1
|
Lindsay AC, Delgado D, Valdez MJ, Granberry P. Latinx fathers report low awareness and knowledge of the human papillomavirus vaccine, but high willingness to vaccinate their children if recommended by a healthcare provider: A qualitative study. Glob Public Health 2022; 17:2883-2897. [PMID: 34605379 PMCID: PMC8976858 DOI: 10.1080/17441692.2021.1985580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022]
Abstract
This descriptive qualitative study explored Latinx fathers' awareness, knowledge, and acceptability of the human papillomavirus (HPV) vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analysed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Nineteen, majority foreign-born Latinx fathers participated. Four main themes and two subthemes emerged from the analyses. Results found fathers' low awareness and knowledge of HPV and the HPV vaccine. Results also identified fathers' positive attitudes toward vaccines in general. Moreover, results revealed fathers trust in healthcare providers and high willingness to vaccinate their children against HPV if recommended by their child's primary healthcare provider. Findings indicate the need for increased efforts to raise awareness and knowledge among Latinx fathers of HPV and the HPV vaccine. Given the limited research focused on Latinx fathers, the study's findings are valuable in building a knowledge foundation for developing future studies and interventions to promote the HPV vaccine targeting Latinx fathers living in the United States. Future research should quantify Latinx fathers' awareness, knowledge, and acceptability of the HPV vaccine for their sons and daughters and assess fathers' role in the decision-making process to vaccinate their children against HPV.
Collapse
Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Denisse Delgado
- Department of Public Policy and Public Affairs, McCormack Graduate School of Policy and Global Studies, University of Massachusetts—Boston, Massachusetts, USA
| | - Madelyne J. Valdez
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Phillip Granberry
- College of Liberal Arts and The Mauricio Gastón Institute for Latino Community Development and Public Policy, University of Massachusetts—Boston, Massachusetts, USA
| |
Collapse
|
2
|
Castañeda-Avila MA, Oramas Sepúlveda CJ, Pérez CM, Ramos-Cartagena JM, Acosta Pagán K, Pérez-Santiago J, Godoy-Vitorino F, Ortiz AP. Sex and educational attainment differences in HPV knowledge and vaccination awareness among unvaccinated-sexually active adults in Puerto Rico. Hum Vaccin Immunother 2022; 18:2077065. [PMID: 35695750 PMCID: PMC9481100 DOI: 10.1080/21645515.2022.2077065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Human papillomavirus (HPV) knowledge and HPV vaccination uptake remain suboptimal. We assessed sex and educational attainment differences in HPV knowledge and vaccine awareness. Data from a cross-sectional study (2018–2021) in Puerto Rico among adults aged 21–49 was analyzed (n = 278). Adequate knowledge was defined as a score of ≥70% of correct responses on a 13-item knowledge scale. Multivariable logistic regression was used to assess the association of sex (men vs. women) and education (high school or less vs. more than high school) categories with adequate HPV knowledge and vaccine awareness. Adequate HPV knowledge was higher among women (53%) and men (46%) with more than high school and was lower among women (46%) and men (27%) with high school or less. For HPV vaccine awareness, similar results were observed. Women (OR = 3.0 ; 95%CI = 1.4–6.2) and men (OR = 2.3 , 95%CI = 1.1–4.8) with more than high school and women with high school or less (OR = 2.3 , 95%CI = 1.0–5.2) were more likely to have adequate HPV vaccine knowledge than men with high-school or less education. Heightened HPV vaccine awareness was also seen among more educated women and men and women with similar lower education when compared to men with ≤ high school. Men and individuals with lower educational attainment were more likely to have inadequate HPV knowledge and vaccine awareness. HPV vaccine-oriented educational interventions should target these high-risk groups.
Collapse
Affiliation(s)
- Maira A Castañeda-Avila
- Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Carla J Oramas Sepúlveda
- Division of Cancer Control and Population Sciences, Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Cynthia M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - Jeslie M Ramos-Cartagena
- University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research, University of Puerto Rico, San Juan, Puerto Rico
| | - Kimil Acosta Pagán
- Department of Microbiology and Medical Zoology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Josué Pérez-Santiago
- Division of Cancer Control and Population Sciences, Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Filipa Godoy-Vitorino
- Department of Microbiology and Medical Zoology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Ana P Ortiz
- Division of Cancer Control and Population Sciences, Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.,Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| |
Collapse
|
3
|
Kong WY, Bustamante G, Pallotto IK, Margolis MA, Carlson R, McRee AL, Gilkey MB. Disparities in Healthcare Providers' Recommendation of HPV Vaccination for U.S. Adolescents: A Systematic Review. Cancer Epidemiol Biomarkers Prev 2021; 30:1981-1992. [PMID: 34426414 DOI: 10.1158/1055-9965.epi-21-0733] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/10/2021] [Accepted: 08/11/2021] [Indexed: 01/19/2023] Open
Abstract
Infrequent provider recommendations continue to be a key barrier to human papillomavirus (HPV) vaccination, including among adolescents at higher risk for future HPV cancers. To inform future interventions, we sought to characterize disparities in health care providers' HPV vaccine recommendation for U.S. adolescents. We systematically reviewed studies published in 2012-2019 that assessed provider HPV vaccine recommendations for adolescents aged 9-17. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified 52 eligible studies and used a standardized abstraction form to assess recommendation prevalence by adolescent demographic characteristics. Studies consistently found that fewer parents of boys than girls reported receiving HPV vaccine recommendations (14 studies, range of difference: -11 to -35 percentage points). Studies also found fewer recommendations for adolescents who were younger (2 studies, -3% to -12% points), non-White (3 studies, -5% to -7% points, females only), lower income (3 studies, -1% to -8% points), or uninsured (1 study, -21% points, males only). Studies identified geographic disparities in southern and rural areas. In conclusion, findings from this systematic review identify disparities in HPV vaccine recommendation that may contribute to suboptimal vaccine uptake. Efforts to improve providers' HPV vaccine communication should focus on increasing recommendation consistency, especially for lower-income, non-White, and rural adolescents.
Collapse
Affiliation(s)
- Wei Yi Kong
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gabriela Bustamante
- Medical School, University of Minnesota, Minneapolis, Minnesota.,School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Isabella K Pallotto
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marjorie A Margolis
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rebecca Carlson
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Melissa B Gilkey
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. .,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
4
|
Oh NL, Biddell CB, Rhodes BE, Brewer NT. Provider communication and HPV vaccine uptake: A meta-analysis and systematic review. Prev Med 2021; 148:106554. [PMID: 33857561 DOI: 10.1016/j.ypmed.2021.106554] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 04/06/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022]
Abstract
Provider communication can be critically important to families as they consider HPV vaccination. We sought to characterize the association of provider communication and HPV vaccine uptake, and when communication better motivates vaccination. We searched four databases for studies published between 2006 and 2019. Eligible studies examined health care provider communication (defined as recommendation or discussion) and HPV vaccine uptake (defined as initiation, completion, or follow-through) in the US. Two coders independently identified eligible studies and coded effect sizes and study characteristics. We pooled effect sizes using random-effects meta-analysis. We identified 59 eligible studies of 265,083 patients. Receiving a provider recommendation was associated with higher HPV vaccine initiation (pooled OR = 10.1, 95% CI: 7.6-13.4). HPV vaccine initiation was 24% for patients without and 60% for patients with a provider recommendation. The pooled effect size for provider recommendation and initiation was smaller for probability samples, clinical records, and NIS-Teen (all p < 0.002). Recommendations were equally effective for males and females, for different patient ages, and over time. Provider recommendation was also associated with higher HPV vaccine series completion and follow-through. Provider discussion was similarly associated with higher HPV vaccine initiation (OR = 12.4, 95% CI: 6.3-24.3). In summary, provider communication was robustly associated with HPV vaccination initiation, completion, and follow-through. These findings suggest that US public health efforts to increase HPV vaccine coverage should continue to emphasize provider communication.
Collapse
Affiliation(s)
- N Loren Oh
- University of North Carolina School of Medicine, United States of America; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, United States of America
| | - Caitlin B Biddell
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, United States of America
| | - Blythe E Rhodes
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, United States of America
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina, United States of America.
| |
Collapse
|
5
|
Perceived Barriers and Trends in HPV Vaccination via Patient Survey Responses at Kalamazoo, Michigan's Federally-Qualified Health Center. J Community Health 2020; 45:48-54. [PMID: 31392602 DOI: 10.1007/s10900-019-00719-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. Despite numerous studies proving the safety and efficacy of the HPV vaccine, immunization rates remain low, especially among underserved populations. To identify factors contributing to low HPV vaccination rates, patients at a federally qualified health center in Kalamazoo MI were surveyed. Surveys were administered during routine patient visits to determine self-reported vaccination status and vaccination barriers. A total of 98 vaccine-eligible (males/females, ages 9-26 years old) patients/guardians completed the survey. In all, 46% of respondents completed the multi-dose vaccination course, and 56% of those identified as female. White patients reported higher vaccination rates (50%) than patients of color (45%). Of those vaccinated, the most common reason was "physician recommendation" (39%). Those not fully vaccinated most commonly reported being "too young" (39%). Importantly, individuals who had begun, but not completed, the vaccination course reported that their provider had not spoken to them about future vaccines in the series (74%). This study revealed disparities in vaccination rates between the sexes and racial groups, and emphasized the influential role of physician's recommendation on vaccination. Interestingly, other frequently cited barriers to vaccination-an association with sex, personal/religious beliefs, efficacy-proved to be insignificant barriers for this population. Instead, age-related misunderstandings and lack of consistent physician communication about vaccination provided significant barriers. Based on our results, education and reminders about the HPV vaccine by providers is a significant tool to maximize vaccination coverage.
Collapse
|
6
|
CELLA PAOLA, VOGLINO GIANLUCA, BARBERIS ILARIA, ALAGNA ENRICO, ALESSANDRONI CLAUDIA, CUDA ALESSANDRO, D’ALOISIO FRANCESCO, DALLAGIACOMA GIULIA, DE NITTO SARA, DI GASPARE FRANCESCA, GALLIPOLI ORIANA, GENTILE LEANDRO, KUNDISOV LUCIA, NAVARO MONICA, PROVENZANO SANDRO, SANTANGELO OMARENZO, STEFANIZZI PASQUALE, GIANFREDI VINCENZA. Resources for assessing parents' vaccine hesitancy: a systematic review of the literature. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E340-E373. [PMID: 33150224 PMCID: PMC7595070 DOI: 10.15167/2421-4248/jpmh2020.61.3.1448] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
The concept of Vaccine Hesitancy has begun to appear in the scientific landscape, referring to the reluctance of a growing proportion of people to accept the vaccination offer. A variety of factors were identified as being associated with vaccine hesitancy but there was no universal algorithm and currently there aren’t any established metrics to assess either the presence or impact of vaccine hesitancy. The aim of this study was to systematically review the published questionnaires evaluating parental vaccine hesitancy, to highlight the differences among these surveys and offer a general overview on this matter. This study offers a deeper perspective on the available questionnaires, helping future researches to identify the most suitable one according to their own aim and study setting.
Collapse
Affiliation(s)
- PAOLA CELLA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - GIANLUCA VOGLINO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, University of Turin, Italy
| | - ILARIA BARBERIS
- Health Science Department, University of Genoa, Italy
- Correspondence: Ilaria Barberis, Health Science Department, University of Genoa, largo Rosanna Benzi 10, Pad. 3 San Martino Hospital, Italy - Tel./Fax +39 010 3538502 - E-mail:
| | - ENRICO ALAGNA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - CLAUDIA ALESSANDRONI
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ALESSANDRO CUDA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - FRANCESCO D’ALOISIO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - GIULIA DALLAGIACOMA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - SARA DE NITTO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - FRANCESCA DI GASPARE
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ORIANA GALLIPOLI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - LEANDRO GENTILE
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - LUCIA KUNDISOV
- Post Graduate School of Public Health, University of Siena, Italy
| | - MONICA NAVARO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Campania “L. Vanvitelli”, Italy
| | - SANDRO PROVENZANO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - OMAR ENZO SANTANGELO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - PASQUALE STEFANIZZI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - VINCENZA GIANFREDI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Italy
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
7
|
Central American Immigrant Parents' Awareness, Acceptability, and Willingness to Vaccinate Their Adolescent Children Against Human Papillomavirus: A Pilot Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082869. [PMID: 32326320 PMCID: PMC7215825 DOI: 10.3390/ijerph17082869] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/13/2020] [Accepted: 04/15/2020] [Indexed: 12/15/2022]
Abstract
Despite increasing interest in understanding the factors influencing awareness and acceptability of the human papillomavirus (HPV) vaccine among Latino parents, to date limited information is available specific to Central American parents living in the United States (US). Therefore, this pilot cross-sectional study was designed to explore and assess Central American immigrant parents’ awareness, acceptability, and willingness to vaccinate their children against HPV, and interest in participating in future HPV-associated cancer prevention study. Fifty-six Central American parents, majority immigrant (96.4%; n = 54) from four countries, El Salvador—50% (n = 27); Guatemala—25.9% (n = 14); Honduras—22.2% (n = 12); and Panama—1.9% (n = 1) participated in this study. Participants completed an interviewer-administered questionnaire survey in their preferred language (i.e., Spanish or English). A little over half of the participants were mothers (57.1%; n = 32) and parents’ mean age was 43.2 years (SD = 6.4). The majority was married or cohabitating (76.8%, n = 43), and 39.3% (n = 22) reported having two children. Seventy-five percent (n = 42) of parents reported they had heard of the HPV vaccine. Fewer fathers were aware of the HPV vaccine (58.3%; n = 14 vs.87.5%, n = 28; p = 0.01) than mothers. Among parents who had heard of the HPV vaccine (n = 42), 85.7% (n = 36) reported their children had received at least one dose of the HPV vaccine. Fewer fathers reported their child had been vaccinated against HPV (64.3%, n = 9 vs. 96.4%, n = 27; p = 0.06) than mothers. Moreover, 90% of parents (n = 18) whose children were unvaccinated reported willingness to vaccinate their adolescent children against HPV if recommended by their child’s physician. Findings indicate parents’ low to moderate awareness of the HPV vaccine, and high willingness to vaccinate their adolescent children if recommended by their child’s physician. Findings also demonstrate fathers’ lower awareness and acceptability of the HPV vaccine than mothers. Despite limitations and the need for more research, findings of this pilot study serve as a valuable first step toward building a knowledge foundation that is needed for developing future studies and interventions targeting Central American immigrant parents living in the US. Future studies can build on the findings of this exploratory study with other research designs and address its limitations by having a larger sample size and accounting for additional factors associated with Central American immigrant parents’ HPV awareness, knowledge, beliefs, attitudes, and vaccine acceptability from other communities across the US.
Collapse
|
8
|
Lindsay AC, Greaney ML, Rabello LM, Kim YY, Wallington SF. Brazilian Immigrant Parents' Awareness of HPV and the HPV Vaccine and Interest in Participating in Future HPV-Related Cancer Prevention Study: an Exploratory Cross-Sectional Study Conducted in the USA. J Racial Ethn Health Disparities 2020; 7:829-837. [PMID: 31953637 DOI: 10.1007/s40615-020-00704-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 12/19/2022]
Abstract
This exploratory community-based study assessed Brazilian immigrant parents' awareness of HPV and the HPV vaccine, HPV information sources, and their interest in participating in a future HPV-related cancer prevention study. This study is a cross-sectional analysis of data from a convenience sample of Brazilian immigrant parents living in selected cities in Massachusetts. Participants completed a brief survey in their language of preference (English or Portuguese) administered by bilingual interviewers. Forty-seven Brazilian immigrant parents, each representing a unique family, participated in the study. All participants completed the survey in Portuguese. Although the majority reported being aware of HPV (93.6%, n = 44), only 74.5% (n = 35) were aware of the HPV vaccine. Fewer fathers than mothers had heard of the HPV vaccine (61.9%; n = 13 vs. 84.6%, n = 22; p = 0.04). Of those who were aware of the HPV vaccine (n = 35), 82.6% (n = 29) reported hearing about the HPV vaccine from their child's physician. Additionally, nearly all participants (97.9%, n = 46) reported being interested in participating in future HPV-related cancer prevention study. Findings of this exploratory study indicate parents' low to moderate awareness of the HPV vaccine and high interest in participating in future HPV-related cancer prevention study. These findings are important and serve as a valuable first step toward building a knowledge foundation that is critically needed for developing future studies targeting Brazilians immigrant parents and adolescents living in the USA.
Collapse
Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA.
| | - Mary L Greaney
- Department of Health Studies, University of Rhode Island, Kingston, RI, USA
| | - Luísa M Rabello
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - YuJin Y Kim
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | | |
Collapse
|
9
|
Exploring HPV Knowledge, Awareness, Beliefs, Attitudes, and Vaccine Acceptability of Latino Fathers Living in the United States: An Integrative Review. J Community Health 2019; 44:844-856. [PMID: 30847716 DOI: 10.1007/s10900-019-00636-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
To conduct an integrative review to identify and synthesize studies exploring human papillomavirus (HPV) knowledge, awareness, beliefs, attitudes, and acceptability of the HPV vaccine among Latino fathers living in the United States. The review methodology was informed by those developed by Whittemore and Knafl, which allow for the inclusion of qualitative, quantitative, and mixed methods studies. Using the preferred reporting items for systematic reviews meta-analyses guidelines, five electronic databases (PubMed, Medline, PsycINFO, CINAHL, Science Direct) were searched for peer-reviewed, full-text studies published in English with samples that included Latino fathers and examined knowledge, awareness, beliefs, attitudes about the HPV and the HPV vaccines. Studies that did not provide information on the inclusion of fathers in the sample were excluded. Identified eligible studies were analyzed and synthesized using the matrix method. Eleven eligible studies were identified. Most (n = 10) included mothers and fathers. One study included only fathers, and this study determined that although fathers held positive attitudes toward the HPV vaccine, a notable number of participants were unsure of or had not formed an opinion about the HPV vaccine. Fathers felt that a recommendation from their child's physician would impact whether they vaccinated their child. Moreover, of the ten studies including both parents, only two specifically compared fathers' and mothers' knowledge and awareness about the HPV and vaccine acceptability. These two studies determined that fathers were less aware of the HPV and had lower HPV vaccine-related knowledge than mothers. Nevertheless, all of the 11 examined studies, found moderate to high acceptability of the HPV vaccine among Latino parents despite uncertainty about possible vaccine risks and costs. Only 11 studies were identified that included Latino fathers. Of these studies, only one was conducted exclusively with Latino fathers and two compared fathers and mothers. Additional research focusing on Latino fathers is needed given the central role of the family in the Latino culture and the shared role fathers and mothers have in decision-making related to their children's health.
Collapse
|
10
|
Newman PA, Logie CH, Lacombe-Duncan A, Baiden P, Tepjan S, Rubincam C, Doukas N, Asey F. Parents' uptake of human papillomavirus vaccines for their children: a systematic review and meta-analysis of observational studies. BMJ Open 2018; 8:e019206. [PMID: 29678965 PMCID: PMC5914890 DOI: 10.1136/bmjopen-2017-019206] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 02/22/2018] [Accepted: 03/02/2018] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To examine factors associated with parents' uptake of human papillomavirus (HPV) vaccines for their children. DESIGN Systematic review and meta-analysis. DATA SOURCES Cochrane Library, AIDSLINE, CINAHL, EMBASE, PsycINFO, Social Sciences Abstracts, Ovid MEDLINE, Scholars Portal, Social Sciences Citation Index and Dissertation Abstracts International from inception through November 2017. METHODS We included studies that sampled parents and assessed uptake of HPV vaccines for their children (≤18 years) and/or sociodemographics, knowledge, attitudes or other factors associated with uptake. Study risk of bias was assessed using the Effective Public Health Practice Project tool. We pooled data using random-effects meta-analysis and conducted moderation analyses to examine variance in uptake by sex of child and parent. RESULTS Seventy-nine studies on 840 838 parents across 15 countries were included. The pooled proportion of parents' uptake of HPV vaccines for their children was 41.5% (range: 0.7%-92.8%), twofold higher for girls (46.5%) than for boys (20.3%). In the meta-analysis of 62 studies, physician recommendation (r=0.46 (95% CI 0.34 to 0.56)) had the greatest influence on parents' uptake, followed by HPV vaccine safety concerns (r=-0.31 (95% CI -0.41 to -0.16)), routine child preventive check-up, past 12 months (r=0.22 (95% CI 0.11 to 0.33)) and parents' belief in vaccines (r=0.19 (95% CI 0.08 to 0.29)). Health insurance-covered HPV vaccination (r=0.16 (95% CI 0.04 to 0.29)) and lower out-of-pocket cost (r=-0.15 (95% CI -0.22 to -0.07)) had significant effects on uptake. We found significant moderator effects for sex of child. CONCLUSIONS Findings indicate suboptimal levels of HPV vaccine uptake, twofold lower among boys, that may be improved by increasing physician recommendations, addressing parental safety concerns and promoting parents' positive beliefs about vaccines, in addition to expanding insurance coverage and reducing out-of-pocket costs. Limitations of this meta-analysis include the lack of intervention studies and high risk of bias in most studies reviewed. Further studies should disaggregate HPV vaccine uptake by sex of child and parent.
Collapse
Affiliation(s)
- Peter A Newman
- Centre for Applied Social Research, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Carmen H Logie
- Centre for Applied Social Research, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Ashley Lacombe-Duncan
- Centre for Applied Social Research, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Suchon Tepjan
- Centre for Applied Social Research, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Clara Rubincam
- Centre for Applied Social Research, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nick Doukas
- Centre for Applied Social Research, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Farid Asey
- Centre for Applied Social Research, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|