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Shi G, Lin B, Pan H, He W, Zhong X. Using an extended information-motivation-behavioral skills model to explain HPV vaccination intention among men who have sex with men only and men who have sex with men and women. Hum Vaccin Immunother 2024; 20:2327150. [PMID: 38465886 PMCID: PMC10936628 DOI: 10.1080/21645515.2024.2327150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/03/2024] [Indexed: 03/12/2024] Open
Abstract
Men who have sex with men and women (MSMW) have been reported to differ in psychosocial and sexual behavior patterns from men who have sex with men only (MSMO). However, results regarding the differences in HPV vaccination intention/behavior were inconclusive. We compared HPV vaccination intention between MSMO and MSMW and analyzed the differences in potentially associated factors in China. MSM participants were recruited online using a snowball sampling method. Cross-sectional data were collected via a questionnaire based on the extended information-motivation-behavioral skills model. Structural equation modeling was conducted to examine the relationship between the variables, followed by multi-group analysis to test differences between groups. Of 914 MSM, 77.68% were MSMO and 22.32% were MSMW. MSMW had a higher rate of reluctance to vaccinate than MSMO (23.53% vs. 16.20%, p = .016). Differences between the two groups were statistically significant in risky sexual behavior, behavioral skills, and promotional attitude. In both groups, promotional attitude was the most significant predictor of vaccination intention. Vaccination intention was directly influenced by motivation and indirectly by risky sexual behavior in MSMO, but not significantly in MSMW. Additionally, the direct effect of information on behavioral skills in MSMW was significantly greater than that in MSMO, but we did not find any effect of behavioral skills on vaccination intention. MSMW had lower vaccination intention than MSMO. MSMO may be influenced by risky sexual behavior and motivation, positively impacting their vaccination intention, unlike MSMW. Targeted strategies could help promote HPV vaccination, especially in MSMW.
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Affiliation(s)
- Guiqian Shi
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Bing Lin
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Haiying Pan
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Wei He
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Xiaoni Zhong
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
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Onyango OE, Masinde D, Ouma C. Enhancing cervical cancer knowledge among women of reproductive age: a dialogue-based community health education intervention in rural Kisumu County, Kenya. BMC Womens Health 2024; 24:327. [PMID: 38840127 PMCID: PMC11155059 DOI: 10.1186/s12905-024-03075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/04/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Cervical cancer is a leading cause of cancer death among women of reproductive age despite being treatable if it is diagnosed early. Early diagnosis is possible through regular screening through the public health system. However, screening rates remain low in many low- and middle-income countries, including Kenya, where the screening rate currently stands at 16-18%. The low screening rates are attributed to, among other factors, low knowledge about cervical cancer and the available screening options among women of reproductive age. The current study evaluated the effectiveness of dialogue-based community health education by trained community health volunteers (CHVs) in improving cervical cancer knowledge among women of reproductive age (WRA) in rural Kisumu County. METHODS This was a longitudinal pre- and post-intervention study with a control group. The knowledge of women of reproductive age was assessed at baseline in both the intervention and control groups, followed by dialogue-based community health education in the intervention arm. A final end-line knowledge assessment was performed. The scores at baseline and at the end of the study were compared to assess changes in knowledge due to the intervention. The proportion of WRA with improved knowledge was also calculated, and statistical significance was considered at p ≤ 0.05. RESULTS There was no significant difference between the participants in the two arms, except for the level of education (p = 0.002). The knowledge of the WRA in the intervention arm improved significantly (p < 0.001) following the dialogue-based educational intervention by the trained CHVs. None of the demographic characteristics were associated with knowledge. CONCLUSION Dialogue-based educational intervention significantly improved the knowledge of the WRA in the intervention arm, showing its potential to address the knowledge gap in the community.
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Affiliation(s)
- Ochomo Edwin Onyango
- School of Public Health and Community Development, Maseno University, Private Bag, Maseno, Kenya.
| | - David Masinde
- School of Public Health and Community Development, Maseno University, Private Bag, Maseno, Kenya
| | - Collins Ouma
- School of Public Health and Community Development, Maseno University, Private Bag, Maseno, Kenya
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Wang S, Ren W, Zhang B, Chen M, Liu S, Zhu Y, Wu A, Bao Y, Zhao F, Qiao Y. Knowledge, Attitude, and Uptake of Human Papillomavirus (HPV) Vaccination among Chinese Female Adults: A National Cross-sectional Web-Based Survey Based on a Large E-commerce Platform. Matern Child Health J 2024; 28:746-757. [PMID: 38334863 DOI: 10.1007/s10995-023-03888-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination is a promising step toward cervical cancer elimination. This study was conducted to investigate the knowledge, attitude, and HPV vaccine uptake among female adults in mainland China based on a large e-commerce platform. METHODS We conducted a cross-sectional online survey of female adults between March 4 to April 20, 2022. The survey consisted of sociodemographic information, related knowledge, vaccination uptake, and attitudes toward vaccination. We included women aged 18-45 years in the final analysis. Logistic regressions were conducted to explore influencing factors associated with related knowledge, HPV vaccination uptake, and willingness to be vaccinated. RESULTS In total, 3,572 female adults (34 years, IQR 30-39) were included in the analysis. The majority of the participants were highly educated (78.7%) with a high monthly family income (79.0%). The median HPV knowledge score was 8.25 out of 11. More than 75% of respondents were unvaccinated, while 95.8% of unvaccinated female adults are willing to be vaccinated. Variables such as age, insurance, vaccination history, and whether one had heard of the HPV vaccine influence HPV vaccination practice (all p-values < 0.05). The main barriers to vaccination were vaccine inaccessibility and the high cost of the vaccine. CONCLUSION The findings of our study highlight a moderate knowledge level, poor vaccination rate, and strong willingness to be vaccinated among Chinese female adults who were better educated and wealthier. Targeted health education and practical support should be provided in the future, to reduce gaps between vaccine uptake and vaccine acceptance.
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Affiliation(s)
- Sumeng Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenhui Ren
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingyang Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shujun Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yitong Zhu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Aiyuan Wu
- The Affiliated Cancer Hospital of Xinjiang Medical University, Suzhou Dong Street No. 789, Urumqi, China
| | - Yanping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Fanghui Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Malik AA, Ahmed N, Shafiq M, Elharake JA, James E, Nyhan K, Paintsil E, Melchinger HC, Team YBI, Malik FA, Omer SB. Behavioral interventions for vaccination uptake: A systematic review and meta-analysis. Health Policy 2023; 137:104894. [PMID: 37714082 PMCID: PMC10885629 DOI: 10.1016/j.healthpol.2023.104894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/22/2023] [Accepted: 08/15/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries. METHODS We included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately. FINDINGS Our results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5-4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3-3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes. INTERPRETATION Our findings indicate that "provider recommendation" and "on-site vaccination" along with other behavioral interventions can be employed to increase vaccination rates globally.
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Affiliation(s)
- Amyn A Malik
- Yale Institute for Global Health, New Haven, CT 06510, USA; Analysis Group, Inc, Boston, MA 02199, USA
| | - Noureen Ahmed
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA
| | - Mehr Shafiq
- Yale Institute for Global Health, New Haven, CT 06510, USA; Columbia University School of Public Health, New York, NY 10032, USA
| | - Jad A Elharake
- Yale Institute for Global Health, New Haven, CT 06510, USA; UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA; The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Erin James
- Yale Institute for Global Health, New Haven, CT 06510, USA
| | - Kate Nyhan
- Yale University, New Haven, CT 06510, USA
| | - Elliott Paintsil
- Yale Institute for Global Health, New Haven, CT 06510, USA; Columbia University Institute of Human Nutrition, New York, NY 10032, USA
| | | | | | - Fauzia A Malik
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA
| | - Saad B Omer
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA.
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Liu H, Zeng C, Jiang M, Dai Y, Xu M, Zhou F, Wang Y, Pulliero A, Sobierajski T, Nesser W, Matsuura M, Wang L, Wu J, Ji M. Study on the prevalence and subtypes of human papillomavirus infection among women in the Xuhui District, Shanghai City, China. Transl Cancer Res 2023; 12:2923-2931. [PMID: 37969362 PMCID: PMC10643963 DOI: 10.21037/tcr-23-1491] [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] [Received: 08/17/2023] [Accepted: 09/24/2023] [Indexed: 11/17/2023]
Abstract
Background Human papillomavirus (HPV) can cause various gynecological diseases, create a long-term inflammatory immune microenvironment, and induce the occurrence of cervical tumors. However, the prevalence of HPV is species-specific in different eras or in different countries and regions. This paper aimed to investigate the characteristics of HPV infection in the Xuhui District, Shanghai City, China. Methods We collected HPV data from 6,760 female testers, focusing on the younger population for data analysis. We focused more on the HPV subtypes to which young women were susceptible, performed t-Distributed Stochastic Neighbor Embedding (TSNE) analysis to screen for characteristic subtypes, and compared the prevalent subtypes lacking effective vaccine protection. Results HPV infection exhibited a trend of affecting a younger population, and eight subtypes were more likely to occur in young people. HPV43, 51, 53, and 59 showed a higher incidence and lacked vaccine protection. We performed TSNE dimensionality reduction analysis to organize the HPV data. The results indicated that HPV16, 18, and 51 are characteristic subtypes in the younger population. The Thinprep cytologic test (TCT) also revealed that the infection with HPV43, 51, 53, and 59 also triggers significant pathological phenotypes. Conclusions HPV51 is a subtype that occurs more frequently in young women, can induce a variety of significant pathological features, and lacks effective vaccine protection. This study inspires us to take measures to deal with HPV rejuvenation and conduct research on vaccines for specific HPV subtypes.
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Affiliation(s)
- Han Liu
- Department of Clinical Laboratory, Shanghai Eighth People’s Hospital, Shanghai, China
| | - Chao Zeng
- Department of Laboratory Medicine, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingming Jiang
- Department of Clinical Laboratory, Shanghai Eighth People’s Hospital, Shanghai, China
| | - Yue Dai
- Department of Clinical Laboratory, Shanghai Eighth People’s Hospital, Shanghai, China
| | - Minyi Xu
- Department of Clinical Laboratory, Shanghai Eighth People’s Hospital, Shanghai, China
| | - Fangfang Zhou
- Department of Clinical Laboratory, Shanghai Eighth People’s Hospital, Shanghai, China
| | - Yaling Wang
- Department of Clinical Laboratory, Shanghai Eighth People’s Hospital, Shanghai, China
| | | | - Tomasz Sobierajski
- The Center of Sociomedical Research, Faculty of Applied Social Sciences and Resocialization, University of Warsaw, Warsaw, Poland
| | - Whitney Nesser
- Department of Applied Clinical and Educational Sciences, Indiana State University, Terre Haute, IN, USA
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Lei Wang
- Department of Clinical Laboratory, Shanghai Eighth People’s Hospital, Shanghai, China
| | - Jiaying Wu
- Department of Laboratory Medicine, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Muyuan Ji
- Department of Hematology and Oncology, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Hematology and Oncology, Jinan Children’s Hospital, Jinan, China
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Yohannes E, Beyen MW, Bulto GA, Chaka EE, Debelo BT, Erena MM, Tasu TL. Knowledge and attitude toward human papillomavirus vaccination and associated factors among adolescent school girls in Ambo town, Ethiopia, 2021: A multicenter cross-sectional study. Health Sci Rep 2023; 6:e1305. [PMID: 37266064 PMCID: PMC10230424 DOI: 10.1002/hsr2.1305] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/27/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023] Open
Abstract
Background and Aims The human papillomavirus (HPV) vaccination has shown considerable promise in lowering the incidence of cervical cancer. However, there are few studies done on knowledge and attitude toward the HPV vaccine, especially in the local setting. Therefore, this study aimed to assess knowledge and attitudes regarding HPV vaccination and related factors among adolescent girls in Ambo town, Ethiopia, in 2021. Methods A cross-sectional study was conducted from May 1 to May 30, 2021, at selected schools in Ambo town among 422 adolescent girls. A structured self-administered questionnaire was used to collect the data. The collected data were coded, and entered into Epi-Info 7.2.2.6 and exported to STATA 16 for analysis. Descriptive statistics were used to compute summary statistics and proportions. Bivariate and multivariate logistic regression analyses were carried out. The adjusted odds ratio (AOR) along with a 95% confidence interval (CI) was computed to ascertain the association. Results Current study revealed that 24.9% (95% CI: 20.8-29.0) and 55.6% (95% CI: 50.5-60.4) of respondents had good knowledge and favorable attitude, respectively. The factors like being secondary school students [AOR = 2.01, 95% CI; (1.24, 3.27)], having health workers as a source of information [AOR = 2.13, 95% CI; (1.30, 3.47)], and respondents who have heard about the HPV vaccine at school [AOR = 1.66, 95% CI; (1.02, 2.71)] were significantly associated with respondent's knowledge of HPV vaccine. Moreover, the perceived severity of the diseases [AOR = 2.89, 95% CI; (1.61, 5.21)], and the perceived benefit of the vaccine [AOR = 4.26, 95% CI; (2.43, 7.48)] were factors significantly associated with an attitude of the respondents about the HPV vaccine. Conclusion There was low knowledge and unfavorable attitude toward HPV vaccination among the school adolescents in the study area. Several seemingly major deterrents of knowledge and attitude toward the HPV vaccination were identified. Therefore, all parties involved should collaborate to improve female students' knowledge and attitudes toward Human Papilloma Virus vaccination.
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Affiliation(s)
| | - Mulugeta W. Beyen
- Reproductive Health divisionSouth West Shewa Zone Health OfficeWalisoEthiopia
| | | | - Eshetu E. Chaka
- Department of Public Health, Epidimiology and Biostatistics Unit, College of Medicine and Health SciencesAmbo UniversityAmboEthiopia
| | | | | | - Tefera L. Tasu
- Department of Nursing, College of Medicine and Health SciencesAmbo UniversityAmboEthiopia
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7
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Wang H, Wang X, Chen P, Xu H, Liu Y, Kang R, Zheng L, Sun X, Sun X, Zhang S. Effect of Health Intervention via Web-Based Education on Improving Information-Motivation-Behavioral Skills Related to HPV Vaccination Among Chinese Female College Students. Int J Public Health 2023; 68:1605596. [PMID: 36816834 PMCID: PMC9935583 DOI: 10.3389/ijph.2023.1605596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Objectives: The human papillomavirus (HPV) vaccination rate is generally low in China. This study aimed to assess the effect of web-based education on improving information-motivation-behavior skills related to HPV vaccination among Chinese female college students. Methods: From February to May 2020, female students were recruited from a university and divided into intervention and control groups. The intervention group received 7 days of HPV-related web-based education. Related information were collected using questionnaires in the baseline, 7 days, 1 month, and 3 months after the intervention. Chi-square test and repeated ANOVA were used to compare the differences between the two groups in the four surveys. Results: A total of 449 students (235 in the intervention and 214 in the control group) were included in the analysis. There were no statistical differences in demographic information between the two groups. Compared with the control group, students in the intervention group showed a richer knowledge and subjective norms of HPV vaccination (p < 0.05). Conclusion: The study provides preliminary support for a health intervention via web-based education in increasing HPV vaccination information among female college students.
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Affiliation(s)
- Hong Wang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Xiaoyang Wang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Peipei Chen
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Huifang Xu
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Yin Liu
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Ruihua Kang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Liyang Zheng
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Xingyuan Sun
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Xibin Sun
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
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Esagoff A, Cohen SA, Chang G, Equils O, Van Orman S. Human papillomavirus and Chinese international students in the United States: attitudes, knowledge, vaccination trends, healthcare behaviors, and sexual activity. Hum Vaccin Immunother 2022; 18:1882283. [PMID: 33705223 PMCID: PMC8920154 DOI: 10.1080/21645515.2021.1882283] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the world, with the ability to cause external genital warts and cancers. The HPV vaccine, first released in the United States of America (USA) in 2006, has been shown to protect against the highest risk HPV strains responsible for the majority of HPV-related cancers. In mainland China, the HPV vaccine was only recently approved in 2016 and is therefore not readily available. As a result, Chinese international students (CIS) studying in the USA continue to have low HPV vaccination rates. This study completed in person and online surveying of 396 CIS at a large Southern California university, with the goal of better understanding CIS knowledge and awareness of HPV disease, vaccination and healthcare behaviors, and sexual activity. Among participants, the reported HPV vaccination rate was 61% (females: 85%; males: 32%). HPV vaccination was significantly correlated with a past visit to the on-campus student health center, having university-sponsored student health insurance, higher self-perceived HPV knowledge, and increased willingness to pay for vaccination. A large portion of participants portrayed low levels of sexual activity, which suggests that CIS can take advantage of catch-up HPV vaccination recommendations through 26 years of age. The results of this study can be used to inform policy initiatives, particularly at the campus level, that attempt to improve HPV vaccination rates amongst CIS.
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Affiliation(s)
- Aaron Esagoff
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA,MiOra, Public Health Nonprofit, Encino, CA, USA,CONTACT Aaron Esagoff Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205
| | - Samuel A. Cohen
- MiOra, Public Health Nonprofit, Encino, CA, USA,Stanford University School of Medicine, Stanford, CA, USA
| | - Guoxuan Chang
- Keck School of Medicine of USC, USC Student Health, Los Angeles, CA, USA
| | | | - Sarah Van Orman
- Keck School of Medicine of USC, USC Student Health, Los Angeles, CA, USA
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9
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Pan H, He W, Lin B, Zhong X. Factors influencing HPV vaccination willingness among men who have sex with men in China: a structural equation modeling analysis. Hum Vaccin Immunother 2022; 18:2038504. [PMID: 35275513 PMCID: PMC9009954 DOI: 10.1080/21645515.2022.2038504] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Men who have sex with men (MSM) are at high risk of infection with human papillomavirus (HPV). Some countries have incorporated MSM into their HPV vaccination strategies. The acceptance of the HPV vaccine is an important factor affecting vaccine promotion in MSM. This study aims to analyze the factors influencing HPV vaccination willingness among MSM in China. Non-probability sampling was used to recruit MSM in China in June 2021. The information collected included demographic characteristics, HPV knowledge, attitude, behavior, history of sexually transmitted diseases (STDs), and HPV vaccination intention. A structural equation model was used to analyze the data based on the theory of knowledge-attitude-behavior. Among 889 participants, 736 (82.79%) of the MSM were willing to receive the HPV vaccine. The results of the structural equation model showed that knowledge, attitude, behavior, and STD history influenced the vaccination intention, of which knowledge (total effect of .36) and attitude (total effect of .31) had the greatest influence. Since most MSM in China were willing to be vaccinated against HPV, they should be considered for inclusion in the HPV vaccination program. Enhancing HPV awareness and improving risk awareness may be useful in increasing the vaccination willingness of MSM in China.
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Affiliation(s)
- Haiying Pan
- School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Wei He
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Bing Lin
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
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10
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Marfo EA, King KD, Adjei CA, MacDonald SE. Features of human papillomavirus vaccination education strategies in low- and middle-income countries: a scoping review. Public Health 2022; 213:61-67. [PMID: 36371953 DOI: 10.1016/j.puhe.2022.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 09/05/2022] [Accepted: 09/17/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We aimed to describe studies on human papillomavirus (HPV) vaccination education strategies from low- and middle-income countries in the published literature that could be applicable in Sub-Sahara Africa. STUDY DESIGN This scoping review was guided by Arksey and O'Malley's methodological framework advanced by Levac et al. METHODS We searched four electronic health sciences databases for relevant reports published between January 2006 and January 2021. Two reviewers screened for inclusion and extracted data for analysis and synthesis. Descriptive statistics and narrative descriptions were used to summarize the findings. RESULTS The database search retrieved 1757 reports, of which 48 were from low- and middle-income countries and met the inclusion criteria. Of these, there were 39 interventional studies (81.3%). Less than one-fifth of the studies (n = 9) reported a theoretical basis for their strategies. Most strategies sought to improve knowledge and awareness about HPV (75%, n = 36), whereas outcomes for the remaining studies were related to increasing HPV vaccine acceptability. HPV education strategies (1) primarily targeted females, (2) were mostly provided by health professionals, and (3) used various modalities of learning, including in-person sessions, text-based materials, media, theater, and online delivery. CONCLUSIONS HPV educational strategies are underresearched in most LMICs, suggesting the need for more primary observational, interventional, and experimental research, as well as program evaluations, focused on HPV educational strategies and theoretically informed. Once additional studies are added to the body of evidence, it will be valuable to review and synthesize diverse sources of evidence to determine what educational strategies are most useful and have the greatest impact on HPV vaccination in these settings, particularly Sub-Saharan Africa.
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Affiliation(s)
- E A Marfo
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - K D King
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - C A Adjei
- School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana
| | - S E MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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11
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Aguolu OG, Malik AA, Ahmed N, Omer SB. Overcoming Vaccine Hesitancy for Future COVID-19 and HIV Vaccines: Lessons from Measles and HPV Vaccines. Curr HIV/AIDS Rep 2022; 19:328-343. [PMID: 36114951 PMCID: PMC9483354 DOI: 10.1007/s11904-022-00622-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The discovery of vaccines significantly reduced morbidity and mortality of infectious diseases and led to the elimination and eradication of some. Development of safe and effective vaccines is a critical step to the control of infectious diseases; however, there is the need to address vaccine hesitancy because of its potential impact on vaccine uptake. METHODS We conducted a narrative review of studies on interventions to address measles and human papillomavirus vaccine hesitancy. We discussed how lessons learned from these studies could be applied towards COVID-19 and future human immunodeficiency virus vaccines. RESULTS We found that there are several successful approaches to improving vaccine acceptance. Interventions should be context specific and build on the challenges highlighted in various settings. CONCLUSION Strategies could be used alone or in combination with others. The most successful interventions directly targeted the population for vaccination. Use of financial incentives could be a potential tool to improve vaccine uptake.
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Affiliation(s)
- Obianuju G. Aguolu
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
| | - Amyn A. Malik
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
| | - Noureen Ahmed
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Yale School of Public Health, Yale University, New Haven, CT USA
| | - Saad B. Omer
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
- Yale School of Public Health, Yale University, New Haven, CT USA
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12
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Si M, Su X, Jiang Y, Wang W, Zhang X, Gu X, Ma L, Li J, Zhang S, Ren Z, Liu Y, Qiao Y. An Internet-Based Education Program for Human Papillomavirus Vaccination Among Female College Students in Mainland China: Application of the Information-Motivation-Behavioral Skills Model in a Cluster Randomized Trial. J Med Internet Res 2022; 24:e37848. [PMID: 36178723 PMCID: PMC9568820 DOI: 10.2196/37848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/28/2022] [Accepted: 09/06/2022] [Indexed: 12/05/2022] Open
Abstract
Background Patients diagnosed with cervical cancer in the last 2 decades were mainly young females. Human papillomavirus (HPV) vaccination is the most radical way to prevent HPV infection and cervical cancer. However, most female college students in mainland China have not yet been vaccinated, and their relevant knowledge is limited. Theory-based education delivered via the internet is a potentially accessible and useful way to promote HPV vaccination among this population. Objective This 3-month follow-up study intended to identify the feasibility and efficacy of an information-motivation-behavioral skills (IMB) model–based online intervention for promoting awareness and willingness regarding HPV vaccination among female college students. Methods A 7-day online HPV education program for female college students in mainland China was developed using a cluster randomized trial design. Recruitment and questionnaire surveys were performed online without face-to-face contact. SPSS 23.0 was used for statistical analysis. The chi-square test and t test were used to compare differences in qualitative and continuous variables between intervention and control groups. The generalized estimating equation was used to test the effectiveness of the intervention with a consideration of the time factor. Results Among 3867 participants, 102 had been vaccinated against HPV before the study (vaccination rate of 2.6%). A total of 3484 participants were followed up after the baseline survey, with no statistical difference in the loss rate between the intervention and control groups during the intervention and follow-up periods. At different follow-up time points, HPV-related knowledge, and the motivation, behavioral skills, and willingness regarding HPV vaccination were higher in the intervention group than in the control group. HPV-related knowledge was statistically different between the 2 groups, while the motivation, behavioral skills, and willingness regarding HPV vaccination only showed statistical differences right after the intervention, reaching a peak right after the intervention and then gradually reducing over time. Furthermore, there was no statistical difference in the HPV vaccination rate between the 2 groups. Conclusions IMB model–based online education could be a promising way to increase the HPV vaccination rate and reduce the burden of HPV infection and cervical cancer among high-risk female college students in China. Trial Registration Chinese Clinical Trial Registry ChiCTR1900025476; http://www.chictr.org.cn/showprojen.aspx? proj=42672 International Registered Report Identifier (IRRID) RR2-DOI:10.1186/s12889-019-7903-x
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Affiliation(s)
- Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenjun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaofen Gu
- Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China
| | - Li Ma
- School of Public Health, Dalian Medical University, Dalian, China
| | - Jing Li
- West China School of Public Health, West China Forth Hospital, Sichuan University, Chengdu, China
| | - Shaokai Zhang
- Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Zefang Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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13
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Perroud JM, Soldano S, Avanceña ALV, Wagner A. Adult vaccination uptake strategies in low- and middle-income countries: A systematic review. Vaccine 2022; 40:5313-5321. [PMID: 35953323 DOI: 10.1016/j.vaccine.2022.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/23/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Evidence-based strategies can maximize vaccination intent and uptake among adults. This systematic review summarizes the existing literature on strategies to improve vaccination intent and uptake among adults in low- and middle-income countries (LMICs) to inform future implementation in various populations and contexts. METHODS Eligible studies were identified through a systematic search in Medline, Embase, Cochrane Libraries, as well as grey literature databases published between January 2010 and March 2021. The search was limited to studies in LMICs that evaluated adult vaccination interventions. Data were extracted from the included studies and evaluated against the World Health Organization's Behavioral and Social Drivers of Vaccination Framework. The National Institutes of Health study quality assessment tools were used to evaluate study quality. RESULTS The initial literature review identified 2,854 records, 22 of which met the inclusion criteria. The majority (n = 19 or 86%) of studies were from middle-income countries, with the remaining studies (n = 3 or 13%) set in low-income countries. The majority (15/22, 68%) of interventions were multi-component. 82% (18/22) of studies addressed thoughts and feelings, 59% (13/22) addressed social processes, and 73% (16/22) addressed practical issues. Five studies reported primary outcomes of vaccination intent, and the remaining 17 reported vaccine uptake. 36% (8/22) of the studies cited statistically significant positive intervention effects on vaccination intent or uptake. Few of the included studies (6/22, 27%) were RTCs, and most studies (15/22, 68%) were of poor study quality. The studies reporting the highest increase in vaccination intent and uptake were multi-component interventions that addressed all three determinants of vaccination. DISCUSSION The results of this review highlight levers that can be used to encourage vaccine intent and uptake in the ongoing rollout of COVID-19 vaccines, as well as the deployment of other vaccines to adult populations in LMICs. Of the included studies, multicomponent interventions were most effective, mainly when targeting multiple determinants of vaccination. However, poor study quality indicates the need for additional research to validate these findings.
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Affiliation(s)
- Janamarie M Perroud
- Department of Health Management and Policy, School of Public Health, University of Michigan. 1415 Washington Heights, SPH II, Ann Arbor, MI 48109, USA.
| | - Shad Soldano
- School of Public Health, University of Michigan, 1415 Washington Heights, SPH II, Ann Arbor, MI 48109, USA
| | - Anton L V Avanceña
- Department of Health Management and Policy, School of Public Health, University of Michigan. 1415 Washington Heights, SPH II, Ann Arbor, MI 48109, USA
| | - Abram Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, SPH II, Ann Arbor, MI 48109, USA
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14
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Bai Y, Ip P, Chan K, Ngan H, Yip P. HPV Vaccination Intentions of Female Students in Chinese Universities: A Systematic Literature Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10207. [PMID: 36011838 PMCID: PMC9407966 DOI: 10.3390/ijerph191610207] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To systematically evaluate the human papillomavirus (HPV) vaccination intentions among female university students in China and establish a basis for improving HPV vaccination coverage. METHODS We searched CNKI, EBSCO, JSTOR, MESH or Emtree, Weipu Information Chinese Journal Service Platform, Wanfang Data, China Biomedical Literature Database, PubMed, Embase, Web for the Web of Science, and the Cochrane Library to identify peer-reviewed published research on intentions by female college students in China to receive the HPV vaccination. RESULTS A preliminary search of 408 papers resulted in the inclusion of 12 studies, all cross-sectional, of moderate or high quality, with a sample size of 12,600. The HPV vaccination intention rate among Chinese female university students was 16.67% (95% CI: 12.38% to 21.24%). The vaccination intention rates of medical students, non-medical students, and Tibetan students were 30.37% (95% CI: 28.80-34.12%), 15.53% (95% CI: 11.2-20.22%), and 14.12% (95 % CI: 10.59-18.04%), respectively. The vaccination intention rates of the participants with parental education of junior high school and below, high school, and bachelor's degree and above were 15.36% (95 % CI: 11.59 to 17.54%), 17.18% (95 % CI: 12.33% to 19.61%), and 19.81% (95 % CI: 15.61% to 22.25%), respectively. The intention rates of vaccination among residents of first-tier, second-tier, and third-tier cities were 17.64% (95% CI: 12.76-21.63%), 15.39% (95% CI: 11.74-19.82%), and 13.87% (95% CI: 9.36-15.65%), respectively. The results of the meta-analysis were relatively stable with little publication bias. CONCLUSION The intention rate of HPV vaccination among female university students in China is low and varies among different populations. There is a need to increase HPV vaccination promotion efforts to improve the intention of female university students to receive the vaccine.
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Affiliation(s)
- Yiming Bai
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong (HKU), Hong Kong, China
| | - Karen Chan
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Hextan Ngan
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Paul Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
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15
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Ou L, Youngstedt SD. The Role of Vaccination Interventions to Promote HPV Vaccine Uptake Rates in a College-Aged Population: a Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:244-250. [PMID: 32564253 PMCID: PMC8986718 DOI: 10.1007/s13187-020-01806-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This systematic review provided synthesized evidence regarding the effectiveness of the interventions promoting the human papillomavirus (HPV) vaccination in college-aged population. The HPV infection is the most prevailing sexually transmitted disease. Despite the availability and effectiveness of the 9-Valent HPV vaccine, the vaccine coverage among young adults remained low. In witness to the increasing burden of HPV-related infections and cancers, research focused on the vaccination interventions should be conducted to determine the effectiveness of the vaccination strategy and address the gap. The search was conducted through PubMed, Cochrane, and CINAL. Studies were included if they (1) included vaccination programs, (2) target population was young adults aged 17-26, (3) examined factors associated with the intervention effectiveness, (4) were published in English, and (5) were published between February 2010 and February 2020. HPV-related knowledge and intentions toward HPV vaccination were all reported increased after the intervention. Increased HPV vaccination intentions were found associated with the increased vaccine initiation and completion. Among bisexual or homosexual individuals, females were found more likely to complete the HPV dose 2 and 3. The review findings suggested using vaccination interventions incorporated with educational components to promote vaccine uptake among young adults. Supportive interventions tailored to different populations and settings are crucial to address the suboptimal HPV-related knowledge and vaccination status among the young beneficiaries.
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Affiliation(s)
- Lihong Ou
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ USA
| | - Shawn D. Youngstedt
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ USA
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16
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Wang D, Wu J, Du J, Ong H, Tang B, Dozier M, Weller D, Campbell C. Acceptability of and barriers to human papillomavirus vaccination in China: A systematic review of the Chinese and English scientific literature. Eur J Cancer Care (Engl) 2022; 31:e13566. [PMID: 35229931 PMCID: PMC9287030 DOI: 10.1111/ecc.13566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Widespread adoption of the human papillomavirus (HPV) vaccine will require population acceptance and tailoring of immunisation services to community needs and preferences. We examined peer-reviewed publications on the acceptability of and barriers to the HPV vaccine across China. METHODS We searched English (MEDLINE, Embase, and Web of Science) and Chinese (CNKI, VIP, Wanfang data) databases between 1 January 2006 and 31 December 2017. We adopted a narrative approach for data synthesis. RESULTS We identified 73 studies. The overall median acceptability of HPV vaccine was 71.8% (Q1-Q3: 58.6%-81%). Low levels of acceptability (<40%) of HPV vaccine were found in eastern regions of China. The largest differences of acceptability were observed between rural western regions (all >90%) and urban eastern regions (all <35%). Despite these regional variations, common barriers to HPV vaccine acceptance were concerns about vaccine safety, uncertainty over vaccine effectiveness, low perceived risk of cervical cancer and the price of the vaccine. The level of willingness to pay for the HPV vaccine (over 153 US dollars) was very low (<7%). CONCLUSION The acceptability of and attitudes towards HPV vaccine vary by regions and populations across China. HPV vaccination programmes will need to tailor service delivery as well as information materials to take account of regional concerns.
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Affiliation(s)
- Du Wang
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK.,The George Institute for Global Health, Peking University Health Science Center, Beijing, China
| | - Jing Wu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Haley Ong
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK
| | - Biwei Tang
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Marshall Dozier
- College Lead for Library Academic Support, Medicine & Veterinary Medicine Library & University, University of Edinburgh, Edinburgh, UK
| | - David Weller
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK
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Zhang X, Chen H, Zhou J, Huang Q, Feng XY, Li J. Impact of web-based health education on HPV vaccination uptake among college girl students in Western and Northern China: a follow-up study. BMC Womens Health 2022; 22:46. [PMID: 35197068 PMCID: PMC8864209 DOI: 10.1186/s12905-022-01625-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/08/2022] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate the effect of a web-based educational intervention on changing female college students’ willingness and uptake of human papillomavirus (HPV) vaccines, and factors associated with HPV vaccination acceptance in Western and Northern China. Methods A web-based cluster randomized controlled trial was conducted in Western and Northern China from February to May 2020. A total of 967 female freshmen were recruited from two universities through convenience sampling, stratified sampling (liberal arts or sciences), and cluster sampling. Eligible students were randomized into intervention and control group with a 1:1 allocation ratio. The intervention group received seven days of web-based health education regarding HPV and HPV vaccines, whereas the control group received non-HPV-related materials. All students were asked to complete a post-intervention questionnaire to measure their awareness, uptake, and willingness to receive HPV vaccination at 7-day and one-month intervals. The chi-square test and Student’s t-test were employed to examine the differences between the intervention and control groups for categorical and continuous data. Logistic regressions were used to analyze factors associated with vaccination intentions. Results Nine hundred forty-six female freshmen aged 18.99 ± 0.63 years were enrolled in the study, with 532 in the intervention group and 414 in the control group. Prior to the intervention, 63.8%, 66.3%, and 60.8% of students had heard of HPV, HPV-related diseases, and HPV vaccines, respectively. Only 2.2% of students reported being vaccinated, but 33.0% were willing to be vaccinated against HPV. After seven days of education, students in the intervention group exhibited higher awareness (p < 0.001) and knowledge scores (5.13 ± 1.23 vs. 3.10 ± 1.99, p < 0.001) than those in the control group. Similarly, in the intervention groups, willingness to be vaccinated against HPV was significantly higher than in the control groups (p < 0.001). The high cost (57.7%) and concerns about adverse events (56.0%) were the main reasons female college students did not accept HPV vaccines. School location in urban areas, parents’ higher education backgrounds, history of HPV vaccination counseling, history of sexual behavior, and having heard of HPV vaccines were associated with a higher willingness to be vaccinated. Conclusion Female college students’ HPV vaccination uptake is insufficient, and they have minimal detailed knowledge about HPV and its vaccines. Web-based health education on HPV vaccines is an easy, feasible, and effective way to improve the awareness and acceptance of HPV vaccination among female college students, but it has limited effect on HPV vaccination uptake. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01625-0.
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Affiliation(s)
- Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Hui Chen
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Jing Zhou
- Chenghua District Center for Disease Control and Prevention, Chengdu, 610057, China
| | - Qian Huang
- Student Affairs Department, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiao-Yu Feng
- Shanxi University of Finance and Economics, Taiyuan, 030006, China
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
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Analysis of HPV Vaccination Willingness amongst HIV-Negative Men Who Have Sex with Men in China. Vaccines (Basel) 2021; 9:vaccines9101069. [PMID: 34696177 PMCID: PMC8538591 DOI: 10.3390/vaccines9101069] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: Men who have sex with men (MSM) are high-risk groups of human papillomavirus (HPV) infection, the best measure to prevent this is the HPV vaccine. However, few studies have investigated HPV vaccination willingness in the MSM population in China. We aimed to explore the willingness of human immunodeficiency virus (HIV)-negative MSM for HPV vaccination and the factors affecting their willingness to vaccinate. Methods: We adopted a non-probability sampling method to recruit HIV-negative MSM volunteers. Participants completed a questionnaire, including sociodemographic characteristics, sexual behavior characteristics, HPV infection and vaccine-related knowledge, risk perception, and HPV vaccination willingness and promotion attitudes. Results: Of the 406 HIV-negative MSM surveyed, 86.21% were willing to receive HPV vaccine. HPV infection and vaccine-related knowledge (odds ratio [OR] = 2.167, 95% confidence interval [CI] = 1.049–4.474), HPV infection risk perception (OR = 5.905, 95% CI = 1.312–26.580), and HPV vaccine promotion attitude (OR = 6.784, 95% CI = 3.164–14.546) were all related to HPV vaccination willingness. Conclusion: MSM have a high willingness for HPV vaccination. Strengthening health education for MSM, raising their awareness of HPV infection and vaccines, and promoting their risk perception of HPV infection will help increase their willingness for HPV vaccination.
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Chu H, Ko LK, Ibrahim A, Mohamed FB, Lin J, Shankar M, Amsalu F, Ali AA, Richardson BA, Taylor VM, Winer RL. The impact of an educational forum intervention on East African mothers' HPV vaccine-related knowledge, attitudes, and intentions to vaccinate their adolescent children. Vaccine 2021; 39:3767-3776. [PMID: 34053792 PMCID: PMC9984200 DOI: 10.1016/j.vaccine.2021.05.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/09/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE HPV vaccine uptake in U.S. East African adolescents is low. We developed and evaluated a culturally-targeted interactive educational intervention for East African immigrant mothers to increase HPV-vaccine-related knowledge, attitudes, and intentions to vaccinate adolescent children. METHODS Eligible mothers had ≥ 1 11-17-year-old child and reported all children's HPV vaccination status as unvaccinated or unknown. The intervention was delivered via 10 dinners in the Seattle metropolitan area (8 with the Somali community, 2 with the Ethiopian community). Educational presentations and pre/post-tests on knowledge, attitudes, and intentions were conducted in the participants' native language by a co-ethnic physician. Pre/post differences in responses were evaluated with McNemar's tests and GEE models. HPV vaccination uptake 6-months post-intervention was evaluated using state immunization registry data. RESULTS Of 115 participating mothers, most (84%) were Somali and < 40 years of age (60%). Median years of formal education was 8 (range 0-16), and 61% reported a household income <$25,000. Knowledge of HPV/HPV-vaccines was low pre-intervention, with correct responses ranging from 4% to 39% (61%-91% of responses were "not sure"); correct post-intervention responses ranged from 29% to 97%. Pre-intervention, only 12% of mothers thought they had enough information to make a decision about vaccination, compared to 90% post-intervention. Pre-intervention, only 16% of mothers reported that they were somewhat or very likely to vaccinate their child, compared to 83% post-intervention. All pre/post comparisons were statistically significantly different (p < 0.0001). Although mothers were more likely to report correct HPV-related knowledge and positive vaccine attitudes and intentions post-intervention, only two mothers' children initiated HPV vaccination within 6 months after the intervention. CONCLUSIONS Results illustrate that a culturally targeted educational intervention effectively increased East African mothers' HPV vaccine-related knowledge, attitudes, and intentions to vaccinate their adolescent children. Future research should identify additional intervention components that can bridge the gap between intention and behavior to facilitate HPV vaccine uptake.
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Affiliation(s)
- Huong Chu
- Department of Global Health, University of Washington School of Public Health, 3980 15(th) Ave NE, Box 351620, Seattle, WA 98195, USA.
| | - Linda K. Ko
- Department of Health Services, University of Washington School of Public Health, 3980 15th Ave NE Box 357660, Seattle, WA 98195 USA.,Division of Public Health Services, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-B232, Seattle, WA 98102 USA
| | - Anisa Ibrahim
- Department of Pediatrics, University of Washington, Harborview Medical Center, 325 9(th) Ave, Seattle, WA 98104, USA; Somali Health Board, 7050 32nd AVE S. Seattle, WA 98118, USA.
| | - Farah Bille Mohamed
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 981195 USA
| | - John Lin
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 98195, USA.
| | - Megha Shankar
- Department of Medicine, University of Washington, 1959 NE Pacific St, Box 356421, Seattle, WA 98195, USA.
| | - Fanaye Amsalu
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 98195, USA.
| | - Ahmed A. Ali
- Somali Health Board, 7050 32nd AVE S. Seattle, WA 98118 USA
| | - Barbra A. Richardson
- Department of Global Health, University of Washington School of Public Health, 3980 15th Ave NE, Box 351620, Seattle, WA 98195, USA.,Department of Biostatistics, University of Washington School of Public Health, 3980 15th Ave NE, Box 351617, Seattle, WA 98195 USA
| | - Victoria M. Taylor
- Division of Public Health Services, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-B232, Seattle, WA 98102 USA
| | - Rachel L. Winer
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 981195 USA
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Zhang X, Wang Z, Ren Z, Li Z, Ma W, Gao X, Zhang R, Qiao Y, Li J. HPV vaccine acceptability and willingness-related factors among Chinese adolescents: a nation-wide study. Hum Vaccin Immunother 2021; 17:1025-1032. [PMID: 33121330 DOI: 10.1080/21645515.2020.1812314] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Adolescents are the primary target population for human papillomavirus (HPV) vaccination. The objective of this study is to explore the acceptability of HPV vaccines and evaluate factors related to willingness to be vaccinated among Chinese adolescents. METHODS A nation-wide survey was conducted across 14 schools in mainland China. The questionnaire consisted of questions relating to socio-demographic characteristics, knowledge of adolescent sexual health, cervical cancer, HPV and HPV-related disease, and students' willingness to be vaccinated. Chi-square tests and multivariable logistic regression were conducted in the data analysis. RESULTS A total of 4,062 students participated in this study. Among them, only 17.1% of students reported having heard of HPV vaccines; however, 67.3% were willing to receive the HPV vaccine. Multivariable regression analysis showed that students who were from rural areas, have received sexual health education, have heard of cervical cancer or HPV vaccine, have a positive attitude toward vaccination, reported they were at the risk of developing cervical cancer, and those who value their parents' and teachers' opinions were more willing to receive HPV vaccination. CONCLUSIONS Awareness about the HPV vaccine is low among Chinese adolescents. The factors that most related to willingness to vaccinate among Chinese adolescents were school location, education about vaccination, HPV, and HPV vaccines. Integrating health education on HPV vaccination into existing school-based sexual health curricula may be an effective way to increase HPV vaccination coverage in mainland China.
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Affiliation(s)
- Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Zengzhen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Zefang Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhifang Li
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Xiaohong Gao
- Department of Epidemiology, School of Public Health, Dalian Medical University, Dalian, China
| | - Rong Zhang
- Postdoctoral Research Station, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Youlin Qiao
- Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College School of population medicine & public health, Beijing, China
| | - Jing Li
- Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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21
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Yin G, Zhang Y, Chen C, Ren H, Guo B, Zhang M. Have you ever heard of Human Papillomavirus (HPV) vaccine? The awareness of HPV vaccine for college students in China based on meta-analysis. Hum Vaccin Immunother 2021; 17:2736-2747. [PMID: 33787459 DOI: 10.1080/21645515.2021.1899731] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: To evaluate the awareness of College Students (CSs) of HPV vaccine in China and provide evidence-based recommendations for HPV vaccine's publicity and promotion.Methods: Web of Science, PubMed, Science of Direct, EBSCO, China National Knowledge Infrastructure and Wanfang Data were searched. A random effects meta-analysis was conducted to determine pooled estimates of Awareness Rate (AR) for HPV vaccine.Results: Of the 36 studies included, the estimated AR of HPV vaccine was 40.27% (95% CI: 30.86%, 50.06%) among Chinese CSs. The AR of HPV vaccine was stratified by factors as gender, major, area, city, survey time, and sampling method of the study. The pooled AR of HPV vaccine among CSs was as follows: 44.17% (95% CI: 31.65%, 57.09%) and 31.93% (95% CI: 13.25%, 54.30%) for females and males; 44.47% (95% CI: 29.90%, 59.55%) and 12.02% (95% CI: 7.69%, 17.15%) for medical-related and nonmedical majors; 44.47% (95% CI: 28.71-60.82%) and 41.16% (95% CI: 26.48-56.64%) for Eastern and Midwestern region; 48.86% (95% CI: 30.63-67.25%) and 33.19% (95% CI: 22.27-45.12%) for first-tier and second- and third-tier city; 29.67 (95% CI: 11.44-52.16%) and 38.81 (95% CI: 27.14-51.21%) for AR before and after HPV vaccine entered in China; 51.51% (95% CI: 32.21%, 70.53%) and 26.21% (95% CI: 17.41%, 36.10%) for nonrandom and random sampling.Conclusion: This review indicates that awareness of HPV vaccine among CSs remains relatively low in China compared with European countries. Our findings may provide useful information to better understand the HPV vaccine awareness status among Chinese CSs.
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Affiliation(s)
- Gang Yin
- Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yulin Zhang
- Department of Business Administration, School of Economics and Management, Wuchang Institute of Technology, Wuhan, China
| | - Chaoyi Chen
- Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huayu Ren
- Department of Ideological and Political Education, School of Marxism, Harbin Medical University, Harbin, China
| | - Botang Guo
- Department of Medical Psychology, School of Health Management, Harbin Medical University, Harbin, China
| | - Meng Zhang
- Department of Ideological and Political Education, School of Marxism, Harbin Medical University, Harbin, China
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Ou L, Chen ACC, Reifsnider E. Review of Chinese young adults' human papillomavirus knowledge, attitudes, and vaccine acceptability. Public Health Nurs 2021; 38:701-714. [PMID: 33715199 DOI: 10.1111/phn.12893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The human papillomavirus (HPV) vaccine is effective in reducing HPV-related disease. The 2-, 4-, and 9-valent HPV vaccines have been approved by the Chinese FDA since 2016; however, factors associated with HPV vaccine acceptability and use in Chinese young adults remain unclear. DESIGN AND SAMPLE We conducted a systematic review to analyze factors affecting HPV vaccine acceptability and use in Chinese young adults. A comprehensive search of databases (e.g., PubMed, CINAHL, and PsycINFO) was conducted, and articles between 2011 and 2020 were included. RESULTS Seventeen studies were included in the final review, and eleven were conducted in mainland China and six in Hong Kong. All studies reported low level of HPV-related knowledge. Better knowledge, more concerns about HPV-associated diseases, and being female were found associated with higher vaccine acceptability. The vaccine cost and safety were the major concerns for vaccination. CONCLUSIONS Findings suggested a low level of HPV-related knowledge and suboptimal vaccination rate in Chinese young adults. Theory-based interventions addressing knowledge and other influencing factors and involving both males and females are urgently needed to increase vaccine acceptability and use in Chinese young adults.
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Affiliation(s)
- Lihong Ou
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Angela Chia-Chen Chen
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Elizabeth Reifsnider
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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Jacob RA, Abraham PS, Thomas FR, Navya V, Sebastian J, Ravi MD, Gurumurthy P. Impact of indirect education on knowledge and perception on cervical cancer and its prevention among the parents of adolescent girls: an interventional school-based study. Ther Adv Vaccines Immunother 2021; 9:2515135521990268. [PMID: 33629029 PMCID: PMC7882753 DOI: 10.1177/2515135521990268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 01/07/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND India has almost 225 million adolescent girls and they seem to be at a disadvantage, both economically and by their lack of knowledge on human papilloma virus (HPV) vaccine, when compared to adolescent girls of other Asian countries. AIM To assess the prevalence of HPV vaccination and to identify the impact of education in improving the knowledge and perception about the HPV infection and vaccination among the parents of adolescent girls. METHODOLOGY The prospective interventional study was conducted in four schools within a South Indian City, Mysuru. The informed consent form and the questionnaire were sent home with the identified adolescent girls during the pre-interventional phase. Educational sessions were conducted for the students in their school and an education leaflet was distributed to their parents. Three weeks later, questionnaires were re-administered to the parents via the enrolled girls and their responses were collected. RESULTS The prevalence of HPV vaccination in the study population was 4.4%. There was a statistically significant improvement in knowledge in the post-interventional phase of the study (p = 0.001), but could not identify a significant change in their perception (p = 0.479). Parents belonging to the socioeconomic class of upper middle and upper lower showed better improvement at the end of the study, with a percentage improvement of 58.93% and 48.44%, respectively. CONCLUSION The study proved that the healt care professional can target school children to communicate effectively to their parents on the importance of HPV vaccine as the study clearly observed a positive behavioral change among the study population.
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Affiliation(s)
- Rony Abraham Jacob
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Priya Srambical Abraham
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Feba Rachel Thomas
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Vytila Navya
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Juny Sebastian
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, S S Nagara, Mysuru, Karnataka 570015, India
| | - Mandyam Dhati Ravi
- Department of Paediatrics, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Parthasarathi Gurumurthy
- Pharmacovigilance and Clinical Trials, Botswana Medicines Regulatory Authority, Gaborone, Botswana
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24
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Liu J, Shi Y, Wang L, Wang J, Fan D, Han S, Wei L. Epidemiology and persistence of cervical human papillomavirus infection among outpatient women in Heilongjiang province: A retrospective cohort study. J Med Virol 2020; 92:3784-3792. [PMID: 32297986 DOI: 10.1002/jmv.25899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 03/29/2020] [Accepted: 04/14/2020] [Indexed: 11/09/2022]
Abstract
As persistent carcinogenic human papillomavirus (HPV) infection is a prominent driver of cervical cancer, it is essential to explore HPV persistence and its associated factors for cancer screening and prevention. A retrospective cohort study was performed in outpatient women between March 2010 and 2019 in Heilongjiang, northeast China. HPV genotyping was performed by polymerase chain reaction-membrane hybridization. An unconditional logistic regression model was used to analyze the association of factors with persistence. The overall prevalence of HPV at baseline was 27.1%, with a downward trend from 2010 to 2019 (P < .0001). The most commonly observed high- and low-risk HPVs were HPV16 (N = 1094, 5.9%) and HPV11 (N = 596, 3.2%), respectively. The probabilities of 6-month persistence were high for women infected with HPV16 (P = .0001), HPV58 (P = .018), and HPV53 (P = .014), as well as for women with multiple infections (P = .009), and those who were 51 to 60 years old (P = .004) or more than 60 years old (P = .007). The probabilities of 12-month persistence were high for women infected with HPV53 (P = .017) and 51- to 60-year-old women (P = .044). HPV16 is the dominant HPV type in Heilongjiang. An age in the range of 51 to 60 years and infection with HPV53 is associated with HPV infection persistence in the Heilongjiang population.
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Affiliation(s)
- Jiaxin Liu
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Yafeng Shi
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lishuang Wang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiao Wang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Dongxue Fan
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Shiyu Han
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lanlan Wei
- Department of Microbiology, Harbin Medical University, Harbin, China
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Ji M, Huang Z, Ren J, Sun X, Wagner AL. Chinese Vaccine Providers' Perspectives on the HPV Vaccine. Glob Pediatr Health 2020; 7:2333794X20967592. [PMID: 33195744 PMCID: PMC7597565 DOI: 10.1177/2333794x20967592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/19/2020] [Accepted: 09/29/2020] [Indexed: 11/17/2022] Open
Abstract
China approved a human papillomavirus (HPV) vaccine in 2018. Recommendations from health care providers can positively impact vaccine receipt. This study characterized vaccine providers’ attitudes toward the HPV vaccine and contrasted attitudes by the providers’ demographic characteristics. In total, 120 vaccine providers in Shanghai, China, completed a questionnaire. Associations between essential characteristics of the HPV vaccine and providers’ urbanicity and working length were explored using the Kruskal-Wallis test. Doctors with ≤5 years’ work experience were more likely to think it important to emphasize that HPV is a sexually transmitted disease compared to doctors with longer work experiences (P = .0231). More suburban than urban providers thought that China should include the HPV vaccine into the publicly funded Expanded Program on Immunization (P = .0315). Differences in attitudes toward HPV could lead to variation in how providers talk to parents and adolescents about the HPV vaccine, with disparities in vaccine uptake as a result.
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Affiliation(s)
- Mengdi Ji
- University of Michigan, Ann Arbor, USA
| | - Zhuoying Huang
- Shanghai Municipal Centers for Disease Control & Prevention, China
| | - Jia Ren
- Shanghai Municipal Centers for Disease Control & Prevention, China
| | - Xiaodong Sun
- Shanghai Municipal Centers for Disease Control & Prevention, China
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26
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Wang Q, Zhang W, Cai H, Cao Y. Understanding the perceptions of Chinese women of the commercially available domestic and imported HPV vaccine: A semantic network analysis. Vaccine 2020; 38:8334-8342. [PMID: 33190947 DOI: 10.1016/j.vaccine.2020.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/08/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND A domestic human papillomavirus (HPV) vaccine, Cecolin, that protects against HPV strains 16 and 18 was introduced to the Chinese market at a relatively low price in May 2020.This study has explored Chinese women's perceptions of both domestic and imported HPV vaccines, which differ in price and valency. METHODS Sentiment analysis and semantic network analyses were performed based on a sample of 45,729 domestic HPV vaccine-related posts from females on the Sina Weibo between April 17 and May 2, 2020. The geographic distribution was also analyzed based on the users' locations, which were retrieved from the database. RESULTS Most of the posts were positive and neutral (85%), although 15% were negative (e.g., expressions of anger, sadness, fear and disgust). Semantic analyses of the negative posts revealed that Chinese women generally had positive attitudes towards the HPV vaccine and were willing to be vaccinated. However, obvious geographical variations were identified. Women who lived in economically developed areas expressed a stronger desire to obtain imported quadrivalent or nonavalent vaccines due to concerns regarding effectiveness and quality. The women expressed disgust and anger mainly regarding difficulties in making an appointment, age restrictions for the nonavalent vaccine and gender restrictions. However, the population targeted by the domestic vaccine, namely women who lived in economically undeveloped areas and had relatively low incomes, had a low awareness of the HPV vaccine. CONCLUSION Government should provide programs, which educate females that bivalent HPV vaccine can offer protection against the majority of high-risk HPV types. Increasing awareness of the domestic vaccine among the population in economically undeveloped areas and provision of free domestic bivalent HPV vaccination/screening for low-income high-risk women would help to prevent cervical carcinoma. This issue also depends on rebuilding trust and repairing damage to the relationship between government/domestic vaccine manufacturers and the public.
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Affiliation(s)
- Qi Wang
- School of Industrial Design, Hubei University of Technology, 28 Nanli Road, Wuhan 430068, PR China
| | - Wen Zhang
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Wuhan 430073, PR China.
| | - Hongning Cai
- Department of Gynecological Oncology, Hubei Maternal and Child Health Care Hospital, Wuhan 430070, Hubei, PR China
| | - Yuan Cao
- Cloud-clone Diagnostic Reagents Institute, Wuhan 430056, Hubei, PR China
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27
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Torabizadeh C, Nick N, Vizeshfar F, Jamalimoghadam N, Bagheri S. Effectiveness of an Educational Intervention to Increase Human Papillomavirus Knowledge and Attitude in Staff and Nursing Students. J Community Health Nurs 2020; 37:214-221. [PMID: 33150811 DOI: 10.1080/07370016.2020.1809857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the effect of education about human papilloma virus and its vaccine on awareness and attitude of healthcare workers and nursing students. DESIGN This was a quasi-experimental study. METHODS The sample size was 250 (155 healthcare workers and 95 students), and both groups received educational intervention. Questionnaires were used to collect data before, after, and also 3 months following the intervention. FINDINGS The mean age of participants was 30.1 ± 10.23 years. Results showed a significant increase in knowledge (P < .001), overall attitude (P = .000), and perceived behavior (P < .001) of the participants after the educational intervention. CONCLUSION Educational intervention was effective in knowledge, attitude, and behavior of students and healthcare workers. CLINICAL EVIDENCE Educational intervention can be one of the strategies to prevent individuals from acquiring the virus and to increase vaccine compliance.
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Affiliation(s)
- Camellia Torabizadeh
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Narjes Nick
- Student Research Committee, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Fatemeh Vizeshfar
- Nursing Department, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Neda Jamalimoghadam
- Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Shahpar Bagheri
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences , Shiraz, Iran
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28
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Fisher H, Audrey S, Chantler T, Finn A, Letley L, Mounier-Jack S, Thomas C, Yates J, Hickman M. Co-production of an educational package for the universal human papillomavirus (HPV) vaccination programme tailored for schools with low uptake: a participatory study protocol. BMJ Open 2020; 10:e039029. [PMID: 33148744 PMCID: PMC7643513 DOI: 10.1136/bmjopen-2020-039029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/01/2020] [Accepted: 10/11/2020] [Indexed: 11/24/2022] Open
Abstract
AIM To co-produce with young people an educational package about the human papillomavirus (HPV) vaccine that is tailored to increase vaccine uptake in schools and populations with lower uptake. INTRODUCTION Persistent infection with HPV can result in cancers affecting men and especially women. From September 2019, the English-schools-based HPV vaccination programme was expanded to include young men (in addition to young women) aged 12-13 years. Some young people attending schools with lower uptake of the vaccine have unmet information needs. We hypothesise that mechanisms to address information needs and increase young people's autonomy in consent procedures will result in higher uptake. METHODS AND ANALYSIS The Medical Research Council's framework for development and evaluation of complex interventions will inform intervention development. Recruitment of young people aged 12-15 years and key stakeholders (National Health Service commissioners, school staff, immunisation nurses and youth workers/practitioners) will be facilitated through existing links with healthcare organisations, schools and youth organisations in areas with lower uptake of the HPV vaccination programme. The proposed research will comprise three phases: (1) a rapid review of adolescent immunisation materials and preliminary qualitative interviews with young people and key stakeholders, (2) theory development and co-production of HPV vaccine communication materials through an iterative process with young people and (iii) testing delivery mechanisms and acceptability of the educational package in four schools with lower uptake. ETHICS AND DISSEMINATION The University of Bristol's Faculty of Health Sciences and London School of Hygiene and Tropical Medicine's Research Ethics Committees provided approvals for the study. A dissemination event for young people and key stakeholders and webinar with the National Immunisation Network will be organised. The study findings will be published in peer-reviewed journals and presented at conferences. Recommendations for a future larger scale study will be made.
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Affiliation(s)
- Harriet Fisher
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Adam Finn
- Division of Clinical Sciences, University of Bristol, Bristol, UK
| | - Louise Letley
- National Infection Service, Public Health England, London, UK
| | - Sandra Mounier-Jack
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Clare Thomas
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Suo T, Lu Q. Parental Acceptability of HPV Vaccination for Adolescent Daughters and Associated Factors: A Cross-Sectional Survey in Bozhou, China. Res Theory Nurs Pract 2020; 34:340-357. [PMID: 33199407 DOI: 10.1891/rtnp-d-19-00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to investigate parents' acceptability of human papillomavirus (HPV) vaccination for their daughters and associated factors. METHODS This cross-sectional study was conducted in a city in China with a sample population of parents with a daughter in middle school. Participants' demographic characteristics, knowledge level regarding HPV and the HPV vaccine, perspectives on the health belief model (HBM) constructs, social norms, and acceptability of the HPV vaccine were determined through self-administered questionnaires. RESULTS Among the 523 parents who completed the questionnaire, 71.5% expressed willingness to have their daughters vaccinated against HPV infection and cervical cancer. Logistic regression analysis revealed higher acceptability in the participants with higher perceived severity of HPV infection (OR = 4.823, 95% CI = 2.683, 12.049), higher knowledge-assessment score (OR = 1.298, 95% CI = 1.055, 1.476), and higher perceived safety of the HPV vaccine (OR = 6.372, 95% CI = 3.856, 14.062). Parents influenced by social norms (OR = 4.959, 95% CI = 2.989, 14.386) and those who complied with physicians' recommendations (OR = 4.896, 95% CI = 1.936, 9.258) reported higher levels of acceptability. IMPLICATIONS Our results provide preliminary evidence on the need for health education programs and HPV vaccination campaigns. Future studies should focus on whether the factors associated with vaccination can increase parental acceptability of the HPV vaccine.
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Affiliation(s)
- Tonghui Suo
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui
| | - Qi Lu
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui .,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui
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30
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Nkwonta CA, Hilfinger Messias DK, Felder T, Luchok K. Increasing Human Papillomavirus Vaccination and Cervical Cancer Screening in Nigeria: An Assessment of Community-Based Educational Interventions. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 41:89-99. [PMID: 32741317 DOI: 10.1177/0272684x20916611] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We explored the impact of two community-based educational interventions on Nigerian adults' knowledge and intention to take or encourage human papillomavirus (HPV) vaccine and cervical screenings. Face-to-face presentation and printed pamphlet intervention were delivered to 266 men and women aged 18 to 65 years in 12 locations in urban setting. At baseline, the majority (80%) had poor knowledge of HPV, and less than 12% had ever received or have a family member who had received HPV vaccine or cervical screening. Postintervention, there was significant increase (>70%) in the participants knowledge and intention to take or encourage HPV vaccination and cervical screening. In addition, more than half were willing to pay for HPV vaccine and screening even when expensive. Gender-focused and context-specific low-cost community-based educational interventions are effective in increasing HPV vaccine and cervical screening in sub-Saharan Africa.
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Affiliation(s)
| | - DeAnne K Hilfinger Messias
- College of Nursing, University of South Carolina.,Department of Women and Gender Studies, University of South Carolina
| | - Tisha Felder
- College of Nursing, University of South Carolina.,College of Social Work, University of South Carolina
| | - Kathryn Luchok
- Department of Anthropology, University of South Carolina
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31
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Chen H, Zhang X, Wang W, Zhang R, Du M, Shan L, Li Y, Wang X, Liu Y, Zhang W, Li X, Qiao Y, Ma J, Zhou J, Li J. Effect of an educational intervention on human papillomavirus (HPV) knowledge and attitudes towards HPV vaccines among healthcare workers (HCWs) in Western China. Hum Vaccin Immunother 2020; 17:443-450. [PMID: 32692948 DOI: 10.1080/21645515.2020.1780093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) play a key role in the recommendation of HPV vaccination. Our study aimed to understand to what extent a structured health intervention could change the knowledge and attitudes toward HPV and its vaccines among HCWs in Western China. METHODS This was a multi-center, questionnaire-based interventional study conducted across 12 cities of seven provinces in Western China, from November 2018 to July 2019. Participants were recruited from local health systems by e-invitation. Questionnaires were administered to participants before and after the intervention. RESULTS A total of 1448 HCWs attended the educational lectures and 1354 participants completed both pre- and post-study questionnaires. In general, HCWs had satisfactory baseline knowledge regarding HPV and its vaccines compared with other populations, and a significantly higher knowledge level was observed after the intervention. However, some more specific knowledge on the vaccination procedures, other HPV-related diseases and whether HPV testing was required before vaccination was relatively poor. Following the educational intervention, the correct responses to the above questions increased (P < .001). However, it was still lower compared with answers to other questions. Change was also detected regarding HCWs' willingness to recommend HPV vaccines to the appropriate population (P < .001). CONCLUSION Educational intervention on HPV and its vaccines is effective in improving HCWs' knowledge levels and willingness to recommend HPV vaccines. Future educational interventions should focus more on knowledge regarding HPV-related diseases and HPV vaccination. Education campaigns targeting rural HCWs are urgently needed in the near future.
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Affiliation(s)
- Hui Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Xi Zhang
- Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute , Beijing, China
| | - Wei Wang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China , Chengdu, China
| | - Rong Zhang
- Postdoctoral Research Station, Xinjiang Center for Disease Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention , Urumqi, China
| | - Mei Du
- Dali Maternal & Child Health Hospital/Dali Children's Hospital , Dali, China
| | - Li Shan
- Northwest Women's and Children's Hospital , Shannxi, China
| | - Yucong Li
- Chongqing University Cancer Hospital , Chongqing, China
| | - Xiaohui Wang
- Gansu Provincial Cancer Hospital/Gansu Provincial Academic Institute for Medical Research , Lanzhou, China
| | - Yijun Liu
- Zunyi Medical University , Zunyi, China
| | - Wen Zhang
- Kunming Women and Children's Hospital , Kunming, China
| | - Xiaoling Li
- Yuxi Hospital of Traditional Chinese Medicine , Yuxi, China
| | - Youlin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China
| | - Jianqiao Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Jing Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, Sichuan, China.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , London, UK
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32
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Altamimi T. Human papillomavirus and its vaccination: Knowledge and attitudes among female university students in Saudi Arabia. J Family Med Prim Care 2020; 9:1849-1855. [PMID: 32670930 PMCID: PMC7346958 DOI: 10.4103/jfmpc.jfmpc_1205_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 12/28/2019] [Accepted: 03/22/2020] [Indexed: 01/05/2023] Open
Abstract
Context: College students worldwide have low levels of knowledge on human papillomavirus (HPV)-related diseases, highlighting the lack of awareness about HPV infection. To date, no study has examined the level of knowledge of cervical cancer and the HPV vaccine in the northern region of Saudi Arabia. Aim: This study aimed to assess the level of knowledge of cervical cancer and its risk factors, as well as HPV vaccine acceptance among female students in Saudi Arabia enrolled in health colleges. Methods: A descriptive cross-sectional survey was conducted using a valid and reliable self-administered questionnaire. The questionnaire was completed by 966 female students enrolled at the University of Hail, northern region of Saudi Arabia, with a response rate of 83.5%. The main outcome measure was the identification of the knowledge gap pertaining to HPV infection and its prophylactic vaccine. Results: The findings highlighted a lack of knowledge about cervical cancer, Pap smears, and HPV vaccine among most female university students. The knowledge score positively correlated to the duration of education. Students enrolled in applied medical science and medical colleges showed significantly higher knowledge scores, as did students in their senior academic years. Vaccine uptake barriers included concerns about its side effects and a lack of information. Conclusions: Our findings can be used to formulate effective future awareness programs in the northern region of Saudi Arabia. A larger number of educational programs are required to enlighten Saudi women about cervical cancer and its prophylactic vaccine, including the benefits of screening programs and prevention strategies.
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Affiliation(s)
- Tahani Altamimi
- Department of Family Medicine and Community Medicine, College of Medicine, University of Hail, Hail, Saudi Arabia
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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.
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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
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Qin S, Fu JX, Chen MZ, Meng YT, Xu C, Luo Y. Acceptability of vaccination against human papillomavirus among women aged 20 to 45 in rural Hunan Province, China: A cross-sectional study. Vaccine 2020; 38:4732-4739. [PMID: 32471777 DOI: 10.1016/j.vaccine.2020.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/21/2020] [Accepted: 05/06/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study aimed to examine the intentions of and barriers to vaccination against human papillomavirus (HPV) among women aged 20 to 45 in rural areas, and to determine the popular sources to getting information about HPV vaccine and vaccination. METHODS This cross-sectional study was conducted in 2018 with a sample of women aged 20 to 45 from rural areas of Hunan Province in China. Anonymous self-administered questionnaires were used to collect sociodemographic information and characteristics related to reproductive health of participants, and intentions of and barriers to HPV vaccination. All statistical analysis methods were performed with SPSS 18.0. RESULTS A total of 2101 women participated in the study, with 58.55% intended to vaccinate against HPV. Increased intention of HPV vaccination was associated with higher age (adjusted odds ratio [AOR] = 1.35 and 1.50, respectively) and education level (AOR = 1.13 and 1.47, respectively). Women who have heard of HPV vaccine (AOR = 2.67, 95% confidence interval [CI]: 1.20-5.98) and have been aware of that cervical cancer could be prevented (AOR = 2.01, 95%CI: 1.44-2.82) were more willing to vaccinate. Having never heard of HPV vaccine and worry about efficacy and safety of vaccines were the most commonly cited reasons to refuse vaccination. The preferred source to get the knowledge was medical personnel (58.45%), followed by WeChat or Microblog, TV programs, and Internet. CONCLUSION We found the intention of HPV vaccination among women aged 20 to 45 in rural China is low. Findings highlighted the importance of knowledge and trust in HPV vaccine, and suggested strengthening educational interventions on HPV vaccine and vaccination through multiple sources, including HPV vaccine coverage in health insurance to increase access.
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Affiliation(s)
- Si Qin
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Jing-Xia Fu
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Ming-Zhu Chen
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Yan-Ting Meng
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Chen Xu
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Yang Luo
- Xiangya Nursing School of Central South University, Changsha, PR China.
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Exploring Chinese College Students' HPV Awareness, Knowledge, Attitudes, and Intent of HPV Vaccination: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 36:1211-1218. [PMID: 32314310 DOI: 10.1007/s13187-020-01750-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Human papillomavirus (HPV) infection is the world's most prevalent sexually transmitted infection and causes cancers. In China, about 47,739 deaths occur annually from HPV-related cervical cancer, and this number continues to increase. HPV vaccines have shown promising results in preventing HPV-associated cancers; however, the vaccination rate in Chinese college students remains extremely low. This qualitative research explored Chinese college students' HPV-related awareness, knowledge, attitudes and beliefs, and their vaccination intention as well as the strategies promoting vaccination in China. We conducted four focus groups with 18 male and 20 female students; prompts were developed based on the health belief model (HBM). Discussions were audiotaped, transcribed, and translated from Chinese to English by three bilingual researchers. Content analysis of the data revealed eight themes addressing HBM. Participants demonstrated high awareness (71% had heard of HPV) with limited knowledge. They perceived very low risks of being infected but expressed high vaccination intention if the cost was covered by the government. Participants identified reasons that facilitate and prevent vaccination and proposed culturally and developmentally congruent strategies to promote vaccination in China. It is essential to address facilitators and barriers at individual, societal, political, and cultural levels to promote HPV vaccination in Chinese college students.
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Effect of a school-based educational intervention on HPV and HPV vaccine knowledge and willingness to be vaccinated among Chinese adolescents : a multi-center intervention follow-up study. Vaccine 2020; 38:3665-3670. [DOI: 10.1016/j.vaccine.2020.03.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/12/2020] [Accepted: 03/16/2020] [Indexed: 12/22/2022]
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Awareness and knowledge of human papillomavirus vaccination and their influential factors among Chinese women: a systematic review. FRONTIERS OF NURSING 2019. [DOI: 10.2478/fon-2019-0048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objectives
To systematically review the knowledge attitudes and the influential factors on human papillomavirus (HPV) vaccination among Chinese women.
Methods
Published studies on knowledge and attitudes of HPV vaccination for preventing cervical cancer among Chinese female population were retrieved using the major Chinese and English databases. Meanwhile, handwork retrieval was also conducted and the references including in the literature were retrieved. The quality of the literature was rigorously evaluated and extracted independently by two researchers and the data were analyzed and described by review manager 5.3 (RevMan5.3) software.
Results
In all, 19 articles including 8 articles in Chinese and 11 in English were chosen. A total of 30,176 participants were included and the sample size ranged from 64 to 6,024. The overall awareness of HPV and HPV vaccine among Chinese women was at a low level. Chinese women generally showed poor knowledge about HPV and HPV vaccine. Acceptance of HPV vaccination among Chinese women was at a high level. Vaccination intentions were influenced by the theory of planned behavior (TPB) and measured by attitudes subjective norms and perceived behavioral control.
Conclusions
The health authorities may evaluate and develop TPB-based interventions to increase HPV vaccination intentions of Chinese women. HPV vaccination programs should focus on carrying out multi-level and targeted health education and developing effective public health strategies after balancing the cost and benefit of HPV vaccine program. Medical staff should play the positive role in promoting the use of HPV vaccines in China. Integration of policy and community perspectives and multi-level interventions are essential to maximize the public health benefits of HPV vaccination.
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Si M, Su X, Jiang Y, Qiao Y, Liu Y. Interventions to improve human papillomavirus vaccination among Chinese female college students: study protocol for a randomized controlled trial. BMC Public Health 2019; 19:1546. [PMID: 31752785 PMCID: PMC6873719 DOI: 10.1186/s12889-019-7903-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023] Open
Abstract
Background While the HPV vaccines have been approved by the US FDA since 2006, in recent years an increasing number of women are living with cervical cancer globally. Among them, Chinese women have a higher cervical cancer incidence and mortality rate than the global average, with mortality rates being almost twice the global average. However, the current approach of HPV vaccination in China is not satisfactory given the high disease burden of cervical cancer. The current study is a randomized controlled trial designed to identify the barriers and facilitators of HPV vaccination among Chinese female students. This study will also test a health intervention measure via a popular form of new media in order to improve the HPV vaccine uptake under the framework of Information-Motivation-Behavioral skill Model (IMB). Methods This investigation is a multicenter, school-based, prospective, randomized, parallel group, double-blind, blank-controlled trial involving a 7-day education intervention with a further 6-month follow-up. We will enroll at least 3360 participants older than 18 years. The enrolled participants will be randomly divided into two groups (1:1 ratio). The intervention group will be offered a 7-day mobile health education, and participants in both groups will fill out 4 questionnaires at the baseline, 1 month, 3 months and 6 months after the intervention. The primary outcome is the difference in HPV vaccination or reservation for the HPV vaccine between the intervention and control groups. Secondary outcomes will include the comparison of (1) knowledge, attitudes, motivation, beliefs and behavioral skill about HPV and cervical cancer prevention, and (2) the willingness to uptake HPV vaccination. Discussion This study will examine the theory-based intervention in improving HPV vaccination among Chinese female college students. We will conduct the randomized controlled trial to provide scientific evidence on the potential effect of the IMB theory-based intervention. Findings from this study will contribute to a growing research field which assesses the effectiveness of mobile-based, school-targeted and theoretically guided interventions for promoting HPV vaccination in adolescents. Trial registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR1900025476; Registered on 27 August 2019.
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Affiliation(s)
- Mingyu Si
- School of Public Health, Chinese Academy of Medical Sciences &Peking Union Medical College, 5 DongDanSanTiao, Dongcheng District, Beijing, China
| | - Xiaoyou Su
- School of Public Health, Chinese Academy of Medical Sciences &Peking Union Medical College, 5 DongDanSanTiao, Dongcheng District, Beijing, China.
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Sciences &Peking Union Medical College, 5 DongDanSanTiao, Dongcheng District, Beijing, China
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences &Peking Union Medical College, 5 DongDanSanTiao, Dongcheng District, Beijing, China
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Liu CR, Liang H, Zhang X, Pu C, Li Q, Li QL, Ren FY, Li J. Effect of an educational intervention on HPV knowledge and attitudes towards HPV and its vaccines among junior middle school students in Chengdu, China. BMC Public Health 2019; 19:488. [PMID: 31046722 PMCID: PMC6498581 DOI: 10.1186/s12889-019-6823-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 04/15/2019] [Indexed: 02/05/2023] Open
Abstract
Background Little is known about the knowledge and attitudes towards human papillomavirus (HPV) and its vaccines among adolescents in mainland China. Also, limited information has been available on how to improve their knowledge and willingness towards HPV and its vaccines to ensure a successful vaccination program in the future. Methods This was a school-based interventional follow-up study. One urban and one rural junior middle school in Chengdu were selected by convenience sampling. At baseline, half of the grade one students were randomly selected as controls and the rest were interventions. A set of self-administered questionnaires on HPV and its vaccines were completed by both groups at baseline. After that, only the intervention group received a PowerPoint-oriented health education and finished the post-education questionnaires. One year later, both groups completed the same questionnaires as the follow-up survey. Results In total, 1675 students finished the pre-intervention questionnaires; 751 were from the control group and 924 were from the intervention group. Among them, only 34.3% had heard of cervical cancer/genital warts, while only 15.1% of them had ever heard of HPV. However, 55.2% of students showed their willingness to be vaccinated even before any intervention. Seven variables were found to be associated with the willingness to be vaccinated at baseline. Immediately after the intervention, 88.4% of students were willing to vaccinate themselves. After 1 year, the effectiveness of intervention remained but decreased. Compared with the control group, the intervention group was more aware about cervical cancer, HPV and its vaccines with statistical significance. However, the level of HPV knowledge and willingness to be vaccinated among the intervention group had significantly decreased compared with that immediately after the intervention (P < 0.001). Conclusions The baseline level of knowledge on HPV, its vaccines, and cervical cancer was very low among junior middle school students in Chengdu, China. However, the willingness to be vaccinated seemed positive. School-based health education is effective and appropriate in increasing the awareness of HPV and willingness towards its vaccines. Regular health education on HPV and cervical cancer prevention at a shorter interval should be guaranteed to ensure continuous effectiveness.
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Affiliation(s)
- Chun-Rong Liu
- Chinese Evidence-based Medicine Center and CREAT Group, West China Hospital, Sichuan University , Chengdu, Sichuan, 610041, People's Republic of China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Hao Liang
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xi Zhang
- Department of Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100021, People's Republic of China
| | - Chen Pu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.,Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, 610041, People's Republic of China
| | - Qin Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.,Department of Hospital Infection Control, Women's and Children's Hospital of Sichuan Province, Chengdu, Sichuan, 610031, People's Republic of China
| | - Qiao-Ling Li
- Chengdu Xi-Bei Foreign Language Middle School, Chengdu, Sichuan, 610045, People's Republic of China
| | - Fei-Yang Ren
- Tang Hu Middle School, Chengdu, Sichuan, 610200, People's Republic of China
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
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Shetty S, Prabhu S, Shetty V, Shetty AK. Knowledge, attitudes and factors associated with acceptability of human papillomavirus vaccination among undergraduate medical, dental and nursing students in South India. Hum Vaccin Immunother 2019; 15:1656-1665. [PMID: 30648913 DOI: 10.1080/21645515.2019.1565260] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose: To evaluate knowledge, attitudes and factors associated with acceptability of human papillomavirus (HPV) vaccine among undergraduate medical, dental, and nursing students in South India. Methods: Using a post-test study design, a convenience sample of 988 students (age 18-26 years) were surveyed. The primary outcome was vaccine acceptability (likely to intend to receive the vaccine). Bivariate analysis using Chi-Square test of independence and multivariate binary logistic regression analysis was used to examine factors associated with vaccine acceptability. Results: Out of 988 students surveyed, majority had heard about cervical cancer (95%), HPV (89.3) or genital warts(77.5). Only 59.7% had heard of HPV vaccine prior to the survey; 65.2% intended to receive the vaccine and 68.3% were willing to recommend the vaccine to others. Participants aged <22 years were less likely to accept the vaccine (OR:0.85, CI:0.76-0.96) compared with participants aged older than 22 years. Medical students (OR:1.12, CI:1.03-1.23), students who reported alcohol use (OR:1.15, CI:1.03-1.29) and those with moderate knowledge scores were more likely to intend to receive the vaccine (OR:1.14, CI:1.04-1.24), compared to others. On multivariate analysis, only course (OR 1.366, CI 1.016-1.835) and attitude score (OR 4.17; CI 2.12-8.2) were statistically associated with intention to receive the HPV vaccine. Conclusion: Two-thirds of students intended to receive the HPV vaccine. Although the overall awareness of the HPV-related disease and prevention is good, considerable knowledge gaps exists in many areas suggesting that that more education about HPV disease and benefits of vaccination should be included in the undergraduate medical school curriculum.
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Affiliation(s)
- Seemitha Shetty
- a Department of Microbiology, K.S. Hegde Medical Academy (KSHEMA) , Mangaluru , India
| | - Sumathi Prabhu
- b Department of Mathematics, Manipal Institute of Technology , Manipal , India
| | - Veena Shetty
- a Department of Microbiology, K.S. Hegde Medical Academy (KSHEMA) , Mangaluru , India
| | - Avinash K Shetty
- c Department of Pediatrics, Wake Forest School of Medicine and Brenner Children's Hosptial , Winston-Salem , NC , USA
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Ramakrishnan V, Akram Husain RS, Ramya D, Pradeep MA, Govindaraju S. Knowledge on human papillomavirus and cervical cancer awareness among women in South India. SAUDI JOURNAL FOR HEALTH SCIENCES 2019. [DOI: 10.4103/sjhs.sjhs_69_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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He J, He L. Knowledge of HPV and acceptability of HPV vaccine among women in western China: a cross-sectional survey. BMC WOMENS HEALTH 2018; 18:130. [PMID: 30053844 PMCID: PMC6063014 DOI: 10.1186/s12905-018-0619-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/12/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Since most cervical cancer cases are caused by persistent high-risk human papillomavirus (HR-HPV) infection, knowledge of HPV among women is essential for the prevent of cervical cancer. This study was aimed to assess knowledge among women in western China about HPV and its association with cervical cancer, and to assess their acceptance of HPV vaccination. METHODS A sample of healthy women undergoing routine physical examinations in the Health Management Center of West China Hospital, Sichuan University between January and December 2014 completed a questionnaire. RESULTS A total of 1300 questionnaires were distributed, and 1109 were completed and analyzed. Only 28.85% of respondents (n = 320) had heard of HPV; among this subgroup, only half (53.44%) knew that it causes cervical cancer, only 26 (8.13%) correctly answered all questions about HPV. Multivariate analysis showed that respondents who had heard of HPV were more likely than other respondents to have a family history of any cancer, to undergo regular Pap tests and to have completed at least secondary education. Half of all respondents (51.22%) reported that they would be willing to be vaccinated against HPV. CONCLUSION Although most women in western China lack basic knowledge about HPV, at least half are willing to take the HPV vaccine. Public health efforts to educate the public about HPV and its connection to cervical cancer should be strengthened and expanded.
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Affiliation(s)
- Junyong He
- Health Management Center of West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China
| | - Lixia He
- Health Management Center of West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
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Odunyemi FT, Ndikom CM, Oluwatosin OA. Effect of Nursing Intervention on Mothers' Knowledge of Cervical Cancer and Acceptance of Human Papillomavirus Vaccination for their Adolescent Daughters in Abuja - Nigeria. Asia Pac J Oncol Nurs 2018; 5:223-230. [PMID: 29607384 PMCID: PMC5863433 DOI: 10.4103/apjon.apjon_75_17] [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] [Received: 05/24/2017] [Accepted: 11/20/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the effect of nursing intervention on mothers' knowledge of cervical cancer and acceptance of human papillomavirus (HPV) vaccination for their adolescent daughters in Abuja, Nigeria. METHODS This was a quasi-experimental study that utilized two groups pre and post-test design. The study was carried out among civil servant mothers in Bwari (experimental group [EG]) and Kwali (control group[CG]) Area Councils of Abuja, Nigeria. One hundred and forty-six women who met the inclusion criteria were purposively selected for this study. EG consists of 69 women while 77 are from CG. The intervention consisted of two days workshop on cervical cancer and HPV vaccination. Descriptive and inferential analyses of the data were performed using SPSS software 20 version. RESULTS The mean age of the respondents was 35 years ± 6.6 in the EG and 41 years ± 8.2 in the CG. The mean knowledge score of cervical cancer was low at baseline in both EG (9.58 ± 7.1) and CG (11.61 ± 6.5). However, there was a significant increase to 21.45 ± 6.2 after the intervention in EG (P < 0.0001). The baseline acceptance of HPV vaccination was high in EG after intervention from 74% to 99%. Exposure to nursing intervention and acceptance of HPV vaccination was statistically significant after intervention (P < 0.0001). CONCLUSIONS The nursing intervention has been found to increase mothers' knowledge of cervical cancer and acceptance of HPV vaccination. It is therefore recommended that nurses should use every available opportunity in mothers' clinic to educate on cervical cancer and HPV vaccination.
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Affiliation(s)
- Funmilola T. Odunyemi
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Chizoma M. Ndikom
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - O. Abimbola Oluwatosin
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Xue L, Hu W, Zhang H, Xie Z, Zhang X, Zhao F, Qiao Y, Gao L, Ma W. Awareness of and willingness to be vaccinated by human papillomavirus vaccine among junior middle school students in Jinan, China. Hum Vaccin Immunother 2017; 14:404-411. [PMID: 29048994 DOI: 10.1080/21645515.2017.1393132] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Willingness to be vaccinated with human papillomavirus (HPV) vaccine among junior middle school students in China is not well understood. We conducted a cross-sectional study to assess awareness of HPV and the HPV vaccine and explore the factors associated with willingness to be vaccinated. METHODS First-year students from two junior middle schools in Jinan, China were selected by cluster sampling on December 28, 2015, December 26, 2016, and January 11, 2017, and a self-administered questionnaire was used to collect information. Multivariate logistic regression was conducted to explore the factors associated with willingness to be vaccinated with the HPV vaccine. RESULTS A total of 1021 junior middle school students participated in this survey. Only 15.5% of them had heard of HPV and 18.9% of them had heard of the HPV vaccine. Students who were willing to take the HPV vaccine in the future accounted for 66.9%. Factors associated with the HPV vaccination were: urban junior middle school students (AOR: 1.51, 95% CI: 1.09-2.09), female students (AOR: 1.90, 95% CI: 1.36-2.66), students surveyed in 2015 (AOR: 1.69, 95% CI: 1.26-2.28), regarding menstruation/spermatorrhoea as a normal physiological phenomenon (AOR: 1.64, 95% CI: 1.14-2.36), believing vaccination is an important way to prevent diseases (AOR: 1.36, 95% CI: 1.01-1.83), believing that the first vaccination should be in infancy (AOR: 1.41, 95% CI: 1.04-1.92), believing that cervical cancer is a concern for themselves (AOR: 1.95, 95% CI: 1.28-2.97), and having heard of HPV (AOR: 1.84, 95% CI: 1.13-2.98). CONCLUSIONS Awareness of HPV and the HPV vaccine among junior students was low, however willingness to be vaccinated was high. Education focusing on HPV-related knowledge in addition to sex education is needed to promote the coverage of the HPV vaccine.
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Affiliation(s)
- Li Xue
- a Department of Epidemiology , School of Public Health, Shandong University , Jinan , China
| | - Wenqi Hu
- a Department of Epidemiology , School of Public Health, Shandong University , Jinan , China
| | - Haiman Zhang
- b Division of Biology , The High School Affiliated To Shandong University , Jinan , China
| | - Zhongling Xie
- c Youth League, The Yanxin Middle School , Jinan , China
| | - Xi Zhang
- d Department of Epidemiology , Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Fanghui Zhao
- d Department of Epidemiology , Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Youlin Qiao
- d Department of Epidemiology , Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Lijie Gao
- a Department of Epidemiology , School of Public Health, Shandong University , Jinan , China
| | - Wei Ma
- a Department of Epidemiology , School of Public Health, Shandong University , Jinan , China
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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: 16] [Impact Index Per Article: 2.3] [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.
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Nwanodi O, Salisbury H, Bay C. Multimodal Counseling Interventions: Effect on Human Papilloma Virus Vaccination Acceptance. Healthcare (Basel) 2017; 5:healthcare5040086. [PMID: 29113137 PMCID: PMC5746720 DOI: 10.3390/healthcare5040086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 10/27/2017] [Accepted: 10/29/2017] [Indexed: 12/25/2022] Open
Abstract
Human papilloma virus (HPV) vaccine was developed to reduce HPV-attributable cancers, external genital warts (EGW), and recurrent respiratory papillomatosis. Adolescent HPV vaccination series completion rates are less than 40% in the United States of America, but up to 80% in Australia and the United Kingdom. Population-based herd immunity requires 80% or greater vaccination series completion rates. Pro-vaccination counseling facilitates increased vaccination rates. Multimodal counseling interventions may increase HPV vaccination series non-completers’ HPV-attributable disease knowledge and HPV-attributable disease prophylaxis (vaccination) acceptance over a brief 14-sentence counseling intervention. An online, 4-group, randomized controlled trial, with 260 or more participants per group, found that parents were more likely to accept HPV vaccination offers for their children than were childless young adults for themselves (68.2% and 52.9%). A combined audiovisual and patient health education handout (PHEH) intervention raised knowledge of HPV vaccination purpose, p = 0.02, and HPV vaccination acceptance for seven items, p < 0.001 to p = 0.023. The audiovisual intervention increased HPV vaccination acceptance for five items, p < 0.001 to p = 0.006. That HPV causes EGW, and that HPV vaccination prevents HPV-attributable diseases were better conveyed by the combined audiovisual and PHEH than the control 14-sentence counseling intervention alone.
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Affiliation(s)
- Oroma Nwanodi
- Obstetrics and Gynecology Locum Tenens, Salinas, CA 93902, USA.
| | - Helen Salisbury
- College of Graduate Health Studies, A. T. Still University, Mesa, AZ 85206, USA.
| | - Curtis Bay
- Department of Interdisciplinary Sciences, A. T. Still University, Mesa, AZ 85026, USA.
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Ward JM, Schmalenberg K, Antonishyn NA, Hambleton IR, Blackman EL, Levett PN, Gittens-St.Hilaire MV. Human papillomavirus genotype distribution in cervical samples among vaccine naïve Barbados women. Cancer Causes Control 2017; 28:1323-1332. [DOI: 10.1007/s10552-017-0959-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/08/2017] [Indexed: 11/27/2022]
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Baloch Z, Yasmeen N, Li Y, Zhang W, Lu H, Wu X, Xia X, Yang S. Knowledge and Awareness of Cervical Cancer, Human Papillomavirus (HPV), and HPV Vaccine Among HPV-Infected Chinese Women. Med Sci Monit 2017; 23:4269-4277. [PMID: 28867818 PMCID: PMC5595099 DOI: 10.12659/msm.903370] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background It is important to understand the knowledge that various groups of a population have about cervical cancer and human papillomavirus (HPV) and their attitudes toward HPV vaccination, as it will ultimately influence their decision-making for or against the acceptability of vaccines and other preventive methods. This study was designed to determine the level of knowledge and awareness about cervical cancer, HPV, and the HPV vaccine among Chinese women in Yunnan province. Material/Methods A survey was conducted in Yunnan province by the Laboratory of Molecular Virology in collaboration with the Yunnan First People’s Hospital in Feb 2015. A total of 388 women were recruited and asked to participate in a questionnaire-based interview that collected information related to their awareness and knowledge about: (1) cervical cancer, (2) HPV and HPV vaccine and willingness to have their children receive vaccination, and (3) demographic characteristics. Results A total of 388 HPV-positive women were included; 300/388 (73.3%) were Han, and 88/388 (22.7%) were other ethnicities. Overall, 204/388 (52.6%) of the women were aware of cervical cancer, with a significant difference between Han women and women of other ethnic groups (168/388, 56.0% and 36/88, 40.9%; P=0.015). Overall, 26.5% of the women were aware of the role of HPV in cervical cancer; 29.0% of the Han women and 18.2% of women of other ethnic groups were aware of this role of HPV (P=0.05). The knowledge that HPV infection leads to cervical cancer was higher among Han women (29.0%) compared to women of other ethnicities (18.2%). Knowledge about the HPV vaccine was very low in all ethnic groups, but the Han women were more willing to allow their children to be vaccinated before they become sexually active. A similar difference has also been found in women from various regions. Conclusions Although level of awareness and knowledge about cervical cancer was moderate, knowledge and awareness of HPV and the HPV vaccine was very low. Targeted communication is very important among populations in which knowledge gaps exist in order to promote dialogue about the vaccine among patients and their healthcare providers.
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Affiliation(s)
- Zulqarnain Baloch
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Nafeesa Yasmeen
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Yuanyue Li
- Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Wenhui Zhang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Hongyu Lu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Xiaomei Wu
- The 1st People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Xueshan Xia
- The Research Center for Molecular Medicine, Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China (mainland)
| | - Shihua Yang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
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Wu E, Tiggelaar SM, Jiang T, Zhao H, Wu R, Wu R, Xu F. Cervical cancer prevention-related knowledge and attitudes among female undergraduate students from different ethnic groups within China, a survey-based study. Women Health 2017; 58:661-684. [DOI: 10.1080/03630242.2017.1333076] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Enqi Wu
- State Nationalities Affairs Commission and Department of Educational Key Lab of Minority Traditional Medicine, Minzu University of China, Beijing, China
| | - Sarah M. Tiggelaar
- UT Family Medicine, University of Tennessee Health Science Center, University of Tennessee, Memphis, Tennessee, USA
| | - Tao Jiang
- State Nationalities Affairs Commission and Department of Educational Key Lab of Minority Traditional Medicine, Minzu University of China, Beijing, China
| | - Huanhu Zhao
- State Nationalities Affairs Commission and Department of Educational Key Lab of Minority Traditional Medicine, Minzu University of China, Beijing, China
| | - Ritu Wu
- State Nationalities Affairs Commission and Department of Educational Key Lab of Minority Traditional Medicine, Minzu University of China, Beijing, China
| | - Rilige Wu
- School of Economics and Management, Inner Mongolia University for the Nationalities, Tongliao, China
| | - Fangmei Xu
- Department of Pediatrics, Hubei Danjiangkou Maternal and Child Health Care Hospital, Danjiangkou, China
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Rao BA, Seshadri JG, Thirthahalli C. Impact of Health Education on HPV Vaccination. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2017. [DOI: 10.1007/s40944-017-0134-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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