Cross-sectional associations between psychological traits, and HPV vaccine uptake and intentions in young adults from the United States

The effect of education based on planned behavior theory on women's knowledge and attitudes about human papillomavirus

Human papillomavirus is the most common sexually transmitted infection in the world. Improving knowledge and attitude is the key to controlling and preventing, but women's knowledge about this virus is not enough. This study aimed to determine the effect of educational intervention based on planned behavior theory on knowledge and attitude toward HPV and its vaccination in women of reproductive age. The study was a single-blind, randomized clinical trial study with a control group was done in 2022, which was conducted on 85 women referred to selected comprehensive health centers in Shiraz, Iran. In this study, the sampling was performed is a multi-stage random way. Eighty-three women who met the inclusion criteria were randomly divided into two intervention and control groups. The data collection tool was the knowledge and attitude questionnaire about HPV and its vaccine, which was confirmed to be valid and reliable. Data analysis was performed with descriptive and analytic statistics at a significance level of P < 0.05 with SPSS (22) software. The results showed that the educational intervention has caused a significant increase in the components of knowledge, attitude, social norms, perceived behavior control, and willingness to receive the HPV vaccine in the intervention group. So that in both stages after the intervention, there was a significant difference between the intervention group and the control group in the studied components (P < 0.05). The educational intervention based on the planned behavior theory significantly affected the knowledge, attitude, social norms, and intention for HPV vaccination in women of reproductive age. Therefore, educational intervention recommended as awareness-raising programs and strategies for women.Trial registration: (RCT code: IRCT20220131053891N1). First Registration date: 28/04/2022.

How does collectivism help deal with perceived vaccine artificiality? The case of COVID-19 vaccination intent in European young adults

Vaccine "unnaturalness" (artificiality) is one of the major anti-vaccine arguments raised in public debate. Therefore, health communication should rebut unnaturalness arguments and be cautious when emphasizing human intervention (e.g., advanced vaccine technology), which may entail perceiving vaccines as artificial. Understanding how the relationship between perceived vaccine artificiality and vaccination intent differs across social groups can help enforce the above health communication efforts by focusing them on specific audiences. The objective of the current paper is to assess the moderating role of a particular socio-cultural factor-vertical collectivism (reflecting the orientation on social hierarchy)-in the relationship between perceived vaccine artificiality and vaccination intent. It is proposed that vertical collectivism diminishes the negative effect of perceived vaccine artificiality. Two studies with European young adults measured COVID-19 vaccination intent and vertical collectivism. Study 1 (N = 418) was correlational, measuring perceived vaccine artificiality. The data were analyzed with a moderation model. Study 2 (N = 203) was experimental, manipulating perceived vaccine artificiality by human-intervention appeal (i.e., emphasizing human intervention in vaccine development and operation). The data were analyzed with moderation and moderated mediation models. Study 1 demonstrated that the effect of perceived vaccine artificiality on vaccination intent was less negative when the level of vertical collectivism was higher. In Study 2, with higher levels of vertical collectivism, the effect of human-intervention appeal on vaccination intent was less negative, and the indirect effect through perceived vaccine artificiality turned even positive. Those results contribute to the fields of perceived naturalness/artificiality, vaccination behavior, health communication, and cultural dimensions theory, providing empirical evidence that the negative effect of perceived vaccine artificiality on vaccination intent is diminished by vertical collectivism, as proposed. Health practitioners are guided on how to consider different levels of collectivism of their audiences while referring to vaccine artificiality in their communication. Specifically, it is suggested that rebutting "unnaturalness" anti-vaccine arguments should be focused on people low in vertical collectivism, and messages featuring human intervention (e.g., a vaccine's technological advancement) should be targeted at people high in vertical collectivism.

Coping during COVID-19: how attitudinal, efficacy, and personality differences drive adherence to protective measures

INTRODUCTION

COVID-19 has had a devastating impact on people's lives since its initial outbreak and global spread in 2020. While the U.S. government and public health officials have recommended best practices such as social distancing, wearing a mask, and avoiding large public gatherings, these orders have been met with varying levels of acceptance from the public. Given the disparate compliance, this study builds on Social Cognitive Theory (SCT) to explore individual differences and personal motivation factors in order to better understand what may influence one's likelihood to adhere to COVID-19 protective measures.

METHODS

A U.S. national survey (N = 2,049) was conducted April-May 2020, roughly one month after stay-at-home orders were issued in some states. Participants were asked to report their likelihood of taking individual and community protective measures. Multivariate hierarchical linear regressions were run to analyze the extent to which participants' concerns about COVID-19's impact, individual and collective self-efficacy, coping behaviors, and personality traits influenced the dependent variables.

RESULTS

Findings showed that COVID-19-related health concerns, collective efficacy, and proactive coping strategies were positively related to participants' likelihood of taking protective measures. Those with greater concerns about their general well-being and the economy, adverse coping strategies like denial and joking, as well as sensation-seeking personalities, were less likely to take protective measures.

CONCLUSION

The discussion considers how individual differences fit into broader global efforts to stem COVID-19. Practical implications for public health messaging are that communication may focus on facilitating efficacy in order to boost compliance with protective measures.

The Social Contagion Potential of Pro-Vaccine Messages on Black Twitter

Black Americans in the US not only suffered from disproportionately high hospitalization and death rates throughout the pandemic but also from the consequences of low COVID-19 vaccination rates. This pattern of disparity is linked to distrust of public health systems that originates from a history of medical atrocities committed against Black people. For that reason, mitigation of race-based inequity in COVID-19 impacts might find more success in grassroots information contagion than official public health campaigns. While Black Twitter is well-positioned as a conduit for such information contagion, little is known about message characteristics that would afford it. Here, we tested the impact of four different message frames (personalization, interactive, fear appeal, neutral) on the social contagion potential of bi-modal social media messages promoting COVID-19 vaccinations and finding personalized messages to be the most shareable. Wary of recommending personalization as the blueprint for setting a social contagion health campaign in motion, we probed further to understand the influence of individual-level variables on the communicability of personalized messages. Subsequently, regression models and focus group data were consulted, revealing that thinking styles, vaccine confidence levels, and attitudes toward social media were significant factors of influence on the contagion potential of personalized messages. We discussed the implications of these results for health campaigns.

What do Young People Think About HPV and HPV Vaccination? The Role of Health Education Interventions and Health Professionals

Background

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and its highest prevalence is observed in adolescents and young adults. This review examined studies that explore awareness about HPV among adolescents and young adults, as well as their attitudes and willingness towards the HPV vaccine. Besides, the impact of health professionals and health education interventions on HPV awareness and attitudes towards HPV vaccine is identified.

Objective

The aim of this review is, firstly, to systematically identify the studies that explore awareness about HPV among adolescents and young adults, as well as their attitudes and willingness towards the HPV vaccine. Secondly, the aim is to identify the impact of health professionals and health education interventions on HPV awareness and attitudes towards HPV vaccine among the same group.

Methods

The systematic review was conducted in the international databases PubMed, Scopus, and Google Scholar, between 2016-2019.

Results

The review revealed low to moderate levels of awareness and knowledge regarding HPV (10 studies), while a more favorable attitude towards the HPV vaccine (3 studies). The role of health professionals was ineffective (4 studies), while studies focused on the impact of health education interventions showed a positive impact on knowledge and awareness of HPV (4 studies).

Conclusion

Continuous training of health personnel is necessary and new studies are needed to identify barriers to adolescents not being vaccinated.

A Digital Personal Health Library for Enabling Precision Health Promotion to Prevent Human Papilloma Virus-Associated Cancers

Human papillomavirus (HPV) causes the most prevalent sexually transmitted infection (STI) in the United States. Sexually active young adults are susceptible to HPV, accounting for approximately 50% of new STIs. Oncogenic HPV subtypes 16 and 18 are associated with squamous intraepithelial lesions and cancers and are mostly preventable through prophylactic HPV vaccination. Accordingly, this study's objectives are to (1) summarize SDoH barriers and implication for low HPV vaccination rates among young adults (18-26 years), (2) propose a digital health solution that utilizes the PHL to collect, integrate, and manage personalized sexual and health information, and (3) describe the features of the PHL-based app. Through the application of novel techniques from artificial intelligence, specifically knowledge representation, semantic web, and natural language processing, this proposed PHL-based application will compile clinical, biomedical, and SDoH data from multi-dimensional sources. Therefore, this application will provide digital health interventions that are customized to individuals' specific needs and capacities. The PHL-based application could promote management and usage of personalized digital health information to facilitate precision health promotion thereby, informing health decision-making regarding HPV vaccinations, routine HPV/STI testing, cancer screenings, vaccine safety/efficacy/side effects, and safe sexual practices. In addition to detecting vaccine hesitancy, disparities and perceived barriers, this application could address participants' specific needs/challenges with navigating health literacy, technical skills, peer influence, education, language, cultural and spiritual beliefs. Precision health promotion focused on improving knowledge acquisition and information-seeking behaviors, promoting safe sexual practices, increasing HPV vaccinations, and facilitating cancer screenings could be effective in preventing HPV-associated cancers.

Contribution of rationality to vaccine attitudes: Testing two hypotheses

Although previous studies have demonstrated an association between vaccine attitudes and cognitive biases, often resulting in vaccination hesitancy, the exact contribution of rationality has not been fully clarified. We tested two hypotheses regarding the impact of rationality on vaccine attitudes stemming from bounded and expressive rationality. We focused on parental vaccine attitudes operationalized by the affective, behavioral, and cognitive attitude components and investigated how these are influenced by disillusionment toward authorities and ability to engage in rational thinking operationalized using cognitive reflection and heuristics and biases tasks. The study was of a cross‐sectional correlational design with a non‐probabilistic sample of 823 volunteer participants surveyed online in April and May 2018 in Croatia. The results identified disillusionment toward authorities as a predictor of all components. Furthermore, performance on heuristics and biases tasks also predicted the affective and cognitive, but not the behavioral component, whereas cognitive reflection had no impact on vaccine attitudes. Next, a moderation effect of disillusionment toward authorities on the association between the omission bias task and all attitude components was identified. Parents with low disillusionment demonstrated positive vaccine attitudes regardless of their rationality, whereas for parents with high disillusionment a significant positive correlation between performance on the omission bias task as assessed with a vaccination vignette and attitudes was identified. This suggests that the ability to resist vaccine specific omission bias, that is, higher rationality, can decrease the negative effects of disillusionment, which supports the bounded rationality hypothesis.

The role of intuition in vaccination attitudes

This study tested the idea that faith in intuition (people’s reliance on their intuition when making judgments or decisions) is negatively associated with vaccination attitudes in the U.S. populace. Intuition is an implicit, affective information processing mode based on prior experiences. U.S. citizens have few threatening experiences with vaccines because vaccination coverage for common vaccine-preventable diseases is high in the United States. Experiences with vaccination-side effects, however, are more prevalent. This is likely to shape an intuition that favors refusal over vaccination. Results of multiple regression analyses support this supposition. With increasing faith in intuition, people’s vaccination attitudes become less favorable.

A clinical update on vaccines: focus on determinants of under-immunization and special considerations for adolescents

PURPOSE OF REVIEW

The current article reviews recent literature related to pediatric and adolescent vaccination, specifically focusing on social determinants of under-immunization, expanding adolescent immunization rates, and new recommendations surrounding the meningococcal serotype B vaccine (MenB).

RECENT FINDINGS

Vaccine refusals and vaccine-preventable diseases have been rising in some parts of the world, and appear to be linked to household factors, such as a family's socioeconomic status. Adolescents have lower immunization rates than younger children. Newer vaccines targeted at adolescents, such as the MenB vaccine, have yet to be widely accepted by pediatric providers, parents, and patients.

SUMMARY

Pediatric healthcare providers should attempt to increase local immunization rates by vaccinating children at all eligible office visits and utilizing electronic health record decision-support tools. Although the number of families who choose not to vaccinate their children may be rising, providers can be innovative (e.g. incorporate digital vaccine reminder systems) and increase their familiarity with new vaccine recommendations to continue to prevent serious vaccine-preventable diseases.

Knowledge, attitudes and awareness of the human papillomavirus among health professionals in New Zealand

Background

Human papillomavirus (HPV) is a common sexually transmitted infection that is implicated in 99.7% of cervical cancers and several other cancers that affect both men and women. Despite the role that HPV plays in an estimated 5% of all cancers and the evolving role of HPV vaccination and testing in protecting the public against these cancers, preliminary research in New Zealand health professionals suggest knowledge about HPV may not be sufficient.

Methods

A total of 230 practice nurses, smear takers and other clinical and laboratory staff who attended a range of training events completed a cross-sectional survey between April 2016 and July 2017. The survey explored four broad areas: demographics and level of experience, HPV knowledge (general HPV knowledge, HPV triage and test of cure (TOC) knowledge and HPV vaccine knowledge), attitudes towards the HPV vaccine and self-perceived adequacy of HPV knowledge.

Results

The mean score on the general HPV knowledge questions was 13.2 out of 15, with only 25.2% of respondents scoring 100%. In response to an additional question, 12.7% thought (or were unsure) that HPV causes HIV/AIDS. The mean score on the HPV Triage and TOC knowledge questions was 7.4 out of 10, with only 9.1% scoring 100%. The mean score on the HPV vaccine knowledge questions was 6.0 out of 7 and 44.3% scored 100%. Only 63.7% of respondents agreed or strongly agreed that they were adequately informed about HPV, although 73.3% agreed or strongly agreed that they could confidently answer HPV-related questions asked by patients. Multivariate analyses revealed that knowledge in each domain predicted confidence in responding to patient questions. Furthermore, the number of years since training predicted both HPV knowledge and Triage and TOC knowledge.

Discussion

Although overall level of knowledge was adequate, there were significant gaps in knowledge, particularly about the role of HPV testing in the New Zealand National Cervical Screening Programme. More education is required to ensure that misinformation and stigma do not inadvertently result from interactions between health professionals and the public.