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Huang LC, Eiden AL, He L, Annan A, Wang S, Wang J, Manion FJ, Wang X, Du J, Yao L. Natural Language Processing-Powered Real-Time Monitoring Solution for Vaccine Sentiments and Hesitancy on Social Media: System Development and Validation. JMIR Med Inform 2024; 12:e57164. [PMID: 38904984 PMCID: PMC11226933 DOI: 10.2196/57164] [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: 02/07/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Vaccines serve as a crucial public health tool, although vaccine hesitancy continues to pose a significant threat to full vaccine uptake and, consequently, community health. Understanding and tracking vaccine hesitancy is essential for effective public health interventions; however, traditional survey methods present various limitations. OBJECTIVE This study aimed to create a real-time, natural language processing (NLP)-based tool to assess vaccine sentiment and hesitancy across 3 prominent social media platforms. METHODS We mined and curated discussions in English from Twitter (subsequently rebranded as X), Reddit, and YouTube social media platforms posted between January 1, 2011, and October 31, 2021, concerning human papillomavirus; measles, mumps, and rubella; and unspecified vaccines. We tested multiple NLP algorithms to classify vaccine sentiment into positive, neutral, or negative and to classify vaccine hesitancy using the World Health Organization's (WHO) 3Cs (confidence, complacency, and convenience) hesitancy model, conceptualizing an online dashboard to illustrate and contextualize trends. RESULTS We compiled over 86 million discussions. Our top-performing NLP models displayed accuracies ranging from 0.51 to 0.78 for sentiment classification and from 0.69 to 0.91 for hesitancy classification. Explorative analysis on our platform highlighted variations in online activity about vaccine sentiment and hesitancy, suggesting unique patterns for different vaccines. CONCLUSIONS Our innovative system performs real-time analysis of sentiment and hesitancy on 3 vaccine topics across major social networks, providing crucial trend insights to assist campaigns aimed at enhancing vaccine uptake and public health.
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Affiliation(s)
| | | | - Long He
- Melax Tech, Houston, TX, United States
| | | | | | | | | | | | | | - Lixia Yao
- Merck & Co, Inc, Rahway, NJ, United States
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2
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Guo X, Han Q, Wang Y, Zhang R, Huang Y, Guo B. Influenza Vaccine Hesitancy among Cancer Survivors in China: A Multicenter Survey. Vaccines (Basel) 2024; 12:639. [PMID: 38932368 PMCID: PMC11209103 DOI: 10.3390/vaccines12060639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Cancer survivors are at higher risk of developing severe complications from influenza due to their compromised immune systems. Despite their increased vulnerability to influenza and the availability of vaccines, vaccine hesitancy among cancer survivors remains a significant public health concern in China. METHODS A multicenter, cross-sectional study was conducted among cancer survivors in China from January to December 2023. A total of 500 participants were recruited from the oncology departments of five tertiary hospitals. A structured, self-administered questionnaire was used to collect data on socio-demographic characteristics, cancer-related information, medical history, lifestyle factors, and influenza vaccine hesitancy. Univariate and multivariate logistic regression analyses were performed to identify factors associated with influenza vaccine hesitancy. RESULTS The response rate was 97.0% (485/500). Among all participants, 204 (42.06%) reported vaccine hesitancy. The results of multiple logistic regression showed that the longer the end of anti-cancer treatment, without a history of adverse vaccine reactions, and the level of family support played a protective role in vaccine hesitancy. Current rehabilitation status, frequent colds, not being informed by doctors about vaccination, exercising, lack of community vaccination education programs, and concerns about vaccine safety were risk factors that increase vaccine hesitancy. CONCLUSIONS A high proportion of cancer survivors in our study reported influenza vaccine hesitancy. Addressing concerns about vaccine safety, improving access to vaccination services, and enhancing doctor-patient communication are crucial for increasing influenza vaccine uptake in this vulnerable population.
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Affiliation(s)
- Xin Guo
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China (R.Z.)
| | - Qi Han
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China (R.Z.)
| | - Yuqin Wang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China (R.Z.)
| | - Rui Zhang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China (R.Z.)
| | - Yuenan Huang
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Botang Guo
- Department of Medical Psychology, Harbin Medical University, Baojian Road 158, Harbin 150078, China
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen 518001, China
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3
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Foster S, Carvallo M, Song H, Lee J, Lee J. When culture and health collide: feminine honor endorsement and attitudes toward catch-up HPV vaccinations in college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1454-1462. [PMID: 34398700 DOI: 10.1080/07448481.2021.1935970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/22/2021] [Accepted: 05/02/2021] [Indexed: 06/13/2023]
Abstract
Sexual promiscuity stigma constitutes a significant barrier which prevents young women from receiving catch-up human papillomavirus (HPV) vaccinations. Our objective was to explore how this stigma may be particularly detrimental to women in cultures of honor, where women are expected to maintain a reputation of sexual purity. Participants were a sample of 182 young women who had not previously received an HPV vaccination. We measured feminine honor endorsement, HPV sexual promiscuity stigma, HPV vaccination shame, HPV vaccination intentions, and a set of covariates. Analyses revealed that the significant association between feminine honor endorsement and HPV vaccination intentions is fully explained by HPV sexual purity stigma and HPV vaccination shame. These findings indicate that honor-endorsing women are significantly impacted by sexual purity stigma, minimizing intentions to receive HPV vaccinations. These findings also highlight the need for the inclusion of cultural factors in the study of HPV vaccine uptake.
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Affiliation(s)
| | | | - Hairong Song
- Psychology, University of Oklahoma, Norman, Oklahoma, USA
| | - Joyce Lee
- Psychology, University of Oklahoma, Norman, Oklahoma, USA
| | - Jongwon Lee
- College of Nursing, University of New Mexico, Albuquerque, New Mexico, USA
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4
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Wortsman J, Glaser Chodik N, Chodick G. Correlations of HPV vaccine uptake among eight-grade students in Israel: the importance of ethnicity and level of religious observance. Women Health 2023:1-9. [PMID: 37315958 DOI: 10.1080/03630242.2023.2223721] [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: 02/25/2022] [Revised: 04/04/2023] [Accepted: 05/16/2023] [Indexed: 06/16/2023]
Abstract
In Israel, human papilloma virus (HPV) vaccines are included in the national childhood immunization program for eight-grade students, but uptake remains relatively low. This article explores which demographic factors are correlated with HPV vaccination rates. HPV vaccination data for the school year 2017-2018 was assessed among members of Maccabi Healthcare Services, the second largest health service provider in Israel. By matching eighth grade students to their family members' demographic data via an electronic medical records (EMR) system, we assessed vaccination rates by taking into account sex, socioeconomic status (SES), ethnic categorization, and maternal characteristics. In a total of 45,160 eligible students, 55.3 percent of girls and 48.5 percent of boys were vaccinated for HPV. In a multivariable model, students in Arab communities had a significantly (p < .001) higher odds ratio (2.02; 95 percent CI:1.55-2.64) of being vaccinated, while ultra-orthodox (UO) Jewish students were much less likely to be vaccinated compared to all other students (OR = 0.05; 95 percent CI:0.05-0.06). Ethnicity and level of religious practice are major determinants of HPV vaccine uptake in Israel. This should be taken into account when planning intervention programs in order to improve the uptake of the vaccine.
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Affiliation(s)
- Joshua Wortsman
- Maccabi Healthcare Services, Maccabitech Institute for Research and Innovation, Tel Aviv, Israel
| | | | - Gabriel Chodick
- Maccabi Healthcare Services, Maccabitech Institute for Research and Innovation, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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5
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Varer Akpinar C, Alanya Tosun S. Knowledge and perceptions regarding Human Papillomavirus (HPV) and willingness to receive HPV vaccination among university students in a north-eastern city in Turkey. BMC Womens Health 2023; 23:299. [PMID: 37280608 DOI: 10.1186/s12905-023-02455-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/30/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND For a HPV vaccination program to be successful, it is important that the target population has sufficient knowledge about HPV and HPV vaccines. The aim of this study was to evaluate HPV-related knowledge levels among students at a university in northern Turkey, to assess vaccination willingness, and to determine factors associated with HPV-related knowledge. METHODS This cross-sectional study was conducted on 824 (93.1%) students studying at 16 different faculties. The study population was identified through the proportional stratified sampling method. Data were collected through a questionnaire including socio-demographic characteristics and the HPV Knowledge Scale. Multiple linear regression analysis was performed to identify factors that may be associated with knowledge scores. RESULTS 43.6% of the students had never heard of HPV, 50.6% of them had never heard of HPV screening tests or HPV vaccination. Only 2.7% of the students were vaccinated against HPV and 15.7% were willing to receive HPV vaccination. Awareness of HPV and willingness to receive vaccination were found to be higher among women, while previous experience with sexual intercourse was higher in men (p < 0.05). The mean HPV knowledge score was quite low (6.74 ± 7.13 out of 29 points). The studying in a field related to health sciences, being a senior student, intending to be vaccinated, being a woman, having had sex were found to be associated with high knowledge levels (p < 0.05). CONCLUSIONS Educational programmes should be developed to increase university students' knowledge about HPV and the HPV vaccine.
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Affiliation(s)
- Ceren Varer Akpinar
- Department of Public Health, Giresun University Faculty of Medicine, Giresun, Turkey.
| | - Sebnem Alanya Tosun
- Department of Obstetrics & Gynaecology, Giresun University Faculty of Medicine, Giresun, Turkey
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Ebrahimi N, Yousefi Z, Khosravi G, Malayeri FE, Golabi M, Askarzadeh M, Shams MH, Ghezelbash B, Eskandari N. Human papillomavirus vaccination in low- and middle-income countries: progression, barriers, and future prospective. Front Immunol 2023; 14:1150238. [PMID: 37261366 PMCID: PMC10227716 DOI: 10.3389/fimmu.2023.1150238] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/25/2023] [Indexed: 06/02/2023] Open
Abstract
Human papillomavirus (HPV) is a viral infection that, if does not go away, can cause health problems like genital warts and cancer. The national immunization schedules for individuals before sexual debut, significantly decreased HPV-associated mortality and it will be affordable. However, immunization programs remain vulnerable to macroeconomic factors such as inflation, fiscal policy, employment levels, and national income. This review aims to investigate the association between national income in lower-middle-income countries to explore recent advances and potential issues, as well as how to deal with challenges.
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Affiliation(s)
- Narges Ebrahimi
- Immunology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Yousefi
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Gholamreza Khosravi
- Immunology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Marjan Golabi
- Immunology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Monireh Askarzadeh
- Immunology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Shams
- Department of Medical Immunology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Behrooz Ghezelbash
- Immunology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Eskandari
- Immunology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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7
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Adekanmbi V, Guo F, Hsu CD, Shan Y, Kuo YF, Berenson AB. Incomplete HPV Vaccination among Individuals Aged 27-45 Years in the United States: A Mixed-Effect Analysis of Individual and Contextual Factors. Vaccines (Basel) 2023; 11:820. [PMID: 37112732 PMCID: PMC10142711 DOI: 10.3390/vaccines11040820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Background: In the United States, the human papillomavirus (HPV) vaccine is approved for use in individuals up to age 45. Individuals 15 years and older require three doses of the vaccine to complete the recommended dosing series. Incomplete HPV vaccination rates (i.e., one or two doses) among those over age 26, however, remain high. This study examined the independent effects of individual- and neighborhood-level factors on incomplete HPV vaccination rates in the United States (U.S.) among those aged 27-45 years. Methods: This retrospective cohort study used administrative data from Optum's de-identified Clinformatics® Data Mart Database to identify individuals aged 27-45 years who received one or more doses of HPV vaccine between July 2019 and June 2022. Multilevel multivariable logistic regression models were applied to the data on 7662 individuals identified as being fully or partially vaccinated against HPV, nested within 3839 neighborhoods across the U.S. Results: Approximately half of the patients in this study (52.93%) were not completely vaccinated against HPV. After adjusting for all other covariates in the final model, being older than 30 years old decreased the odds of not completing the HPV vaccine series. Participants living in South-region neighborhoods of the U.S. had enhanced odds of not completing the vaccine series compared with those residing in Northeast-region neighborhoods (aOR 1.21; 95% CrI 1.03-1.42). There was significant clustering of incomplete HPV vaccination rates at the neighborhood level. Conclusions: This study revealed that individual- and neighborhood-level factors were associated with the risk of not completing the HPV vaccine series among individuals aged 27-45 years in the U.S. Interventions to improve HPV vaccination series completion rates for this age group should take into consideration both individual and contextual factors.
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Affiliation(s)
- Victor Adekanmbi
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
| | - Fangjian Guo
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
| | - Christine D. Hsu
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
| | - Yong Shan
- Department of Biostatistics and Data Science, The University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Yong-Fang Kuo
- Department of Biostatistics and Data Science, The University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Abbey B. Berenson
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
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8
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Garcia S, Hopfer S, Amaro H, Tanjasiri S. HPV vaccine delay and refusal among unvaccinated Mexican American young adult women: a qualitative investigation of Mexican-born and US-born HPV vaccine decision narratives. J Behav Med 2023; 46:88-99. [PMID: 35610490 PMCID: PMC9130004 DOI: 10.1007/s10865-022-00326-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/29/2022] [Indexed: 12/23/2022]
Abstract
Low HPV vaccination rates among Latina young adults perpetuate HPV-associated cancer disparities. Using qualitative methods, this study explored individual, interpersonal, and community factors that influence HPV vaccine delay and refusal among Mexican- and U.S.-born Mexican American young adult women. Participants (N = 30) between 18 and 26 years old were purposively sampled from two federally qualified health centers in Orange County, California. The National Institute on Minority Health and Health Disparities research framework and narrative engagement theory guided semi-structured phone interviews coded inductively and deductively. Participants primarily attributed vaccine status to individual and interpersonal reasons. Emerging themes included low HPV vaccine knowledge, insufficient provider communication, negative perceptions about HPV and the vaccine, motherhood responsibilities, mother's communication about HPV, cultural family norms, health care access, and misinformation. Compared to U.S.-born Latinas, Mexican-born participants more frequently expressed avoiding health care discussions with family. HPV vaccine recommendations for young Mexican American women should include socioculturally tailored messages that may improve HPV vaccination acceptance and uptake.
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Affiliation(s)
- Samantha Garcia
- Department of Health, Society, and Behavior, Program in Public Health, University of California, 653 E. Peltason Drive, AIRB, Room 2020D, Irvine, CA 92697-3957 USA
| | - Suellen Hopfer
- Department of Health, Society, and Behavior, Program in Public Health, University of California, 653 E. Peltason Drive, AIRB, Room 2020D, Irvine, CA 92697-3957 USA
| | - Hortensia Amaro
- Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC4 Room 419, Miami, FL 33199 USA
| | - Sora Tanjasiri
- Department of Epidemiology and Biostatistics, Program in Public Health, University of California, 653 E. Peltason Drive, AIRB, Room 3072, Irvine, CA 92697-3957 USA
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9
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Cousin L, Roberts S, Brownstein NC, Whiting J, Kasting ML, Head KJ, Vadaparampil ST, Giuliano AR, Gwede CK, Meade CD, Christy SM. Factors associated with parental COVID-19 vaccine attitudes and intentions among a national sample of United States adults ages 18-45. J Pediatr Nurs 2023; 69:108-115. [PMID: 36716520 PMCID: PMC9852321 DOI: 10.1016/j.pedn.2023.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/27/2022] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE This study explored factors associated with parents' attitudes and intentions to seek information about the COVID-19 vaccine for their children (ages 0-18) and intentions to vaccinate their age-eligible children. DESIGN AND METHODS As part of an anonymous online cross-sectional survey, parents' vaccine attitudes, COVID-19 vaccine intentions for their children, health literacy, health numeracy, and sociodemographic variables were assessed. Multivariable ordered logistic regression models identified factors associated with parents' COVID-19 vaccine intentions for their children. RESULTS Parents/guardians (n = 963) were mostly White (82.3%), insured (88.0%), and college graduates (57.3%). Men reported higher intentions than women to seek information about the COVID-19 vaccine for their children (p = 0.003) and higher intentions to vaccinate their children (p = 0.049). Parental characteristics associated with increased intentions to have their children vaccinated included higher educational attainment (p < 0.001), more positive general vaccine attitudes (p < 0.001), preference for health information in a language other than English (p = 0.006), higher income (p = 0.048), having health insurance (p = 0.05), health literacy (p = 0.024), and health numeracy (p = 0.049). CONCLUSIONS Multiple sociodemographic characteristics including male gender, higher health literacy and numeracy, and language preference are noteworthy factors associated with parental COVID-19 vaccine intentions that could inform the planning and implementation of educational interventions. PRACTICE IMPLICATIONS Nurses are important sources of trusted information and play an important role in parent/family health education and in understanding myriad factors that may improve attitudes and enhance readiness toward vaccine uptake. Our findings emphasize the potential value of examining tailored/targeted COVID-19 vaccine education according to key influencing factors.
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Affiliation(s)
- Lakeshia Cousin
- College of Nursing, University of Florida, Gainesville, FL, United States of America
| | - Stephanie Roberts
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Naomi C Brownstein
- Dept. of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Junmin Whiting
- Dept. of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Monica L Kasting
- Dept. of Public Health, Purdue University, West Lafayette, IN, United States of America; Cancer Prevention and Control Program, Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, United States of America
| | - Katharine J Head
- Dept. of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States of America
| | - Susan T Vadaparampil
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Dept. of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Anna R Giuliano
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America; Dept. of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Clement K Gwede
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Dept. of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Dept. of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Cathy D Meade
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Dept. of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Dept. of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Shannon M Christy
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Dept. of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America; Dept. of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
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10
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Turner K, Brownstein NC, Whiting J, Arevalo M, Vadaparampil S, Giuliano AR, Islam JY, Meade CD, Gwede CK, Kasting ML, Head KJ, Christy SM. Impact of the COVID-19 pandemic on human papillomavirus (HPV) vaccination among a national sample of United States adults ages 18-45: A cross-sectional study. Prev Med Rep 2023; 31:102067. [PMID: 36439896 PMCID: PMC9677560 DOI: 10.1016/j.pmedr.2022.102067] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/24/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
To assess how the COVID-19 pandemic affected catch-up HPV vaccination among age-eligible adults (ages 18-45). The current study leverages a national, cross-sectional sample of US adults ages 18-45 years to assess the prevalence and determinants of COVID-19 pandemic-related disruptions to catch-up HPV vaccination in 2021. The sample was restricted to adults intending to receive the HPV vaccine. Multinomial logistic regression analysis was conducted to assess the probability of 1) pandemic-related HPV vaccination disruption and 2) uncertainty about pandemic-related HPV vaccination disruption. Report of 'no pandemic-related HPV vaccination disruption' served as the reference category. Among adults intending to get the HPV vaccine (n = 1,683), 8.6 % reported pandemic-related HPV vaccination disruption, 14.7 % reported uncertainty about vaccination disruption, and 76.7 % reported no disruption. Factors associated with higher odds of pandemic-related vaccination disruption included non-English language preference (OR: 3.20; 95 % CI: 1.99-5.13), being a parent/guardian (OR: 1.77; 95 % CI: 1.18-2.66), having at least one healthcare visit in the past year (OR: 1.97; 95 % CI: 1.10-3.53), being up-to-date on the tetanus vaccine (OR: 1.81; 95 % CI: 1.19-2.75), and being a cancer survivor (OR: 2.57; 95 % CI: 1.52-4.34). Catch-up HPV vaccination for age-eligible adults is a critical public health strategy for reducing HPV-related cancers. While a small percentage of adults reported pandemic-related disruptions to HPV vaccination, certain adults (e.g., individuals with a non-English language preference and cancer survivors) were more likely to report a disruption. Interventions may be needed that increase accessibility of catch-up HPV vaccination among populations with reduced healthcare access during the pandemic.
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Affiliation(s)
- Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Department of Oncological Sciences, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
| | - Naomi C. Brownstein
- Department of Public Health Sciences, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Junmin Whiting
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Mariana Arevalo
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Susan Vadaparampil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Department of Oncological Sciences, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
| | - Anna R. Giuliano
- Department of Oncological Sciences, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Jessica Y. Islam
- Department of Oncological Sciences, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Cathy D. Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Department of Oncological Sciences, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
- Department of Genitourinary Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Clement K. Gwede
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Department of Oncological Sciences, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
- Department of Genitourinary Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Monica L. Kasting
- Department of Public Health, Purdue University, 812 W. State Street, Room 216, West Lafayette, IN 47907, USA
| | - Katharine J. Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, 425 University Blvd., Indianapolis, IN 46202, USA
| | - Shannon M. Christy
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Department of Oncological Sciences, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
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Sun L, Hu J, Gao H, Wang S, Wang B, Wang J, Li H, Wang J, Yuan C, Zhang X. Long-term effect of mobile phone-based education and influencing factors of willingness to receive HPV vaccination among female freshmen in Shanxi Province, China. Hum Vaccin Immunother 2022; 18:2051990. [PMID: 35446735 PMCID: PMC9225224 DOI: 10.1080/21645515.2022.2051990] [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: 12/20/2022] Open
Abstract
BACKGROUND This study was conducted to characterize the long-term effect of mobile-based education on Chinese female freshmen and disclose the possible predictors of their willingness to get vaccinated based on the information-motivation-behavioral skills (IMB) model. METHODS We randomly assigned 509 participants to a 7-day mobile-based educational intervention or control group and collected information about general information, health, and sexual behavior, HPV vaccination intention and action, HPV-related knowledge, cognition, and behavioral skill by an online self-administrated questionnaire at baseline, post-intervention, and at the 1-month and 3-month follow-ups. RESULTS The intervention arm showed an improvement in IMB scores after education. Despite the persistent improvement in knowledge, the improvement in their motivation and behavioral skills decreased at the 1-month and 3-month follow-ups. Participants' vaccination willingness was elevated after the baseline survey in both the intervention and control groups, while the overall appointment/vaccination rate was only 3.73% 3 months later. The intention to get vaccinated was associated with knowing HPV (adjusted OR: 2.37, 95% CI: 1.44 - 3.89), perceiving more barriers (adjusted OR: 2.16, 95% CI: 1.44 - 3.25), higher subjective norms (adjusted OR: 2.05, 95% CI: 1.26 - 3.32), and having more behavioral skills (adjusted OR: 2.95, 95% CI: 1.79 - 4.87). CONCLUSION Seven-day mobile-based education was effective to increase IMB model scores among female freshmen. However, the improvement in motivation and behavioral skills was not persistent. Information, perceived barriers, subjective norms, and behavioral skills were discovered to be influencing factors of vaccination intention. Future research with longer, more convenient, and more tailored education to the main influencing factors is warranted.
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Affiliation(s)
- Liying Sun
- Department of Pediatrics and Adolescent Gynecology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jingjing Hu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Huihui Gao
- Department of Pediatrics and Adolescent Gynecology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Sunyi Wang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Binghan Wang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiawen Wang
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hui Li
- Division of Health Promotion, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Changzheng Yuan
- Department of Pediatrics and Adolescent Gynecology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - 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
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12
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Muthukrishnan M, Loux T, Shacham E, Tiro JA, Arnold LD. Barriers to human papillomavirus (HPV) vaccination among young adults, aged 18–35. Prev Med Rep 2022; 29:101942. [PMID: 36161130 PMCID: PMC9502683 DOI: 10.1016/j.pmedr.2022.101942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/14/2022] [Accepted: 08/05/2022] [Indexed: 10/31/2022] Open
Abstract
Most HPV vaccine eligible adults are not at all likely to get vaccinated for HPV. Motivational barriers include the belief that the vaccine is unnecessary and unsafe. When other barriers are present, lack of provider recommendation is not associated.
In the United States (US), an estimated 35,900 human papillomavirus (HPV)-related cancers are diagnosed annually. HPV vaccines are projected to eliminate ∼90% of these cancers. Routine vaccination is recommended at age 11–12 with “catch-up” vaccination through age 26 and shared clinical decision making for ages 27–45. However, vaccine uptake has been slow with many young adults remaining unvaccinated. This study examined barriers to HPV vaccination among individuals aged 18–35 years and assessed likelihood of future HPV vaccination. Age-eligible participants (n = 499) recruited through Facebook advertisements, Facebook posts, and clinics (6/2019–3/2020) completed an online survey. Descriptive statistics and bivariate analysis examined HPV vaccine barriers and intent. Logistic regression models examined predictors of HPV vaccine intent. Most (57.1%) reported they were not at all likely to get vaccinated for HPV in the future. Lower intent was associated with belief that the vaccine is not necessary (aOR: 0.134, 95% CI: 0.073, 0.246) and not safe (aOR: 0.312, 95% CI: 0.126, 0.773). Intent was positively associated with the belief that health insurance would not cover vaccination (aOR: 2.226, 95% CI: 1.070, 4.631). Provider recommendation was not significantly associated with vaccine intention. This study highlights challenges to HPV vaccine uptake for young adults. Though several successful interventions exist, most target adolescents and their parents or providers. Future steps should use this evidence to inform development of targeted interventions to increase HPV vaccine intention and uptake in adults, ultimately reducing the burden of HPV-related cancers.
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13
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Sidiropoulou M, Gerogianni G, Kourti FE, Pappa D, Zartaloudi A, Koutelekos I, Dousis E, Margari N, Mangoulia P, Ferentinou E, Giga A, Zografakis-Sfakianakis M, Dafogianni C. Perceptions, Knowledge and Attitudes among Young Adults about Prevention of HPV Infection and Immunization. Healthcare (Basel) 2022; 10:healthcare10091721. [PMID: 36141333 PMCID: PMC9498464 DOI: 10.3390/healthcare10091721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Human papilloma virus (HPV) is one of the most common sexually transmitted infections and is widely known as the main causative agent for cervical cancer. The aim of this study was to investigate the perceptions, knowledge and attitudes of young Greek adults concerning prevention of HPV infection and HPV immunization. Material and Methods: This constitutes a cross-sectional online survey. A convenience sample of young Greek adults (n = 883) residing in Greece, aged 17 to more than 35 years was surveyed from December 2020 to March 2021. Two validated questionnaires were used to collect data. Results: Participants demonstrated moderate knowledge about HPV infection and vaccination, with a mean knowledge score of 53.26 (SD ± 20.65) and 38.92 (SD ± 17.58), respectively. Cronbach’s alpha value was 0.77 and 0.80. Female participants were better informed than males. Approximately 52.3% of respondents had been vaccinated and 65.5% were willing to get vaccinated in the future. Vaccination rate was significantly associated with gender (OR = 11.99; 99% CI = 6.59–21.84), knowledge about the HPV vaccine (OR = 1.04; 99% CI = 1.03–1.04) and age (OR = 0.07; 99% CI = 0.03–0.15). Reasons for vaccine refusal were insufficient information (36.8%) and fear of side effects (19%). Correlates of positive vaccination intention were knowledge about HPV (OR = 1.02; 99% CI = 1.01–1.02). Conclusions: The findings suggest that the Greek government’s continuing HPV promotion efforts and education on the risks of HPV infection among young people are likely to increase vaccination acceptance among this group.
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Affiliation(s)
- Maria Sidiropoulou
- School of Social Sciences, Hellenic Open University, 26335 Patra, Greece
| | - Georgia Gerogianni
- Department of Nursing, University of West Attica, 12243 Athens, Greece
- Correspondence:
| | | | - Despoina Pappa
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | | | | | - Evangelos Dousis
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Nikoletta Margari
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Polyxeni Mangoulia
- Department of Nursing, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | | | - Anna Giga
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | | | - Chrysoula Dafogianni
- School of Social Sciences, Hellenic Open University, 26335 Patra, Greece
- Department of Nursing, University of West Attica, 12243 Athens, Greece
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14
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Brownstein NC, Reddy H, Whiting J, Kasting ML, Head KJ, Vadaparampil ST, Giuliano AR, Gwede CK, Meade CD, Christy SM. COVID-19 vaccine behaviors and intentions among a national sample of United States adults ages 18-45. Prev Med 2022; 160:107038. [PMID: 35398369 PMCID: PMC8988441 DOI: 10.1016/j.ypmed.2022.107038] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/31/2021] [Accepted: 04/02/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Vaccination for SARS-CoV-2, the virus that causes COVID-19 illness, is an important public health tool to reduce hospitalizations and deaths. PURPOSE This report focuses on intentions and behaviors related to COVID-19 vaccination among United States (U.S.) adults ages 18-45. METHODS From February 25-March 24, 2021, we conducted an online survey assessing COVID-19 vaccine intentions and behaviors, health beliefs, vaccine attitudes, and sociodemographic characteristics. Participants were adults aged 18-45, living throughout the U.S. with oversampling in Florida, panelists of a research panel company directly or via verified partners, and able to read, write, and understand English. Associations between COVID-19 vaccination uptake, intentions, and other study variables were examined through multivariable logistic and proportional odds regression analyses. RESULTS Among participants in the final analytic sample (n = 2722), 18% reported having received at least one dose of a COVID-19 vaccine. Approximately 31% of unvaccinated participants reported strong intentions to receive a COVID-19 vaccine in the next year, whereas 35% reported strong intentions to receive a COVID-19 vaccine if it were strongly recommended by a healthcare provider. All COVID-19 vaccination outcomes were associated with male gender, sexual minority status, higher levels of education, and previous influenza vaccination. All vaccination intention outcomes were associated with vaccine attitudes and geographic region. Vaccination status and intentions were differentially associated with multiple additional sociodemographic, attitudinal, and/or healthcare experience variables. CONCLUSIONS Several demographic variables, vaccine attitudes, and healthcare experiences were found to contribute to COVID-19 vaccine receipt and intentions. Targeted efforts are necessary to increase uptake of the vaccine in the U.S.
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Affiliation(s)
- Naomi C Brownstein
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States of America; Department of Oncologic Sciences, University of South Florida, United States of America.
| | - Harika Reddy
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; College of Public Health and Health Professions, University of Florida, United States of America
| | - Junmin Whiting
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Monica L Kasting
- Department of Public Health, Purdue University, West Lafayette, IN, United States of America; Cancer Prevention and Control Program, Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, United States of America
| | - Katharine J Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States of America
| | - Susan T Vadaparampil
- Department of Oncologic Sciences, University of South Florida, United States of America; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Clement K Gwede
- Department of Oncologic Sciences, University of South Florida, United States of America; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Cathy D Meade
- Department of Oncologic Sciences, University of South Florida, United States of America; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Shannon M Christy
- Department of Oncologic Sciences, University of South Florida, United States of America; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America
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15
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Arevalo M, Brownstein NC, Whiting J, Meade CD, Gwede CK, Vadaparampil ST, Tillery KJ, Islam JY, Giuliano AR, Christy SM. Strategies and Lessons Learned During Cleaning of Data From Research Panel Participants: Cross-sectional Web-Based Health Behavior Survey Study. JMIR Form Res 2022; 6:e35797. [PMID: 35737436 PMCID: PMC9264135 DOI: 10.2196/35797] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/13/2022] [Accepted: 05/20/2022] [Indexed: 01/12/2023] Open
Abstract
Background The use of web-based methods to collect population-based health behavior data has burgeoned over the past two decades. Researchers have used web-based platforms and research panels to study a myriad of topics. Data cleaning prior to statistical analysis of web-based survey data is an important step for data integrity. However, the data cleaning processes used by research teams are often not reported. Objective The objectives of this manuscript are to describe the use of a systematic approach to clean the data collected via a web-based platform from panelists and to share lessons learned with other research teams to promote high-quality data cleaning process improvements. Methods Data for this web-based survey study were collected from a research panel that is available for scientific and marketing research. Participants (N=4000) were panelists recruited either directly or through verified partners of the research panel, were aged 18 to 45 years, were living in the United States, had proficiency in the English language, and had access to the internet. Eligible participants completed a health behavior survey via Qualtrics. Informed by recommendations from the literature, our interdisciplinary research team developed and implemented a systematic and sequential plan to inform data cleaning processes. This included the following: (1) reviewing survey completion speed, (2) identifying consecutive responses, (3) identifying cases with contradictory responses, and (4) assessing the quality of open-ended responses. Implementation of these strategies is described in detail, and the Checklist for E-Survey Data Integrity is offered as a tool for other investigators. Results Data cleaning procedures resulted in the removal of 1278 out of 4000 (31.95%) response records, which failed one or more data quality checks. First, approximately one-sixth of records (n=648, 16.20%) were removed because respondents completed the survey unrealistically quickly (ie, <10 minutes). Next, 7.30% (n=292) of records were removed because they contained evidence of consecutive responses. A total of 4.68% (n=187) of records were subsequently removed due to instances of conflicting responses. Finally, a total of 3.78% (n=151) of records were removed due to poor-quality open-ended responses. Thus, after these data cleaning steps, the final sample contained 2722 responses, representing 68.05% of the original sample. Conclusions Examining data integrity and promoting transparency of data cleaning reporting is imperative for web-based survey research. Ensuring a high quality of data both prior to and following data collection is important. Our systematic approach helped eliminate records flagged as being of questionable quality. Data cleaning and management procedures should be reported more frequently, and systematic approaches should be adopted as standards of good practice in this type of research.
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Affiliation(s)
- Mariana Arevalo
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Naomi C Brownstein
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States
- Department of Oncological Sciences, University of South Florida, Tampa, FL, United States
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Junmin Whiting
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
- Department of Oncological Sciences, University of South Florida, Tampa, FL, United States
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - Clement K Gwede
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
- Department of Oncological Sciences, University of South Florida, Tampa, FL, United States
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, United States
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
- Department of Oncological Sciences, University of South Florida, Tampa, FL, United States
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States
| | - Kristin J Tillery
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL, United States
| | - Jessica Y Islam
- Department of Oncological Sciences, University of South Florida, Tampa, FL, United States
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, United States
| | - Anna R Giuliano
- Department of Oncological Sciences, University of South Florida, Tampa, FL, United States
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, United States
| | - Shannon M Christy
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
- Department of Oncological Sciences, University of South Florida, Tampa, FL, United States
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States
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16
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Effect of Different Educational Interventions on Knowledge of HPV Vaccination and Cervical Cancer among Young Women: A Preliminary Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095191. [PMID: 35564586 PMCID: PMC9105621 DOI: 10.3390/ijerph19095191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 11/17/2022]
Abstract
The incidence and mortality rates of cervical cancer are rising among young women in Japan. In November 2021, the Japanese Ministry of Health, Labour, and Welfare reinstated the active recommendation for the human papillomavirus (HPV) vaccine, which was discontinued in June 2013 due to reports of adverse reactions, including chronic pain and motor dysfunction, following vaccination. However, vaccine hesitancy among the younger generation remains, and it is essential to identify the barriers in vaccination uptake. Therefore, we aimed to conduct a randomized study using different methods of providing educational contents to improve health literacy regarding cervical cancer and HPV vaccination among female students in Japan. Here, we present the results of our preliminary report and discuss current topics related to HPV vaccination in Japan. Data were collected from 27 female students—divided into three groups: no intervention, print-based intervention, and social networking service-based intervention—using the health literacy scale and communicative and critical health literacy scale. Our primary results indicate that participants’ knowledge and health literacy improved post-intervention. Therefore, medical professionals must provide accurate scientific knowledge regarding routine HPV vaccination and the risk of cervical cancer to young women to improve their health literacy and subsequently increase the HPV vaccination rates.
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17
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Knowledge and Practice of Pap Smear and Vaccination Regarding Human Papillomavirus Among Female Medical Students in Karachi, Pakistan. HEALTH SCOPE 2021. [DOI: 10.5812/jhealthscope.119411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Cervical cancer is the leading cause of women’s death in developing countries. The change in the epidemiological trends has been attributed to mass screening with the help of a Pap smear. Objectives: This study aimed to determine the knowledge level and practice regarding a Pap smear and human papillomavirus (HPV) vaccination among female medical students in Karachi, Pakistan. Methods: In this cross-sectional study, 147 participants were selected through multistage stratified random sampling. The knowledge level was categorized as adequate if the participants answered 60% of the items. Questionnaire validity was determined through Cronbach’s alpha value (α = 0.69). Binary logistic regression was applied to determine the factors associated with the knowledge level among the students. A confidence interval (CI) of 95% was considered with a margin of error of 5% and a P-value of 0.05 as statistically significant. Results: Most students (60.5%) had adequate knowledge regarding a Pap smear and HPV vaccination. Only 3.4% of the students underwent a Pap smear test. The most common factors contributing to the knowledge level were marriage (OR = 2.98; 95% CI: 1.23 - 11.09; P = 0.003), first academic year of students (OR = 10.78; 95% CI: 1.03 - 12.01; P = 0.046), family history of cancer (OR = 2.76; 95% CI: 1.34 - 7.90; P = 0.004), and family income less than < 100000 Pakistani Rupee (OR = 5.45; 95% CI: 2.09 - 9.06; P = 0.005). Conclusions: Being medical students studying in the first academic year, family history of cancer, and family income less than 100000 Pakistani Rupee had significant effect on knowledge gap about a Pap smear and HPV vaccination. There is a need for an increased level of knowledge in this regard by addressing the risk factors contributing to the knowledge level.
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18
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Sonawane K, Lin YY, Damgacioglu H, Zhu Y, Fernandez ME, Montealegre JR, Cazaban CG, Li R, Lairson DR, Lin Y, Giuliano AR, Deshmukh AA. Trends in Human Papillomavirus Vaccine Safety Concerns and Adverse Event Reporting in the United States. JAMA Netw Open 2021; 4:e2124502. [PMID: 34533574 PMCID: PMC8449282 DOI: 10.1001/jamanetworkopen.2021.24502] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE In the US, safety concern has been identified as a primary barrier to initiating the human papillomavirus (HPV) vaccine. It is unclear if the public's sentiment concerning HPV vaccine safety aligns with postmarketing vaccine safety surveillance data. OBJECTIVE To perform a parallel assessment of trends in HPV vaccine safety concerns and HPV vaccine adverse event (AE) reporting. DESIGN, SETTING, AND PARTICIPANTS This study was a cross-sectional analysis of the National Immunization Survey (NIS) and Vaccine Adverse Event Reporting System (VAERS). Participants in the NIS were adolescents aged 13 to 17 years. AEs were reported to VAERS by patients, health care clinicians, or other sources. Statistical analysis was performed from October 2020 to May 2021. MAIN OUTCOMES AND MEASURES Secular trends in HPV vaccine safety concerns and spontaneous AE reporting for HPV vaccination from 2015 to 2018. RESULTS Caregivers of 39 364 unvaccinated adolescents with a mean (SD) age of 15.57 (0.08) years (26 996 White adolescents [62.9%], 22 707 male adolescents [56.1%], 11 392 privately insured [62.6%], and 32 674 above the poverty level [79.3%]) reported their reasons for not initiating the HPV vaccine series in the 2015-2018 NIS. Citing safety concerns as the primary reason for not initiating the HPV vaccine series increased from 13.0% (95% CI, 12.1%-14.0%) in 2015 to 23.4% (95% CI, 21.8%-25.0%) in 2018 (P for trend < .001), equating to a change from 170 046 to 259 157 US adolescents not initiating the vaccine because of safety concerns. The proportion of parents citing safety concerns as the main reason for HPV vaccine hesitancy increased in 30 states. The largest increases (more than 200%) were observed in California, Hawaii, South Dakota, and Mississippi. During 2015 to 2018, 16 621 AE reports following HPV vaccination were reported to VAERS. The AE reporting rate per 100 000 doses distributed decreased from 44.7 in 2015 to 29.4 in 2018 (P for trend < .001). The serious AE reporting rate, including those leading to hospitalizations, disability, life-threatening condition, or death did not change. CONCLUSIONS AND RELEVANCE In this descriptive cross-sectional study, a rise in citing safety concerns was observed among parents with HPV vaccine hesitancy, contrary to the nonserious and serious AE reporting trends. These findings suggest an urgent need to combat the rising sentiment of safety concerns among caregivers to increase HPV vaccine confidence.
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Affiliation(s)
- Kalyani Sonawane
- Center for Healthcare Data, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Yueh-Yun Lin
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Haluk Damgacioglu
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Yenan Zhu
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Maria E Fernandez
- Center for Health Promotion and Prevention Research, UTHealth School of Public Health, Houston, Texas
| | | | - Cecilia Ganduglia Cazaban
- Center for Healthcare Data, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Ruosha Li
- Department of Biostatistics and Data Science, School of Public Health, UT Health Science Center at Houston, Houston, Texas
| | - David R Lairson
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Ying Lin
- Department of Industrial Engineering, University of Houston, Houston, Texas
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Ashish A Deshmukh
- Center for Healthcare Data, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
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Raymond S, Li L, Taioli E, Nash D, Liu B. The effect of the Affordable Care Act dependent coverage provision on HPV vaccine uptake in young adult women, National Health and Nutrition Examination Survey 2007-2016. Prev Med 2021; 148:106536. [PMID: 33798531 DOI: 10.1016/j.ypmed.2021.106536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/24/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
The human papillomavirus (HPV) vaccine protects against cancers caused by HPV. The study objective was to examine the effect of the Affordable Care Act (ACA) dependent child coverage provision on HPV vaccination initiation, HPV vaccine completion, HPV infection, and health insurance coverage among young women. Using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), 2172 female participants were included. The impact of the dependent coverage provision on the four outcomes was examined using difference-in-difference analyses with linear probability regressions, controlling for race/ethnicity, age, income, head of household education, and family employment. ACA exposure group was operationalized by age, with those targeted by the dependent coverage provision (ages 19-25) serving as the intervention group and those similar in age but not targeted (ages 18 and 26) serving as the control group. From 2007 to 2016, HPV vaccine initiation, HPV vaccine completion, and health insurance prevalence increased and HPV infection prevalence decreased. In the difference-in-difference adjusted models, ACA exposure was not associated with HPV vaccine initiation (0.045 percentage points [95% CI -0.087, 0.178]), completion (-0.044 percentage points [95% CI -0.152, 0.063]), HPV 16/18 infection (-0.051 percentage points [95% CI -0.123, 0.021]), or health insurance (0.065 percentage points [95% CI -0.032, 0.162]) among women aged 19 to 25. The dependent coverage provision may not have addressed relevant barriers to HPV vaccination. However, given that the effect of the dependent coverage provision on HPV vaccination and health insurance has been demonstrated previously, small sample size is a concern.
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Affiliation(s)
- Samantha Raymond
- Department of Epidemiology and Biostatistics, City University of New York (CUNY) School of Public Health, New York, NY, United States of America.
| | - Lihua Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Emanuela Taioli
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Denis Nash
- Department of Epidemiology and Biostatistics, City University of New York (CUNY) School of Public Health, New York, NY, United States of America; Institute for Implementation Science in Population Health, CUNY, New York, NY, United States of America
| | - Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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Self-efficacy and HPV Vaccine Attitudes Mediate the Relationship Between Social Norms and Intentions to Receive the HPV Vaccine Among College Students. J Community Health 2021; 45:1187-1195. [PMID: 32418009 DOI: 10.1007/s10900-020-00837-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Human papillomavirus (HPV) has been linked to genital warts and multiple cancers affecting both men and women. Despite college students' high risk for HPV, their vaccination rates remain suboptimal. The current observational study examined the relationship between social norms and HPV vaccine intentions and potential mechanisms underlying this relationship among undergraduates. Participants (N = 190; 66.8% female) completed a survey assessing HPV vaccine social norms, attitudes, self-efficacy, and intentions. Three mediation analyses were conducted to examine whether self-efficacy and attitudes mediated the relationship between social norms (i.e., parents, friends, doctor) and intentions, controlling for demographic and health care covariates. Social norms were indirectly related to intentions through self-efficacy and attitudes in multiple models (ps < .05). Specifically, perceiving greater support for HPV vaccination from one's friends, parents, and doctor was related to greater HPV vaccine self-efficacy, which, in turn, was related to increased vaccine intentions. In addition, perceiving greater parental and doctor support for HPV vaccination was related to more favorable attitudes towards the vaccine, which, in turn, were related to increased vaccine intentions. Findings suggest potential targets for future interventions to promote HPV vaccination among young adults.
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Fiorito TM, Krilov LR, Nonaillada J. Human Papillomavirus Knowledge and Communication Skills: A Role-Play Activity for Providers. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2021; 17:11150. [PMID: 33907710 PMCID: PMC8063629 DOI: 10.15766/mep_2374-8265.11150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Human papillomavirus (HPV) infection and related cancers are a major cause of morbidity and mortality worldwide. Routine vaccination against HPV is recommended for patients starting at age 9-12 years. Discussing this vaccine with parents of young children can be challenging for clinicians. Barriers include parental beliefs, strength and quality of clinician recommendations, physician knowledge of HPV disease and vaccines, and provider comfort levels with discussing sexuality. METHODS Our interactive workshop began with a predidactic role-play session addressing common concerns about the HPV vaccine where participants took turns playing a concerned parent or provider. We then gave a 30-minute didactic lecture and conducted a postdidactic role-play session to practice communication skills in promoting the HPV vaccine. All participants completed pre- and postintervention knowledge and skill self-assessments. RESULTS Twenty-eight pediatric residents and medical students participated. We observed significant improvement in their ability to appropriately recommend the HPV vaccine in the postdidactic role-play (all ps < .02). Learner knowledge improved from pre- to postintervention (from 34% to 100%, p < .0025, based on average score), as did self-perceived comfort and confidence levels (from 3.6 to 4.3, p < .0001, average score based on a 5-point Likert scale). DISCUSSION An interactive workshop utilizing role-play supplemented by a didactic lecture was effective in improving participants' knowledge, communication skills, comfort levels, and confidence levels regarding HPV disease and vaccines. The workshop offers a practical and interpersonal approach to improving learners' skills in discussing the HPV vaccine with parents.
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Affiliation(s)
- Theresa M. Fiorito
- Attending Physician, Department of Pediatrics, Division of Pediatric Infectious Diseases, NYU Langone Long Island Hospital; Assistant Professor, Department of Pediatrics, NYU Long Island School of Medicine
| | - Leonard R. Krilov
- Chief, Department of Pediatrics, Division of Pediatric Infectious Diseases, NYU Langone Long Island Hospital; Professor, Department of Pediatrics, NYU Long Island School of Medicine; Chair, Department of Pediatrics, NYU Langone Long Island Hospital
| | - Jeannine Nonaillada
- Associate Professor, Department of Medicine, Division of Geriatric Medicine, NYU Long Island School of Medicine; Assistant Dean, Faculty Development and Mentoring, NYU Long Island School of Medicine
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22
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McLendon L, Puckett J, Green C, James J, Head KJ, Yun Lee H, Young Pierce J, Beasley M, Daniel CL. Factors associated with HPV vaccination initiation among United States college students. Hum Vaccin Immunother 2021; 17:1033-1043. [PMID: 33325794 DOI: 10.1080/21645515.2020.1847583] [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] [Indexed: 12/22/2022] Open
Abstract
Human papillomavirus (HPV) remains the most common sexually transmitted infection (STI) in the U.S. despite widespread availability of a safe, effective vaccine. Although young adults are at greatest risk of HPV infection, extensive vaccine promotion and intervention efforts has been directed toward 11-12-year-olds. College students represent an ideal audience for HPV vaccine "catch-up;" however, research indicates inconsistent HPV vaccination rates within this demographic. An online survey assessing HPV and HPV vaccine knowledge and behaviors was distributed to all undergraduate college students at a large, public university in the Deep South region of the U.S. The primary outcome was receipt of HPV vaccination (binary response options of Yes/No). Logistic regression analyses were performed to determine predictors of HPV vaccination. Of the 1,725 who completed the survey, 47.0% reported having received at least one dose of HPV vaccine; overall series completion (series = 3 doses for this population) was 17.4%. The primary outcome was HPV initiation among college students, defined as having received at least one dose of the HPV vaccine. Results indicated substantial gaps in participants' knowledge of their vaccination status. Provider and parental recommendations as well as social influences were shown to significantly impact student vaccination status, emphasizing the importance of incorporating these elements in future interventions, potentially as multi-level strategies. Future college interventions should address HPV and vaccination knowledge and the importance of provider and parental recommendations.
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Affiliation(s)
- Lane McLendon
- Department of Family Medicine, University of South Alabama College of Medicine, Mobile, AL, USA
| | - Jesse Puckett
- Department of Family Medicine, University of South Alabama College of Medicine, Mobile, AL, USA
| | - Chelsea Green
- Department of Family Medicine, University of South Alabama College of Medicine, Mobile, AL, USA
| | - Jenna James
- Division of Cancer Control and Prevention, University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA
| | - Katharine J Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Hee Yun Lee
- School of Social Work, University of Alabama School of Social Work, Tuscaloosa, AL, USA
| | - Jennifer Young Pierce
- Division of Cancer Control and Prevention, University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA
| | - Mark Beasley
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Casey L Daniel
- Department of Family Medicine, University of South Alabama College of Medicine, Mobile, AL, USA
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Mathewson K, Sundaram M, Bednarczyk RA. Young Adult Human Papillomavirus and Influenza Vaccine Coverage: A Comparison Across College Enrollment Status. J Community Health 2021; 46:13-21. [PMID: 32415521 PMCID: PMC7666656 DOI: 10.1007/s10900-020-00833-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To determine human papillomavirus and influenza vaccine coverage among young adults in the US and assess differences in vaccine uptake by college enrollment status, we conducted an online survey of young adults aged 18-26 (n = 417) using Survey Monkey, with recruitment occurring through Amazon's Mechanical Turk (MTurk) platform. We collected data on self-reported preventive health behaviors, including vaccine receipt, current college enrollment status, and other demographics. Overall, 49% of participants reported receiving at least one dose of human papillomavirus vaccine and 57% reported receiving at least one influenza vaccine over the past three years. Vaccine coverage estimates did not differ between college-enrolled and non-enrolled respondents. Low vaccine coverage rates demonstrate the need to improve vaccine strategies for young adults. The strongest predictor of vaccine receipt was having received a provider recommendation. There does not appear to be healthcare utilization differences related to ability to access care through student health or community-based settings. Additional research is needed to develop interventions to improve vaccination coverage among young adults, both currently enrolled and not enrolled in college.
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Affiliation(s)
- Kara Mathewson
- Rollins School of Public Health, CNR 7019, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Maria Sundaram
- Rollins School of Public Health, CNR 7019, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Robert A Bednarczyk
- Rollins School of Public Health, CNR 7019, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
- Cancer Prevention and Control Program, Winship Cancer Institute, Emory University, 1365-C Clifton Road NE, Atlanta, GA, USA.
- Emory Vaccine Center, Emory University, 954 Gatewood Road, Atlanta, GA, USA.
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Waters AV, Merrell LK, Thompson EL. Monogamy as a Barrier to Human Papillomavirus Catch-Up Vaccination. J Womens Health (Larchmt) 2021; 30:705-712. [PMID: 33416434 DOI: 10.1089/jwh.2020.8724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection (STI) in the United States. Although a vaccine to prevent HPV infection exists, only 53.7% of females 13-17 years of age were up-to-date on the HPV vaccination series in 2018. There is a catch-up period of vaccination for females 18-26 years of age that shows consistent underparticipation. A potential barrier to vaccination is relationship status, as long-term relationships may negatively impact HPV risk perception. This study examined monogamy as a risk factor for nonvaccination and explored how risk perception may influence this association. Materials and Methods: An electronic survey was distributed to females 18-26 years of age who attended a large public university in the mid-Atlantic region (n = 629). Multivariable and descriptive statistics were estimated using SAS 9.4 to explore the likelihood of vaccination during the catch-up period by relationship status. Results: Most participants had received the HPV vaccine, a small proportion of whom received it during the catch-up period. After adjusting for confounders, women who were in monogamous relationships were significantly less likely to have participated in HPV catch-up vaccination compared to women who were single and dating (adjusted odds ratio: 0.36, 95% confidence interval: 0.15, 0.87). Women in monogamous relationships had a lower average sexually transmitted disease (STD) risk perception compared to women who were single and dating (p < 0.0001). Conclusions: A decreased risk perception may present a barrier to participating in catch-up vaccination for monogamous women. Practitioners and the public health community should focus on communicating HPV risk to women in monogamous relationships, especially given the recently expanded age range for HPV vaccination.
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Affiliation(s)
- Ansley V Waters
- Department of Health Sciences, College of Health and Behavioral Studies, James Madison University, Harrisonburg, Virginia, USA
| | - Laura K Merrell
- Department of Health Sciences, College of Health and Behavioral Studies, James Madison University, Harrisonburg, Virginia, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Singh J, Baliga SS. Knowledge regarding cervical cancer and HPV vaccine among medical students: A cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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26
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Alber JM, Askay D, Kolodziejski LR, Ghazvini S, Tolentino B, Gibbs SL. HPV Vaccine-Related Beliefs and Knowledge among Adults 18–45 Years Old. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1844102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Use of cervical cancer preventive services among US women aged 21-29: an assessment of the 2010 Affordable Care Act rollout through 2018. Cancer Causes Control 2020; 31:839-850. [PMID: 32602058 DOI: 10.1007/s10552-020-01325-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/18/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The 2010 Affordable Care Act (ACA) provided millions of people with health insurance coverage and facilitated routine cancer screening by requiring insurers to cover preventive services without cost-sharing. Despite greater access to affordable cancer screening, Pap testing has declined over time. The aim of this study is to assess participation in Pap test and HPV vaccination, and adherence to guidelines as outlined by the American Cancer Society (ACS) from the 2010 ACA provision eliminating cost-sharing for preventive services. METHODS Using multi-year responses from the Behavioral Risk Factor Surveillance System, we examined the association between the ACA and participation in and adherence to Pap testing and HPV vaccination behaviors as set by the ACS. The sample included women aged 21-29 who completed the survey between 2008 and 2018 (every other year) and who live in 24 US States (N = 37,893). RESULTS Results showed significant decreases in Pap testing rates but increases in the uptake of the HPV vaccine series for all age groups and across all demographics. Post-ACA year significantly predicted increases in HPV + Pap co-testing participation and adherence. Women with health insurance coverage were more likely to engage in both behaviors. CONCLUSION Findings raise concerns around declines in the proportion of women receiving and adhering to Pap testing guidelines. A need exists for research to examine the role of increases in HPV vaccination uptake on decreases in Pap testing. Moreover, effective strategies should target increases in cervical cancer screening uptake among women vaccinated against HPV.
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Hayes KN, Pan I, Kunkel A, McGivney MS, Thorpe CT. Evaluation of targeted human papillomavirus vaccination education among undergraduate college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:781-789. [PMID: 30570453 DOI: 10.1080/07448481.2018.1515742] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/12/2018] [Accepted: 08/16/2018] [Indexed: 06/09/2023]
Abstract
Objective: To design and evaluate pharmacy student-led educational sessions to improve health beliefs about the HPV vaccine in college-aged students. Participants: Students aged 18-26 attending a large, urban university, including 545 respondents to a December 2014 needs assessment survey about HPV-related health beliefs, 131 students participating in educational sessions during 2015-2016 (intervention group), and 369 undergraduate respondents completing the needs assessment survey (control group). Methods: A needs assessment survey was conducted to inform design and implementation of pharmacy student-led educational sessions. A similar survey was administered to students after attending educational sessions. Health beliefs were compared for the intervention versus control group. Results: The intervention group was less likely to report high perceived barriers to HPV vaccination and more likely to report high perceived benefits and intention to vaccinate (if previously unvaccinated). Conclusions: Pharmacy student-led, health belief-based educational sessions were associated with improved health beliefs about HPV vaccination.
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Affiliation(s)
- Kaleen N Hayes
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania, USA
| | - Ingrid Pan
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania, USA
| | - Alyssa Kunkel
- W.G (Bill) Hefner VA Medical Center, Salisbury, Maryland, USA
| | - Melissa Somma McGivney
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania, USA
| | - Carolyn T Thorpe
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania, USA
- Veterans Affairs Pittsburgh Healthcare System, Center for Health Equity Research and Promotion (CHERP), Pittsburgh, Pennsylvania, USA
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29
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Luo X, Zimet G, Shah S. A natural language processing framework to analyse the opinions on HPV vaccination reflected in twitter over 10 years (2008 - 2017). Hum Vaccin Immunother 2019; 15:1496-1504. [PMID: 31194609 DOI: 10.1080/21645515.2019.1627821] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In this research, we developed a natural language processing (NLP) framework to investigate the opinions on HPV vaccination reflected on Twitter over a 10-year period - 2008-2017. The NLP framework includes sentiment analysis, entity analysis, and artificial intelligence (AI)-based phrase association mining. The sentiment analysis demonstrates the sentiment fluctuation over the past 10 years. The results show that there are more negative tweets in 2008 to 2011 and 2015 to 2016. The entity extraction and analysis help to identify the organization, geographical location and events entities associated with the negative and positive tweets. The results show that the organization entities such as FDA, CDC and Merck occur in both negative and positive tweets of almost every year, whereas the geographical location entities mentioned in both negative and positive tweets change from year to year. The reason is because of the specific events that happened in those different locations. The objective of the AI-based phrase association mining is to identify the main topics reflected in both negative and positive tweets and detailed tweet content. Through the phrase association mining, we found that the main negative topics on Twitter include "injuries", "deaths", "scandal", "safety concerns", and "adverse/side effects", whereas the main positive topics include "cervical cancers", "cervical screens", "prevents", and "vaccination campaigns". We believe the results of this research can help public health researchers better understand the nature of social media influence on HPV vaccination attitudes and to develop strategies to counter the proliferation of misinformation.
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Affiliation(s)
- Xiao Luo
- a Purdue School of Engineering and Technology, Indiana University-Purdue University Indianapolis , Indianapolis , IN , USA
| | - Gregory Zimet
- b Pediatric Adolescent Health, Indiana University School of Medicine , Indianapolis , IN , USA
| | - Setu Shah
- a Purdue School of Engineering and Technology, Indiana University-Purdue University Indianapolis , Indianapolis , IN , USA
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Thompson EL, Vamos CA, Piepenbrink R, Kadono M, Vázquez-Otero C, Matthes S, Daley EM. Human papillomavirus risk perceptions and relationship status: a barrier to HPV vaccination? J Behav Med 2019; 42:991-997. [PMID: 30879225 DOI: 10.1007/s10865-019-00025-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/09/2019] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to assess the association between relationship status and perceived risk for human papillomavirus (HPV) among young adults. College adults, aged 18-26 years, completed an online survey from November 2016-April 2017 (n = 385). The survey assessed HPV vaccination status, perceived HPV risk, and current relationship status. Logistic regression models estimated the odds of perceived high risk for HPV, stratified by vaccination status. Among unvaccinated women, relationship status and HPV risk perception were significantly associated, with dating women more likely (OR = 5.33, 95%CI 1.16-24.50) to perceive a high risk for HPV compared to women in a committed relationship. Women in relationships were less likely to perceive themselves at high risk for HPV, even though HPV infection is prevalent among young adults. This association is not present for vaccinated women, suggesting that relationship status and risk perceptions may represent barriers to HPV vaccine uptake.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Cheryl A Vamos
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Rumour Piepenbrink
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Mika Kadono
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
- Department of Anthropology, College of Arts and Sciences, University of South Florida, 4202 East Fowler Ave SOC107, Tampa, FL, 33620, USA
| | - Coralia Vázquez-Otero
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Sarah Matthes
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Ellen M Daley
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
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Gualano MR, Thomas R, Stillo M, Mussa MV, Quattrocolo F, Borraccino A, Zotti C. What is the most useful tool in HPV vaccine promotion? Results from an experimental study. Hum Vaccin Immunother 2018; 15:1607-1614. [PMID: 30240333 PMCID: PMC6746512 DOI: 10.1080/21645515.2018.1526552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/22/2018] [Accepted: 09/11/2018] [Indexed: 10/28/2022] Open
Abstract
Introduction: Human papillomavirus infection (HPV) affects 70-80% of female population throughout the lifetime, exposing them to the risk of developing genital warts and cervical cancer. Despite these correlated risks and the demonstrated efficacy of the vaccine, coverage rates for two-three doses are around 70% in Italy and 67% in Piemonte (below the expected 95%). Aim of the study is to investigate whether this situation is due to a lack of information and awareness among young adults. Results: Students showed increased knowledge after the intervention and more than 90% found the 3 informative materials as sources of useful information. After the intervention students would strongly recommend HPV vaccination (OR = 3.45; p < 0.001). Discussion: Higher rates of correct answers after the distribution of informative material underline the importance of knowledge delivery. Differences among the kind of material were reported; it appears that a combination of leaflet's positive features, such as clarity and intelligibility, and article's completeness of information represents the best solution to reach communication goals in vaccination campaigns targeted on educated populations. Methods: Researchers conducted an experimental study on a large population of undergraduate students from University of Turin. Participants' knowledge about HPV was assessed with questionnaires before and after the examination of 3 different kinds of informative material (journal article describing HPV infection, gynecologist video-interview and institutional leaflet about HPV prevention) on HPV and vaccine. Differences among groups were explored by using univariate tests, differences in pre- post- knowledge were assessed with McNemar tests. Relevant associations were searched with logistic regression models.
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Affiliation(s)
| | - Robin Thomas
- Department of Public Health, University of Torino, Torino, Italy
| | - Michela Stillo
- Department of Public Health, University of Torino, Torino, Italy
| | | | | | | | - Carla Zotti
- Department of Public Health, University of Torino, Torino, Italy
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Karamanidou C, Dimopoulos Κ. Knowledge, beliefs and communication preferences with regards to the HPV vaccine; the perspective of unvaccinated Greek adolescent girls, young women, and mothers of vaccine-eligible girls. Health Psychol Behav Med 2018; 6:180-202. [PMID: 34040827 PMCID: PMC8114387 DOI: 10.1080/21642850.2018.1505518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Every year in Europe 60,000 women develop cervical cancer and 30,000 die from the disease. HPV vaccines are currently believed to constitute an important element of cervical cancer control strategy. The introduction of the HPV vaccine constitutes a shift in health policy and health promotion practice. The aim of this study was to investigate knowledge, beliefs and communication preferences of the Greek public with regards to the HPV vaccine. Methods: Six focus groups (5–8 participants) were conducted with unvaccinated teenage girls, young women and mothers of vaccine-eligible girls, recruited via schools and universities. Pre-focus group questionnaires consisted of: socio-demographic details and a knowledge questionnaire. The discussion guide was based on issues raised by relevant studies such as disease severity and personal risk perception, perceived benefits and barriers to vaccination, etc. Participants were also shown three types of stimuli namely, a leaflet, an expert interview and a documentary containing equivalent information on HPV and the HPV vaccine. Thematic analysis was used for analysis of the qualitative data. Findings: Findings revealed that participants had low to moderate knowledge levels on HPV and cervical cancer. Beliefs specific to the HPV vaccine as well as general beliefs about medicines and their use in everyday life were prevalent. The vaccination dilemma was exacerbated by the conflicting advice received by health professionals coupled with the difficulties participants experienced in evaluating relevant health information. Participants judged all stimuli according to content and format but the documentary was their preferred health information communication option. Conclusions: Findings could contribute to the understanding of health decision making with regards to preventive vaccination and help formulate recommendations for health policy adjustments.
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Affiliation(s)
- Christina Karamanidou
- Department of Social and Educational Policy, Faculty of Social Sciences, University of Peloponnese, Damaskinou and Kolokotroni str, Korinthos, Greece.,Department of Education, University of Nicosia, Nicosia, Cyprus
| | - Κostas Dimopoulos
- Department of Social and Educational Policy, Faculty of Social Sciences, University of Peloponnese, Damaskinou and Kolokotroni str, Korinthos, Greece
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Fernandes R, Potter BK, Little J. Attitudes of undergraduate university women towards HPV vaccination: a cross-sectional study in Ottawa, Canada. BMC Womens Health 2018; 18:134. [PMID: 30071837 PMCID: PMC6090914 DOI: 10.1186/s12905-018-0622-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Persistent infection with certain subtypes of human papillomavirus (HPV) is a necessary cause of cervical cancer. Although two prophylactic vaccines have been licensed in Canada against cancerous subtypes of HPV, vaccine uptake has been lower than anticipated. The primary objective of this study was to determine the acceptability of catch-up HPV vaccination to undergraduate university women under the age of 25, by assessing their perceptions of HPV vaccination. METHODS A total of 401 University of Ottawa female undergraduate students participated in a cross-sectional bilingual web-based survey on HPV vaccination. RESULTS The prevalence of immunization with at least 1 HPV vaccine dose was 49% in the study population. Although the overall attitude of study participants towards the vaccine was positive, vaccinated respondents had a more favourable attitude towards the vaccine than non-vaccinated respondents. Approximately half of the non-vaccinated respondents were interested in receiving the vaccine at some point in the future. The primary barriers to HPV vaccination identified by non-vaccinated respondents were lack of knowledge about the vaccines, potential vaccine side effects and cost of vaccination. Multivariable analysis comparing non-vaccinated respondents who intended to be vaccinated and those who did not suggests that the former group had a more favourable attitude towards the vaccine and would be influenced by doctor recommendation. CONCLUSIONS Offering HPV vaccination for women aged 18 to 25 provides an opportunity to address suboptimal vaccination coverage in the population and may reduce health inequities demonstrated by variations in cervical cancer incidence within jurisdictions.
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Affiliation(s)
- Rachel Fernandes
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 207G, Ottawa, On K1G 5Z3 Canada
| | - Beth K. Potter
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Canada Research Chair in Human Epidemiology, Ottawa, Canada
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Status of HPV vaccine introduction and barriers to country uptake. Vaccine 2018; 36:4761-4767. [DOI: 10.1016/j.vaccine.2018.02.003] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/12/2018] [Accepted: 02/01/2018] [Indexed: 11/20/2022]
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Huang J, Du J, Duan R, Zhang X, Tao C, Chen Y. Characterization of the Differential Adverse Event Rates by Race/Ethnicity Groups for HPV Vaccine by Integrating Data From Different Sources. Front Pharmacol 2018; 9:539. [PMID: 29896103 PMCID: PMC5987677 DOI: 10.3389/fphar.2018.00539] [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: 01/31/2018] [Accepted: 05/04/2018] [Indexed: 01/02/2023] Open
Abstract
Data from the Vaccine Adverse Event Reporting System (VAERS) contain spontaneously reported adverse events (AEs) from the public. It has been a major data source for detecting AEs and monitoring vaccine safety. As one major limitation of spontaneous surveillance systems, the VAERS reports by themselves sometimes do not provide enough information to answer certain research questions. For example, patient level demographics are very limited in VAERS due to the protection of patient privacy, such that investigation of differential AE rates across race/ethnicity groups cannot be conducted using VAERS data only. For many vaccines, racial and ethnical difference in immune responses has been found in studies based on racially diverse cohorts. It is of great interest to characterize the differential AE rates by race and ethnicity groups for vaccines. In this study, we propose a novel statistical method to integrate VAERS data with data from other resources for vaccine pharmacovigilance research. Specifically, we integrate VAERS data with CDC survey data of vaccine coverage and U.S. census data of race/ethnicity distribution to quantify differential AE rates by race/ethnicity groups for HPV vaccine. We utilize the difference of race/ethnicity distributions across U.S. states to investigate the association between AE reporting rate and race/ethnicity groups at the population level. We identify 9 AEs with significantly different reporting rates between non-Hispanic White females and other race/ethnicity groups.
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Affiliation(s)
- Jing Huang
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Jingcheng Du
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Rui Duan
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Xinyuan Zhang
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Cui Tao
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Yong Chen
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States
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Rohde RL, Adjei Boakye E, Christopher KM, Geneus CJ, Walker RJ, Varvares MA, Osazuwa-Peters N. Assessing university students' sexual risk behaviors as predictors of human papillomavirus (HPV) vaccine uptake behavior. Vaccine 2018; 36:3629-3634. [PMID: 29753605 DOI: 10.1016/j.vaccine.2018.05.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVES There exists a significant gap in vaccine coverage of the human papillomavirus (HPV) among college-aged students. This study assessed sexual risk-taking behavior among university students and analyzed predictors of HPV vaccine initiation and completion in this population. MATERIALS AND METHODS Data (n = 746) were from an anonymous online, cross-sectional survey distributed to university students, between the ages of 19-26 years, at a private Midwestern university. Both chi-square and multivariable logistics regression models estimated the association between sociodemographic characteristics and sexual risk factors (including number of vaginal sexual partners, number of oral sexual partners, initiation of oral sex, and initiation of vaginal sex), with HPV vaccine initiation and completion. RESULTS A significant number of participants (40%) had not received a single dose of the HPV vaccine series. Of those who initiated the series, more than half (51%) did not achieve completion. Additionally, a greater number of participants have had multiple (4 or more) oral sexual partners than vaginal sexual partners (25.7% vs. 20.3%). After adjusting for covariates, it was found that sexual risk factors were not significantly associated with HPV vaccine initiation or completion. CONCLUSION HPV vaccine initiation and completion rates are suboptimal among university students. High levels of sexual-risk taking behaviors associated with HPV infection persist, yet are not significant predictors of HPV vaccine behaviors in this age group. To increase uptake among 18-26-year-old students, future public health interventions should focus on HPV vaccine education and uptake across the entire population, irrespective of sexual risk profile.
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Affiliation(s)
- Rebecca L Rohde
- Saint Louis University, School of Medicine, St. Louis, MO 63104, USA
| | - Eric Adjei Boakye
- Saint Louis University College of Public Health and Social Justice, Department of Epidemiology, St. Louis, MO 63104, USA
| | | | - Christian J Geneus
- Tulane University, School of Public Health and Tropical Medicine, Department of Biostatistics and Bioinformatics, New Orleans, LA 70118, USA
| | - Ronald J Walker
- Saint Louis University, Department of Otolaryngology-Head and Neck Surgery, St. Louis, MO 63104, USA
| | - Mark A Varvares
- Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA 02115, USA
| | - Nosayaba Osazuwa-Peters
- Saint Louis University College of Public Health and Social Justice, Department of Epidemiology, St. Louis, MO 63104, USA; Saint Louis University Cancer Center, St. Louis, MO 63104, USA; Saint Louis University, Department of Otolaryngology-Head and Neck Surgery, St. Louis, MO 63104, USA.
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Restivo V, Costantino C, Fazio TF, Casuccio N, D'Angelo C, Vitale F, Casuccio A. Factors Associated with HPV Vaccine Refusal among Young Adult Women after Ten Years of Vaccine Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040770. [PMID: 29673135 PMCID: PMC5923812 DOI: 10.3390/ijerph15040770] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/03/2018] [Accepted: 04/14/2018] [Indexed: 11/16/2022]
Abstract
In Italy, the Human Papillomavirus (HPV) vaccination was implemented for twelve years old girls in 2007, but its coverage was lower than the recommended level. Sicily is one of the Italian administrative regions with lower vaccination coverage, with a value of 59% for those born in 1996 increasing to 62% coverage for those born in 1999. The aim of the study was to investigate factors associated with the refusal of HPV vaccination among young adult women of Palermo, Italy. The study was approved by the Ethics Committee of the Policlinico “Paolo Giaccone” Hospital (Palermo 1) and the questionnaire was validated in a convenience sample representing 10% of the young women. A cross-sectional study was conducted through the administration of a telephone questionnaire, consisting of 23 items on HPV infection and vaccination knowledge based on the Health Belief Model framework. The eligible population were young women (18–21 years old) who had at least a vaccination among all included in the Sicilian vaccination schedule, without starting or completing HPV vaccination. Overall, 141 young women were enrolled (response rate 22%). Among them, 84.4% were unvaccinated and 15.6% had at least one dose of the HPV vaccine. In multivariate analysis, the factors associated with the refusal of the HPV vaccination were a bachelor’s as the education level (OR = 10.2, p = 0.041), lower participation at school seminar on HPV (OR = 0.2, p = 0.047) and lower perception of HPV vaccine benefits (OR = 0.4, p = 0.048). Public health educational program focusing and tailored on benefits perception of HPV vaccine and HPV disease severity, carried out at school or during medical visits, can be useful to improve HPV vaccination uptake.
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Affiliation(s)
- Vincenzo Restivo
- Department of Science for Health Promotion and Mother Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy.
| | - Claudio Costantino
- Department of Science for Health Promotion and Mother Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy.
| | - Tiziana Francesca Fazio
- Department of Science for Health Promotion and Mother Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy.
| | - Nicolò Casuccio
- Department of Medical Prevention, Local Health Unit of Palermo, Palermo 90141, Italy.
| | - Claudio D'Angelo
- Department of Medical Prevention, Local Health Unit of Palermo, Palermo 90141, Italy.
| | - Francesco Vitale
- Department of Science for Health Promotion and Mother Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy.
| | - Alessandra Casuccio
- Department of Science for Health Promotion and Mother Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy.
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The Relationship of Health Beliefs with Information Sources and HPV Vaccine Acceptance among Young Adults in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040673. [PMID: 29617313 PMCID: PMC5923715 DOI: 10.3390/ijerph15040673] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/01/2018] [Accepted: 04/02/2018] [Indexed: 01/01/2023]
Abstract
Despite the HPV vaccine’s efficacy in preventing cervical cancer, its coverage rates among Asians are very low. To increase immunization coverage among these populations, understanding the psychological factors that affect HPV acceptability is critical. To this end, this study examined the relationships between multidimensional health beliefs and HPV vaccine acceptance, and what information sources effectively foster HPV vaccination-related health beliefs. Data were collected using a survey of 323 undergraduate students in Korea. Results showed that perceived susceptibility, perceived severity, perceived benefits, and perceived vaccine safety concerns predicted vaccine acceptance. Multiple dimensions of perceived barriers showed differing impacts on vaccine acceptance. In addition, interpersonal information sources were effective in boosting various health beliefs for HPV vaccination. The Internet also was effective in reducing social barriers, but the effects were opposite to those of social media. Theoretical and practical implications are discussed.
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Oz M, Cetinkaya N, Apaydin A, Korkmaz E, Bas S, Ozgu E, Gungor T. Awareness and Knowledge Levels of Turkish College Students about Human Papilloma Virus Infection and Vaccine Acceptance. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:260-268. [PMID: 27655177 DOI: 10.1007/s13187-016-1116-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Awareness of HPV by the target population is an important determinant of vaccine acceptance. The aim of this study is to evaluate the awareness of HPV infection and acceptability of the HPV vaccines among Turkish college students. College students aged 18-30 who were attending a large public university in Ankara participated in this study. The participants were asked to complete a questionnaire to elicit demographic characteristics, awareness level of HPV and HPV vaccine, and willingness to be vaccinated. One thousand one hundred sixty students responded to the invitation email and completed the questionnaire. The mean scores of female students about HPV and HPV vaccine were 7.1/15 and 3.6/9, respectively, while these scores were 7.9/15 and 3.4/9 among male students, respectively. While 51 % percent of female and 33.5 % of male students had heard of HPV and 32.8 % and 18 % of them had heard of HPV vaccine, respectively, only 1.5 % of female and 0.4 % of male students had been vaccinated against HPV. A total of 507 students (43.7 %) had previously heard of HPV. Only 309 (26.6 %) of the participants had previously heard of the HPV vaccine, and 45.1 % of the students were willing to receive HPV vaccination. The main predictors for willingness to be vaccinated were the following: sexual experience, sexual behavior, past history of sexually transmitted infection (STI), and knowledge about HPV and HPV vaccine. Higher awareness levels of HPV and HPV vaccine are significantly related to greater willingness to be vaccinated, and the main reasons for rejecting the vaccine were insufficient information about the vaccine and possible unknown side effects.
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Affiliation(s)
- Murat Oz
- Department of Gynecological Oncology, Zekai Tahir Burak Women's Health Hospital, Talatpasa Blv. Altindag, Ankara, Turkey.
| | - Nilufer Cetinkaya
- Department of Gynecological Oncology, Zekai Tahir Burak Women's Health Hospital, Talatpasa Blv. Altindag, Ankara, Turkey
| | - Aysen Apaydin
- Division of Statistics, Ankara University Science Faculty, Ankara, Turkey
| | - Elmas Korkmaz
- Department of Gynecological Oncology, Zekai Tahir Burak Women's Health Hospital, Talatpasa Blv. Altindag, Ankara, Turkey
| | - Sevda Bas
- Department of Gynecological Oncology, Zekai Tahir Burak Women's Health Hospital, Talatpasa Blv. Altindag, Ankara, Turkey
| | - Emre Ozgu
- Department of Gynecological Oncology, Zekai Tahir Burak Women's Health Hospital, Talatpasa Blv. Altindag, Ankara, Turkey
| | - Tayfun Gungor
- Department of Gynecology and Obstetrics, Hitit University, Corum, Turkey
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Thompson EL, Vamos CA, Griner SB, Daley EM. Changes in HPV Knowledge Among College Women from 2008 to 2015. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:278-283. [PMID: 27349983 DOI: 10.1007/s13187-016-1068-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The human papillomavirus (HPV) can cause anogenital cancers and genital warts; however, it can be prevented through the HPV vaccine, which has been available since 2006. While this vaccine is targeted toward 11-to-12-year-olds, 18-to-26-year-old young adult women are eligible for "catch-up" vaccination. Knowledge of HPV may impact HPV vaccine uptake among this population. The purpose of this study was to assess changes in HPV knowledge and HPV vaccine information sources among young adult college women over a 7-year period. Two independent samples (N = 223 for 2008; N = 323 for 2015) completed a 23-item knowledge scale and survey regarding HPV. Adjusted logistic regression models compared the odds of correctly answering each knowledge item between each time period. The study found that HPV knowledge increased significantly over time (p < 0.01). The participants in 2015 were more likely than the 2008 participants to accurately report that a condom can decrease the chance of HPV transmission; there is a vaccine for women that prevents certain types of HPV; HPV can cause genital warts; HPV can be passed to a newborn at birth; and even if you do not see a wart, you can transmit HPV. Recent participants were also more likely to correctly report only women can get HPV as false. While improvements in HPV knowledge were found over time, misperceptions regarding outcomes associated with HPV persist. In order to promote HPV vaccination among this population, health literacy skills, in addition to knowledge, should be improved.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
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Healthcare providers' beliefs and attitudes regarding risk compensation following HPV vaccination. PAPILLOMAVIRUS RESEARCH 2018; 2:116-121. [PMID: 27441302 PMCID: PMC4946644 DOI: 10.1016/j.pvr.2016.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Provider recommendation is a significant predictor of HPV vaccine uptake. Prior research suggests that concerns regarding risk compensation could cause some providers to hesitate recommending the HPV vaccine. Methods During 15–30 min semi-structured interviews in early 2015, 22 U.S. pediatric providers were asked about their beliefs regarding sexual risk compensation and cervical cancer screening following HPV vaccination. Providers were asked if these beliefs result in reservations recommending the vaccine. Interviews were audio-recorded, transcribed, and analyzed using inductive content analysis. Results None of the providers believed the HPV vaccine would result in risky sexual behavior. Half indicated it was better to start vaccination early, before sexual activity was a worry. Others noted that patients’ risky behavior decisions happen independently of vaccination. When providers were asked if they were concerned about decreased cervical cancer screening, half said they did not know and some stated they had never thought about it before. The main themes addressed were the significant time lapse between vaccination and screening and that women tend to get over-screened as opposed to under-screened. Conclusion Providers were generally in favor of HPV vaccination and do not perceive risk compensation as a barrier to HPV recommendation.
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Kepka D, Spigarelli MG, Warner EL, Yoneoka Y, McConnell N, Balch A. Statewide analysis of missed opportunities for human papillomavirus vaccination using vaccine registry data. PAPILLOMAVIRUS RESEARCH 2018; 2:128-132. [PMID: 27540595 PMCID: PMC4985178 DOI: 10.1016/j.pvr.2016.06.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background Human papillomavirus (HPV) vaccine 3-dose completion rates among adolescent females in the US are low. Missed opportunities impede HPV vaccination coverage. Methods A population-based secondary data analysis of de-identified vaccination and demographic data from the Utah Statewide Immunization Information System (USIIS) was conducted. Records were included from 25,866 females ages 11–26 years at any time during 2008–2012 who received at least one of the following adolescent vaccinations documented in the USIIS: Tdap (Tetanus, Diphtheria, Pertussis), meningococcal, and/or influenza. A missed opportunity for HPV vaccination was defined as a clinical encounter where the patient received at least one adolescent vaccination, but not a HPV vaccine. Results Of 47,665 eligible visits, there were 20,911 missed opportunities (43.87%). Age group, race/ethnicity, and rurality were significantly associated with missed opportunity (p<0.0001). In a multivariable mixed-effects logistic regression model that included ethnicity, location and age, as fixed effects and subject as a random effect, Hispanics were less likely to have a missed opportunity than whites OR 0.59 (95% CI: 0.52–0.66), small rural more likely to have a missed opportunity than urban youth OR 1.8 (95% CI: 1.5–2.2), and preteens more likely than teens OR 2.4 (95% CI: 2.2–2.7). Conclusion Missed clinical opportunities are a significant barrier to HPV vaccination among female adolescents. Interventions targeted at providers who serve patient groups with the highest missed opportunities are needed to achieve adequate protection from HPV-associated illnesses. Impact This is one of the first studies to utilize state immunization information system data to assess missed opportunities for HPV vaccination.
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Affiliation(s)
- Deanna Kepka
- University of Utah, College of Nursing, 10 S 2000 E, Salt Lake City, UT 84112, USA
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT 84112, USA
- Correspondence to: University of Utah, College of Nursing, Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Room 4144, Salt Lake City, UT 84112, USA.University of Utah, College of Nursing, Huntsman Cancer Institute, Cancer Control and Population Sciences2000 Circle of Hope, Room 4144Salt Lake CityUT84112USA
| | - Michael G. Spigarelli
- University of Utah, College of Nursing, 10 S 2000 E, Salt Lake City, UT 84112, USA
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT 84112, USA
- Utah Department of Health, Utah Statewide Immunization Information System, 288 N 1460 W, Salt Lake City, UT 84116, USA
- University of Utah, Department of Pediatrics, 100 N Mario Capecchi Drive, Salt Lake City, UT 84132, USA
| | - Echo L. Warner
- University of Utah, College of Nursing, 10 S 2000 E, Salt Lake City, UT 84112, USA
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT 84112, USA
| | - Yukiko Yoneoka
- Utah Department of Health, Utah Statewide Immunization Information System, 288 N 1460 W, Salt Lake City, UT 84116, USA
| | - Nancy McConnell
- Utah Department of Health, Utah Statewide Immunization Information System, 288 N 1460 W, Salt Lake City, UT 84116, USA
| | - Alfred Balch
- University of Utah, Department of Pediatrics, 100 N Mario Capecchi Drive, Salt Lake City, UT 84132, USA
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Corriero R, Gay JL, Robb SW, Stowe EW. Human Papillomavirus Vaccination Uptake before and after the Affordable Care Act: Variation According to Insurance Status, Race, and Education (NHANES 2006-2014). J Pediatr Adolesc Gynecol 2018; 31:23-27. [PMID: 28756028 DOI: 10.1016/j.jpag.2017.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 07/17/2017] [Accepted: 07/20/2017] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE The purpose of the study was to compare human papillomavirus (HPV) vaccination rates before and after Affordable Care Act (ACA) implementation among women, and examine differences according to insurance status and other sociodemographic variables. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional analysis of the National Health and Nutrition Examination Survey questionnaire data. Participants (n = 4599) were from a random sample of the United States population. INTERVENTIONS AND MAIN OUTCOME MEASURES HPV vaccination status and number of doses received according to age, income, education, race, and insurance coverage. RESULTS Over time, the proportion of women reporting HPV vaccination increased from 16.4% to 27.6%, and reporting vaccination completion (3 doses) increased from 56.8% to 67.2%. After ACA implementation, respondents were 3.3 times more likely to be vaccinated compared with before ACA implementation (95% confidence interval [CI], 2.0-5.5) adjusting for age, race, and insurance coverage. Similarly, respondents were more likely to have received 2 (odds ratio, 2.8; 95% CI, 1.5-5.3) or 3 doses (odds ratio, 5.8; 95% CI, 2.5-13.6). CONCLUSION Vaccination uptake increased in a comparison of waves of data from before and after ACA implementation. This increase in vaccination coverage could be related to the increased preventative service coverage, which includes vaccines, required by the ACA. Future studies might focus on the role insurance has on vaccination uptake, and meeting Healthy People 2020 objectives for vaccination coverage.
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Affiliation(s)
- Rosemary Corriero
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia
| | - Jennifer L Gay
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia.
| | - Sara Wagner Robb
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Ellen W Stowe
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia
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Human papillomavirus knowledge and vaccine acceptability among adolescents in a Greek region. Public Health 2017; 152:145-152. [DOI: 10.1016/j.puhe.2017.07.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 07/26/2017] [Accepted: 07/30/2017] [Indexed: 11/22/2022]
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Dixon BE, Kasting ML, Wilson S, Kulkarni A, Zimet GD, Downs SM. Health care providers' perceptions of use and influence of clinical decision support reminders: qualitative study following a randomized trial to improve HPV vaccination rates. BMC Med Inform Decis Mak 2017; 17:119. [PMID: 28797293 PMCID: PMC5553598 DOI: 10.1186/s12911-017-0521-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 08/07/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) leads to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. Furthermore, providers recommend the HPV vaccine less than half the time for eligible patients. Prior informatics research has demonstrated the effectiveness of computer-based clinical decision support (CDS) in changing provider behavior, especially in the area of preventative services. METHODS Following a randomized clinical trial to test the effect of a CDS intervention on HPV vaccination rates, we conducted semi-structured interviews with health care providers to understand whether they noticed the CDS reminders and why providers did or did not respond to the prompts. Eighteen providers, a mix of medical doctors and nurse practitioners, were interviewed from five publicly-funded, urban health clinics. Interview data were qualitatively analyzed by two independent researchers using inductive content analysis. RESULTS While most providers recalled seeing the CDS reminders, few of them perceived the intervention as effective in changing their behavior. Providers stated many reasons for why they did not perceive a change in their behavior, yet the results of the trial showed HPV vaccination rates increased as a result of the intervention. CONCLUSIONS CDS reminders may be effective at changing provider behavior even if providers perceive them to be of little use. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02551887 Registered on September 15, 2015.
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Affiliation(s)
- Brian E. Dixon
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St, Indianapolis, IN 46202 USA
- Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, 1481 W. 10th St, 11H, Indianapolis, IN 46202 USA
| | - Monica L. Kasting
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202 USA
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, 4115 East Fowler Ave, Tampa, FL 33617 USA
| | - Shannon Wilson
- Department of Pediatrics, Indiana University School of Medicine, 410 W 10th Street Suite 1001, Indianapolis, IN 46202 USA
| | - Amit Kulkarni
- Merck & Co., 2000 Galloping Hill Road, Kenilworth, NJ 07033 USA
| | - Gregory D. Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 W 10th Street Suite 1001, Indianapolis, IN 46202 USA
| | - Stephen M. Downs
- Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St, Indianapolis, IN 46202 USA
- Department of Pediatrics, Indiana University School of Medicine, 410 W 10th Street Suite 1001, Indianapolis, IN 46202 USA
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Kasting ML, Lake P, Vadaparampil ST. Physicians' current use and preferences for male HPV vaccine-related patient education materials. Vaccine 2017; 35:2613-2616. [PMID: 28404356 PMCID: PMC5847390 DOI: 10.1016/j.vaccine.2017.03.098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 03/23/2017] [Accepted: 03/30/2017] [Indexed: 11/17/2022]
Abstract
Understanding physician preferences for educational materials to support male HPV vaccination is critical to improving vaccine uptake. Pediatric (Peds) and Family Medicine (FM) physicians in Florida completed a survey from May-August 2014 assessing current use of male-specific HPV vaccination patient education materials, and preferences for materials to increase HPV vaccination uptake. Peds and FM responses were compared with chi-squared or nonparametric tests. Most participants were FM (53.2%), White (66.6%), non-Hispanic (74.1%), and provided male patients/parents with HPV educational materials (59.1%). More than half (55.5%) provided a CDC factsheet for parents. Peds were more likely to indicate they provide educational materials (p<0.0001) than FM. The preferred source was the CDC (77.8%). Peds preferred using a factsheet as the medium of information more often than FM (85.6% vs. 68.0%; p<0.0001). When asked about preferences for targeted materials, 74.8% of providers indicated they would prefer materials targeted towards patients, 63.2% preferred information targeted towards parents, and 20.7% indicated they prefer non-targeted materials. Future research should focus on the development and testing of new HPV vaccine-specific materials and communication strategies for Peds and FM physicians.
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Affiliation(s)
- Monica L Kasting
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, 4115 East Fowler Avenue, MFC-CRISP, Tampa, FL 33617, United States; Moffitt Cancer Center, Center for Infection Research in Cancer, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL 33612, United States.
| | - Paige Lake
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, 4115 East Fowler Avenue, MFC-CRISP, Tampa, FL 33617, United States.
| | - Susan T Vadaparampil
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, 4115 East Fowler Avenue, MFC-CRISP, Tampa, FL 33617, United States; Moffitt Cancer Center, Center for Infection Research in Cancer, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL 33612, United States; University of South Florida, College of Medicine, 12901 Bruce B. Downs Blvd, MDC 44, Tampa, FL 33612, United States.
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Thompson EL, Vamos CA, Straub DM, Sappenfield WM, Daley EM. "We've Been Together. We Don't Have It. We're Fine." How Relationship Status Impacts Human Papillomavirus Vaccine Behavior among Young Adult Women. Womens Health Issues 2017; 27:228-236. [PMID: 28277236 DOI: 10.1016/j.whi.2016.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/23/2016] [Accepted: 09/19/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vaccination against the human papillomavirus (HPV) has the potential to significantly reduce morbidity and mortality associated with genital warts and HPV-related cancers. However, HPV vaccination rates continue to be suboptimal among the "catch-up" population of 18- to 26-year-old women. One consistent risk factor for nonvaccination is being in a relationship. This study aimed to understand how relationship status and vaccination status impact risk perceptions and perceived need for the HPV vaccine among young adult women. METHODS In-depth interviews were conducted with a sample (n = 50) of recently HPV vaccinated and unvaccinated college women, and stratified by four relationship categories. Comparative thematic analysis was used to assess relationship status and HPV risk perceptions. RESULTS Women in relationships perceived their risk of HPV to be low, which they attributed to monogamy and few sexual partners. Women in dating relationships reported higher HPV risk, which was linked to unprotected sex and sexual activity. In contrast, single women stated that their low risk for HPV was due to sexual inactivity. CONCLUSIONS This study builds on the epidemiological literature, by understanding how relationship status impacts HPV vaccination among young adult women. Relationship status contributed to HPV risk perceptions and vaccination decisions among these women. Perceptions were framed based on sexual behavior, such as monogamy or number of sexual partners. Future efforts should tailor health messages to young adult women's specific risk misperceptions about HPV.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
| | - Diane M Straub
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - William M Sappenfield
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
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Du J, Xu J, Song H, Liu X, Tao C. Optimization on machine learning based approaches for sentiment analysis on HPV vaccines related tweets. J Biomed Semantics 2017; 8:9. [PMID: 28253919 PMCID: PMC5335787 DOI: 10.1186/s13326-017-0120-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 02/07/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Analysing public opinions on HPV vaccines on social media using machine learning based approaches will help us understand the reasons behind the low vaccine coverage and come up with corresponding strategies to improve vaccine uptake. OBJECTIVE To propose a machine learning system that is able to extract comprehensive public sentiment on HPV vaccines on Twitter with satisfying performance. METHOD We collected and manually annotated 6,000 HPV vaccines related tweets as a gold standard. SVM model was chosen and a hierarchical classification method was proposed and evaluated. Additional feature sets evaluation and model parameters optimization was done to maximize the machine learning model performance. RESULTS A hierarchical classification scheme that contains 10 categories was built to access public opinions toward HPV vaccines comprehensively. A 6,000 annotated tweets gold corpus with Kappa annotation agreement at 0.851 was created and made public available. The hierarchical classification model with optimized feature sets and model parameters has increased the micro-averaging and macro-averaging F score from 0.6732 and 0.3967 to 0.7442 and 0.5883 respectively, compared with baseline model. CONCLUSIONS Our work provides a systematical way to improve the machine learning model performance on the highly unbalanced HPV vaccines related tweets corpus. Our system can be further applied on a large tweets corpus to extract large-scale public opinion towards HPV vaccines.
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Affiliation(s)
- Jingcheng Du
- The University of Texas School of Biomedical Informatics, 7000 Fannin St Suite 600, Houston, TX, 77030, USA
| | - Jun Xu
- The University of Texas School of Biomedical Informatics, 7000 Fannin St Suite 600, Houston, TX, 77030, USA
| | - Hsingyi Song
- The University of Texas School of Biomedical Informatics, 7000 Fannin St Suite 600, Houston, TX, 77030, USA
| | - Xiangyu Liu
- The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Cui Tao
- The University of Texas School of Biomedical Informatics, 7000 Fannin St Suite 600, Houston, TX, 77030, USA.
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Cheruvu VK, Bhatta MP, Drinkard LN. Factors associated with parental reasons for "no-intent" to vaccinate female adolescents with human papillomavirus vaccine: National Immunization Survey - Teen 2008-2012. BMC Pediatr 2017; 17:52. [PMID: 28193249 PMCID: PMC5307730 DOI: 10.1186/s12887-017-0804-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 02/01/2017] [Indexed: 11/10/2022] Open
Abstract
Background 1) To identify socio-demographic factors associated with parental “no-intent” for their 13–17 year old unvaccinated daughter to receive the human papillomavirus (HPV) vaccine series within the next twelve months, 2) to describe patterns in “no-intent” by socio-demographic factors, and 3) to identify socio-demographic factors associated with parental reasons for “no-intent”. Methods Data from 2008–2012 National Immunization Survey - Teen (NIS - Teen) were examined in this study. Parents with “no-intent” to vaccinate their daughters were asked to identify reasons for their decision. All responses were categorized into five domains identified as barriers to receive the HPV vaccine series: 1) Safety and Effectiveness Concerns; 2) Systemic Barriers; 3) Vaccine Misinformation; 4) Lack of Knowledge about the Vaccine; and 5) Socio-cultural Barriers. Multivariable logistic regression models were performed to address the study objectives. Results Number of people in the household, household income, mother’s age, education, health insurance, recommendation of a health care provider, and the survey year were significantly associated with parental “no-intent”. Race/ethnicity, mother’s education, marital status, recommendation of a health care provider, household income, age of the unvaccinated daughter, and the survey year, were significantly associated with one or more domains identified as barriers to receive the HPV vaccine. Conclusions This study identified sub-groups of parents across different socio-demographic factors with “no-intent” for their adolescent daughters to receive the HPV vaccine. Developing strategies that target educational tools towards the identified sub-groups of parents about the purpose, safety, and efficacy of the HPV vaccine, and HPV infection, may help increase HPV vaccine acceptance, initiation and completion rates.
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Affiliation(s)
- Vinay K Cheruvu
- Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Hilltop Drive, 320 Lowry Hall, Kent, 44242, OH, USA.
| | - Madhav P Bhatta
- Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Hilltop Drive, 320 Lowry Hall, Kent, 44242, OH, USA
| | - Lauren N Drinkard
- Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Hilltop Drive, 320 Lowry Hall, Kent, 44242, OH, USA
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DiAnna Kinder F. Parental Refusal of the Human Papillomavirus Vaccine. J Pediatr Health Care 2016; 30:551-557. [PMID: 26776841 DOI: 10.1016/j.pedhc.2015.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/21/2015] [Accepted: 11/30/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study was to explore reasons why parents may defer administration of the human papillomavirus (HPV) vaccine to their children. The literature suggests that parents choose to defer administration of this vaccine for several reasons. Data from this pilot study will contribute to our understanding of why parents defer administration of the vaccine. METHOD This mixed-methods study took place in a pediatric practice. After a health care visit in which the vaccine was deferred, a survey was provided to the parent in a private room. The survey was confidential and anonymous. RESULTS A total of 23 surveys were completed. Demographic data were reported. Data were analyzed for descriptive statistics and themes from open-ended questions. The majority of parents (75%) deferred administration of the HPV vaccine because they believed it was too new or required further research. DISCUSSION Nurse practitioners are in an excellent position to dispel myths and clarify information about HPV vaccination. The data are useful in communicating with parents and promoting best practices to facilitate good health in children.
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