomavirus (HPV) vaccination differs by socio-demographic characteristics among Colombian women; and whether the effect of predictors of having heard about HPV vaccination varies by educational levels and rural/urban area of residence. METHODS Data of 53,521 women aged 13-49 years were drawn from the 2010 Colombian National Demographic and Health Survey. Women were asked about aspects of their health and their socio-demographic characteristics. A logistic regression model was used to identify factors associated with having heard about HPV vaccination. Educational level and rural/urban area of residence of the women were tested as modifier effects of predictors. RESULTS 26.8% of the women had heard about HPV vaccination. The odds of having heard about HPV vaccination were lower among women: in low wealth quintiles, without health insurance, with subsidized health insurance, and those who had children (p<0.001). Although women in older age groups and with better education had higher probabilities of having heard about HPV vaccination, differences in these probabilities by age group were more evident among educated women compared to non-educated ones. Probability gaps between non-educated and highly educated women were wider in the Eastern region. Living in rural areas decreased the probability of having heard about HPV vaccination, although narrower rural/urban gaps were observed in the Atlantic and Amazon-Orinoquía regions. CONCLUSIONS Almost three quarters of the Colombian women had not heard about HPV vaccination, with variations by socio-demographic characteristics. Women in disadvantaged groups were less likely to have heard about HPV vaccination.
Collapse
Affiliation(s)
| | - Cindy Xin Feng
- School of Public Health, University of Saskatchewan, Saskatoon, Canada; Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Rein Lepnurm
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| |
Collapse
|
36
|
Walter D, Schmich P, Wetzstein M, Yvonne D, Wichmann O, Remschmidt C. Knowledge, attitude, and uptake related to human papillomavirus vaccination among young women in Germany recruited via a social media site. Hum Vaccin Immunother 2014. [DOI: 10.4161/hv.29541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
37
|
Kruiroongroj S, Chaikledkaew U, Thavorncharoensap M. Knowledge, Acceptance, and Willingness to Pay for Human Papilloma Virus (HPV) Vaccination among Female Parents in Thailand. Asian Pac J Cancer Prev 2014; 15:5469-74. [DOI: 10.7314/apjcp.2014.15.13.5469] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
38
|
Perlman S, Wamai RG, Bain PA, Welty T, Welty E, Ogembo JG. Knowledge and awareness of HPV vaccine and acceptability to vaccinate in sub-Saharan Africa: a systematic review. PLoS One 2014; 9:e90912. [PMID: 24618636 PMCID: PMC3949716 DOI: 10.1371/journal.pone.0090912] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 02/04/2014] [Indexed: 01/19/2023] Open
Abstract
Objectives We assessed the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate in sub-Saharan African (SSA) countries. We further identified countries that fulfill the two GAVI Alliance eligibility criteria to support nationwide HPV vaccination. Methods We conducted a systematic review of peer-reviewed studies on the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate. Trends in Diphtheria-tetanus-pertussis (DTP3) vaccine coverage in SSA countries from 1990–2011 were extracted from the World Health Organization database. Findings The review revealed high levels of willingness and acceptability of HPV vaccine but low levels of knowledge and awareness of cervical cancer, HPV or HPV vaccine. We identified only six countries to have met the two GAVI Alliance requirements for supporting introduction of HPV vaccine: 1) the ability to deliver multi-dose vaccines for no less than 50% of the target vaccination cohort in an average size district, and 2) achieving over 70% coverage of DTP3 vaccine nationally. From 2008 through 2011 all SSA countries, with the exception of Mauritania and Nigeria, have reached or maintained DTP3 coverage at 70% or above. Conclusion There is an urgent need for more education to inform the public about HPV, HPV vaccine, and cervical cancer, particularly to key demographics, (adolescents, parents and healthcare professionals), to leverage high levels of willingness and acceptability of HPV vaccine towards successful implementation of HPV vaccination programs. There is unpreparedness in most SSA countries to roll out national HPV vaccination as per the GAVI Alliance eligibility criteria for supporting introduction of the vaccine. In countries that have met 70% DTP3 coverage, pilot programs need to be rolled out to identify the best practice and strategies for delivering HPV vaccines to adolescents and also to qualify for GAVI Alliance support.
Collapse
Affiliation(s)
- Stacey Perlman
- Pathfinder International, Watertown, Massachusetts, United States of America
| | - Richard G. Wamai
- Northeastern University, Boston, Massachusetts, United States of America
| | - Paul A. Bain
- Countway Library of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Thomas Welty
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Edith Welty
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Javier Gordon Ogembo
- University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
- * E-mail:
| |
Collapse
|
39
|
Donadiki EM, Jiménez-García R, Hernández-Barrera V, Sourtzi P, Carrasco-Garrido P, López de Andrés A, Jimenez-Trujillo I, Velonakis EG. Health Belief Model applied to non-compliance with HPV vaccine among female university students. Public Health 2014; 128:268-73. [PMID: 24529635 DOI: 10.1016/j.puhe.2013.12.004] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 10/14/2013] [Accepted: 12/06/2013] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To investigate the reasons for refusal of human papillomavirus (HPV) vaccination, and to explore participants' perceptions and attitudes about Health Belief Model (HBM) constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy) among a sample of female university students. STUDY DESIGN Cross-sectional. A self-administered questionnaire based on the HBM was used. METHODS Confirmatory factor analysis was applied to the data to examine the construct validity of the six factor models extracted from the HBM. The predictors of non-HPV vaccination were determined by logistic regression models, using non-HPV vaccination as the dependent variable. RESULTS The sample included 2007 students. The participation rate was 88.9% and the percentage of non-vaccination was 71.65%. Participants who had high scores for 'general perceived barriers', 'perceived barriers to vaccination', 'no perceived general benefits', 'no perceived specific benefits' and 'no general benefits' were more likely to report being unvaccinated. CONCLUSIONS The findings demonstrated the utility of HBM constructs in understanding vaccination intention and uptake. There is an urgent need to improve health promotion and information campaigns to enhance the benefits and reduce the barriers to HPV vaccination.
Collapse
Affiliation(s)
- E M Donadiki
- Department of Public Health, Faculty of Nursing, University of Athens, Athens, Greece.
| | - R Jiménez-García
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - V Hernández-Barrera
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - P Sourtzi
- Department of Public Health, Faculty of Nursing, University of Athens, Athens, Greece
| | - P Carrasco-Garrido
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - A López de Andrés
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - I Jimenez-Trujillo
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - E G Velonakis
- Department of Public Health, Faculty of Nursing, University of Athens, Athens, Greece
| |
Collapse
|
40
|
"HPV? Never heard of it!": a systematic review of girls' and parents' information needs, views and preferences about human papillomavirus vaccination. Vaccine 2013; 31:5152-67. [PMID: 24029117 DOI: 10.1016/j.vaccine.2013.08.091] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/22/2013] [Accepted: 08/28/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Two human papillomavirus vaccines were licenced in 2006/2007 for cervical cancer prevention. National vaccination programmes for schoolgirls were subsequently introduced in some European countries, North America and Australia. To understand factors influencing vaccine uptake and to inform the development of appropriate UK educational materials, we aimed to synthesise evidence of girls' and parents' information needs, views and preferences regarding HPV vaccination. DESIGN Systematic review and mixed method synthesis of qualitative and survey data. DATA SOURCES Twelve electronic databases; bibliographies of included studies 1980 to August 2011. REVIEW METHODS Two reviewers independently screened papers and appraised study quality. Studies were synthesised collaboratively using framework methods for qualitative data, and survey results integrated where they supported, contrasted or added to the themes identified. RESULTS Twenty-eight qualitative studies and 44 surveys were included. Where vaccination was offered, uptake was high. Intention to decline was related to a preference for vaccinating later to avoid appearing to condone early sexual activity, concerns about vaccine safety and low perception of risk of HPV infection. Knowledge was poor and there were many misconceptions; participants tried to assess the potential benefits and harms of vaccination but struggled to interpret limited information about HPV in the context of existing knowledge about sexually transmitted infections and cancer. Conclusion Many girls and their parents have limited understanding to an extent that impinges on their ability to make informed choices about HPV vaccination and could impact on future uptake of cervical screening. This is a considerable challenge to those who design and provide information, but getting the messages right for this programme could help in developing patient information about other HPV related cancers.
Collapse
|
41
|
Dubé E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger JA. Vaccine hesitancy: an overview. Hum Vaccin Immunother 2013; 9:1763-73. [PMID: 23584253 PMCID: PMC3906279 DOI: 10.4161/hv.24657] [Citation(s) in RCA: 1139] [Impact Index Per Article: 103.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 04/04/2013] [Accepted: 04/11/2013] [Indexed: 01/27/2023] Open
Abstract
Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines is now considered a threat to the success of vaccination programs. Vaccine hesitancy is believed to be responsible for decreasing vaccine coverage and an increasing risk of vaccine-preventable disease outbreaks and epidemics. This review provides an overview of the phenomenon of vaccine hesitancy. First, we will characterize vaccine hesitancy and suggest the possible causes of the apparent increase in vaccine hesitancy in the developed world. Then we will look at determinants of individual decision-making about vaccination.
Collapse
Affiliation(s)
- Eve Dubé
- Centre de recherche du CHU de Québec; Québec, QC Canada
- Institut national de santé publique du Québec (INSPQ); Québec, QC Canada
- Université Laval; Québec City, QC Canada
| | | | - Maryse Guay
- Institut national de santé publique du Québec (INSPQ); Québec, QC Canada
- Université de Sherbrooke; Longueuil, QC Canada
- Centre de recherche du CSSS Champlain—Charles-LeMoyne; Longueuil, QC Canada
- Direction de santé publique de la Montérégie; Québec, QC Canada
| | | | - Réal Roy
- University of Victoria; Saanich, BC Canada
| | - Julie A. Bettinger
- University of British Columbia; Vancouver, BC Canada
- Vaccine Evaluation Center; Women’s Health Research Institute; BC Women’s and Children's Hospital; Vancouver, BC Canada
| |
Collapse
|
42
|
Zhang C, Gotsis M, Jordan-Marsh M. Social media microblogs as an HPV vaccination forum. Hum Vaccin Immunother 2013; 9:2483-9. [PMID: 23842072 DOI: 10.4161/hv.25599] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The 2006 US FDA approval of the human papillomavirus (HPV) vaccine brought new hope for cancer prevention. Gardasil and Cervarix are widely available vaccines that can deter HPV infection, which causes 70% of cervical cancer. Acceptance of vaccination varies due to a lack of HPV awareness and HPV vaccine knowledge. Recent observations of the Chinese microblog "SinaWeibo" suggest a new approach to engage health professionals and consumer website bloggers. Websites that present the latest fashion, fitness or beauty news and ways to obtain "deals" have created informative blogs or online communities that appeal to female users. Some users raise health questions of their peers. Health professionals, as website bloggers, can introduce vaccine news or respond to conversations between bloggers and their followers. By transforming medical vocabulary into ordinary chat, microblogs may promote efficiency in vaccine education and communication. A web-based, interactive social media-microblog could offer an ideal platform to speed up information dissemination and increase targeted communication.
Collapse
Affiliation(s)
- Chupei Zhang
- Mork Family Department of Chemical Engineering and Materials Science; Los Angeles, CA USA
| | | | | |
Collapse
|
43
|
Hopkins TG, Wood N. Female human papillomavirus (HPV) vaccination: global uptake and the impact of attitudes. Vaccine 2013; 31:1673-9. [PMID: 23375978 DOI: 10.1016/j.vaccine.2013.01.028] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 01/09/2013] [Accepted: 01/15/2013] [Indexed: 01/27/2023]
Abstract
Human papillomavirus (HPV) is the causative agent in cervical cancer and has been implicated in a range of other malignancies. Preventative vaccines are now internationally available and provide high levels of protection from common viral strains. The introduction of a comprehensive vaccination programme (except 'program' in computers) could prevent over 60% of current cervical cancer cases, but this is dependent on such programmes achieving a high level of coverage. In this review, we summarise the current trends in female HPV vaccination coverage throughout the world, and place it in the context of available research on attitudes towards vaccination amongst the public and health professionals. Where countries have the resources for mass vaccination programmes, uptake has varied. School-based opt-out programmes consistently achieve highest coverage, whilst countries and regions without systematic vaccination schemes have low coverage. In all countries, the success of vaccination programmes is dependent on the support of the public and healthcare professionals. Whilst public acceptance is dependent on multiple factors, it has repeatedly been shown that recommendation by a health professional, particularly clinicians, is key to vaccine uptake. Worryingly, it appears that a proportion of clinicians still have significant reservations about promoting vaccination, particularly for younger age groups. A commitment now, to fully educating both the public and clinicians, has the potential to make a dramatic future impact.
Collapse
Affiliation(s)
- Tom Glass Hopkins
- Institute of Reproductive and Developmental Biology, Imperial College, London, UK.
| | | |
Collapse
|