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Lin Z, Chen S, Su L, Liao Y, Chen H, Hu Z, Chen Z, Fang Y, Liang X, Chen J, Luo B, Wu C, Wang Z. Influences of HPV disease perceptions, vaccine accessibility, and information exposure on social media on HPV vaccination uptake among 11,678 mothers with daughters aged 9-17 years in China: a cross-sectional study. BMC Med 2024; 22:328. [PMID: 39135035 PMCID: PMC11320960 DOI: 10.1186/s12916-024-03538-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/22/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Mothers play a crucial role in influencing their daughters' HPV vaccination decisions. Addressing barriers to receiving HPV vaccination among mothers of girls may achieve two goals in one strike: increasing vaccination coverage among both mothers and their daughters. This study aims to examine the HPV vaccination uptake and its determinants among mothers of girls in China at both the individual and interpersonal levels. METHODS From July to October 2023, a cross-sectional online study was conducted to investigate HPV vaccine refusal for daughters aged 9-17 years among 11,678 mothers in Shenzhen, China. A randomized selection method was employed, targeting 11 primary schools and 13 secondary schools in Shenzhen. The research team invited mothers of girls to participate in an anonymous online survey. Multilevel logistic regression models (level 1: schools; level 2: individual participants) were employed to analyze the data. RESULTS Among 11,678 mothers, 41.1% self-reported receiving at least one dose of HPV vaccination. Through multilevel logistic regression analysis, eight items measuring illness representations of HPV, which refers to how people think about HPV, were associated with higher HPV vaccination uptake (AOR: 1.02-1.14). These items included identity (identifying symptoms of HPV), timeline (whether HPV is acute/chronic), negative consequences, personal and treatment control (whether HPV is under volitional control), concern, negative emotions, and coherence (overall understanding of HPV). In addition, participants refusing HPV vaccines for the index daughters (AOR: 0.82, 95%CI: 0.76, 0.89) had lower vaccine uptake. Perceived more difficulties in accessing the 9-valent vaccines (AOR: 1.06, 95%CI: 1.04, 1.08) and more satisfaction with vaccine-related promotional materials (AOR: 1.50, 95%CI: 1.46, 1.54) at the individual level were associated with higher vaccine uptake. At the interpersonal factors, higher frequency of exposure to testimonials given by others about HPV vaccination on social media (AOR: 1.19, 95%CI: 1.14, 1.25) and thoughtful consideration of the veracity of the information (AOR: 1.11, 95%CI: 1.07, 1.16) were correlated with higher HPV vaccination uptake. CONCLUSIONS These findings offer essential implications for modifying HPV disease perceptions, addressing difficulties in accessing the 9-valent HPV vaccines, and enhancing health communication needs to improve HPV vaccine uptake among mothers of girls.
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Affiliation(s)
- Zian Lin
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lixian Su
- Shenzhen Futian District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Yuxue Liao
- Center for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Zhiqing Hu
- Shenzhen Futian The Second People's Hospital, Xinyidai Industrial Park Social Health Station, Shenzhen, China
| | - Zhuolin Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Xue Liang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jianan Chen
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Biyun Luo
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Chuanan Wu
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Sarmiento-Medina MI, Velásquez-Jiménez CM, Ortiz-Hernández N. Experiences of a group of indigenous women from the Colombian Amazon with cervical cancer prevention screening. Qualitative study in the context of participatory research to reduce inequalities. ETHNICITY & HEALTH 2024:1-15. [PMID: 39107054 DOI: 10.1080/13557858.2024.2387112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 07/27/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVES Despite cervical cancer (CC) being a preventable disease, its incidence remains high in marginalized communities due to inequalities that restrict access to health services. This article investigates the experiences, perceptions, and attitudes regarding the screening of indigenous women in a region of the Colombian Amazon during a cervical cancer prevention initiative facilitated by community participation. DESIGN Qualitative study based on interviews conducted with women and indigenous leaders from Paujil reserve. They participated in research focused on cervical cancer prevention, which employed a methodology of collaboration between academia and communities aimed at enhancing women's health and reducing inequalities in access to healthcare services. The analysis utilized a deductive and inductive approach. RESULTS Five main themes were addressed: 'Barriers within health services'; 'Individual and cultural constraints'; 'Motivations and facilitators'; 'Positive experiences within the research framework'; and 'Suggestions for encouraging women's participation.' Challenges related to appointment scheduling and result delivery were frequently cited as obstacles to access. Misinformation, feelings of shame, fear, and distrust towards health services played significant roles in the reluctance to undergo screening. Factors such as support from family and community networks, respectful treatment, ease of scheduling appointments, the presence of female healthcare professionals, and involvement of leaders fluent in indigenous languages were identified as positive facilitators of screening acceptance. CONCLUSION Understanding the factors that influence access to screening is crucial for reducing inequalities in service delivery for indigenous women. The involvement of trained leaders who can identify these factors and motivate women can have a positive impact on the acceptance and guidance of cervical cancer prevention programs.
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Jung YJ, Gagneux-Brunon A, Bonneton M, Botelho-Nevers E, Verger P, Ward JK, Launay O. Factors associated with COVID-19 vaccine uptake among French population aged 65 years and older: results from a national online survey. BMC Geriatr 2022; 22:637. [PMID: 35918635 PMCID: PMC9344255 DOI: 10.1186/s12877-022-03338-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background In France, the increase in COVID-19 vaccine uptake among older adults slowed down between May and June 2021. Using the data from a national survey, we aimed to assess COVID-19 vaccine uptake among French residents aged 65 years and older, particularly at risk of severe form of the infection, and identify factors associated with non-vaccination. Methods A cross-sectional online survey collected the immunization status/intention to get the COVID-19 vaccine, reasons for vaccination/non-vaccination and factors potentially associated with vaccine uptake between May 10 and 23, 2021 among a large sample of French residents. Characteristics of participants were compared according to immunization status. Factors potentially associated with non-vaccination were computed into a multivariate logistic regression. Results Among the 1941 survey participants, 1612 (83%) reported having received at least one dose of COVID-19 vaccine. Among the 329 unvaccinated, 197 (60%) declared having the intention to get vaccinated. Younger age (adjusted odds ratio (aOR) = 1.50; 95% confidence interval (CI), 1.05–2.14), thinking previously having COVID-19 (aOR = 4.01; 95% CI, 2.17–7.40), having suffered economic impact due to the pandemic (aOR = 2.63; 95% CI, 1.71–4.04), reporting an “unsafe” opinion about COVID-19 vaccine safety (aOR = 6.79; 95% CI, 4.50–10.26), reporting an “unsupportive” opinion about vaccination in general (aOR = 4.24; 95% CI, 2.77–6.49) were independent risk factors for non-vaccination. On the other hand, trust in COVID-19 vaccine information delivered by the doctor (aOR = 0.28; 95% CI, 0.16–0.48) and trust in the government’s actions (aOR = 0.50; 95% CI, 0.34–0.74) were independent protective factors for non-vaccination. Political affiliation also remained significantly associated with vaccine uptake. Conclusions Despite high overall COVID-19 vaccine uptake among the study participants, differences in vaccine uptake according to the level of concerns regarding COVID-19 vaccine safety, socioeconomic profile and trust in the government were observed. Our results reinforce the importance of “reaching out” vaccination strategy that specifically targets the most vulnerable fringe of older adult population. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03338-3.
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Affiliation(s)
- Yu-Jin Jung
- Université de Paris, Inserm, Centre d'Investigation Clinique (CIC) 1417, Assistance Publique - Hôpitaux de Paris, CIC Cochin-Pasteur, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, Paris, France.
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Université de Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U111, Centre National de Recherche Scientifique (CNRS), Unité mixte de recherche (UMR) 530, Lyon, France.,Inserm, CIC 1408 Vaccinologie, CHU de Saint-Etienne, Saint-Etienne, France.,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | | | - Elisabeth Botelho-Nevers
- Centre International de Recherche en Infectiologie, Team GIMAP, Université de Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U111, Centre National de Recherche Scientifique (CNRS), Unité mixte de recherche (UMR) 530, Lyon, France.,Inserm, CIC 1408 Vaccinologie, CHU de Saint-Etienne, Saint-Etienne, France.,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | - Pierre Verger
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France.,Observatoire Régional de la Santé (ORS) - Provence-Alpes-Côte d'Azur, Marseille, France.,VITROME (Aix-Marseille Université, Institut de Recherche pour le Développement, Assistance Publique - Hôpitaux de Marseille, Service de Santé des Armées), Marseille, France
| | - Jeremy K Ward
- VITROME (Aix-Marseille Université, Institut de Recherche pour le Développement, Assistance Publique - Hôpitaux de Marseille, Service de Santé des Armées), Marseille, France.,CERMES3 (Inserm, CNRS, Ecole des Hautes Etudes en Sciences Sociales, Université de Paris, Villejuif, France
| | - Odile Launay
- Université de Paris, Inserm, Centre d'Investigation Clinique (CIC) 1417, Assistance Publique - Hôpitaux de Paris, CIC Cochin-Pasteur, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, Paris, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
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O’Neill J. A lesson from MMR: is choice of vaccine the missing link in promoting vaccine confidence through informed consent? ETHICS & BEHAVIOR 2022. [DOI: 10.1080/10508422.2022.2059757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- J O’Neill
- College of Medical, Veterinary and Life Science, University of Glasgow
- School of Medicine, European University Cyprus
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Wang J, Yuan B, Lu X, Liu X, Li L, Geng S, Zhang H, Lai X, Lyu Y, Feng H, Jing R, Guo J, Huang Y, Liang X, Yu W, Fang H. Willingness to accept COVID-19 vaccine among the elderly and the chronic disease population in China. Hum Vaccin Immunother 2021; 17:4873-4888. [PMID: 34906026 PMCID: PMC8903911 DOI: 10.1080/21645515.2021.2009290] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A cross-sectional field survey was conducted from November 2020 to January 2021 among 7259 participants to investigate the public perception, willingness, and information sources for COVID-19 vaccination, with the focus on the elderly and non-communicable chronic disease (NCD) population. Multiple logistic regressions were performed to identify associated factors of the vaccination willingness. The willingness rate of the elderly to accept the future COVID-19 vaccine (79.08%) was lower than that of the adults aged 18-59 (84.75%). The multiple analysis didn't identify significant relationship between NCD status and the vaccination intention. The main reasons for vaccine hesitancy by the public were: concern for vaccine safety, low infection risk, waiting and seeing others getting vaccinated, concern of vaccine effectiveness and price. Their relative importance differed between adults aged 18-59 and the elderly, and between adults aged 18-59 with or without NCD. Perception for vaccination importance, vaccine confidence, and trust in health workers were significant predictors of the vaccination intention in both age groups. The elderly who perceived high infection risk or had trust in governments were more likely to accept the vaccine. Compared with the adults aged 18-59, the elderly used fewer sources for COVID-19 vaccination information and more trusted in traditional media and family, relatives, and friends for getting vaccination recommendations. To promote vaccine uptake, the vaccination campaigns require comprehensive interventions to improve vaccination attitude, vaccine accessibility and affordability, and tailor strategies to address specific concerns among different population groups and conducted via their trusted sources, especially for the elderly.
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Affiliation(s)
- Jiahao Wang
- School of Public Health, Peking University, Beijing, China,China Center for Health Development Studies, Peking University, Beijing, China
| | - Beibei Yuan
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Xinran Lu
- School of Public Health, Peking University, Beijing, China
| | - Xiaoxue Liu
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Li Li
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shufan Geng
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing, China,China Center for Health Development Studies, Peking University, Beijing, China
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing, China,China Center for Health Development Studies, Peking University, Beijing, China
| | - Yun Lyu
- School of Public Health, Peking University, Beijing, China,China Center for Health Development Studies, Peking University, Beijing, China
| | - Huangyufei Feng
- School of Public Health, Peking University, Beijing, China,China Center for Health Development Studies, Peking University, Beijing, China
| | - Rize Jing
- School of Public Health, Peking University, Beijing, China,China Center for Health Development Studies, Peking University, Beijing, China
| | - Jia Guo
- School of Public Health, Peking University, Beijing, China,China Center for Health Development Studies, Peking University, Beijing, China
| | | | - Xun Liang
- School of Information, Renmin University of China, Beijing, China
| | - Wenzhou Yu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China,CONTACT Wenzhou Yu National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China,Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing, China,Key Laboratory of Reproductive Health National Health Commission of the People’s Republic of China, Beijing, China,Hai Fang China Center for Health Development Studies, Peking University, Beijing, China
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