1
|
Amboree TL, Darkoh C. Barriers to Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: a Systematic Review. J Racial Ethn Health Disparities 2020; 8:1192-1207. [PMID: 33025422 DOI: 10.1007/s40615-020-00877-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/21/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is associated with poor health outcomes, including cervical cancer. Racial/ethnic minority populations experience poor health outcomes associated with HPV at higher rates. A vaccine is available to protect against HPV infections and prevent HPV-related sequelae; however, vaccination rates have remained low in the United States (U.S.) population. Thus, there is an urgent need to increase the HPV vaccination rate. Moreover, little is known about barriers to HPV vaccination in racial/ethnic minority groups. This paper highlights the most recent findings on barriers experienced by these groups. METHODS The PubMed database was searched on July 30, 2020, for peer-reviewed articles and abstracts that had been published in English from July 2010 to July 2020 and covered racial/ethnic disparities in HPV vaccination. RESULTS Similar findings were observed among the articles reviewed. The low HPV vaccination initiation and completion rates among racial/ethnic minority populations were found to be associated with lack of provider recommendations, inadequate knowledge and awareness of HPV and HPV vaccination, medical mistrust, and safety concerns. CONCLUSIONS Provider recommendations and accurate distribution of information must be increased and targeted to racial/ethnic minority populations in order to bolster the rate of vaccine uptake. To effectively target these communities, multi-level interventions need to be established. Further, research to understand the barriers that may affect unvaccinated adults in the catch-up age range, including males, may be beneficial, as majority of the previous studies focused on either parents of adolescents or women.
Collapse
Affiliation(s)
- Trisha L Amboree
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA
| | - Charles Darkoh
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA. .,Microbiology and Infectious Diseases Program, University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
| |
Collapse
|
2
|
Fernandez-Pineda M, Cianelli R, Villegas N, Matsuda Y, Iriarte Parra ES, Montano NP. Salient factors among Hispanic parents in South Florida rural communities for vaccinating their children against human papillomavirus. J Pediatr Nurs 2020; 54:24-33. [PMID: 32521437 PMCID: PMC7484143 DOI: 10.1016/j.pedn.2020.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 05/23/2020] [Accepted: 05/24/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Few studies have tried to understand the factors related to HPV vaccination among Hispanics living in rural communities in the United States (US). Nationally, HPV vaccination among Hispanics is suboptimal (26.1%) compared to the HealthyPeople 2020 goal of 80% and even more suboptimal in rural communties. This study aimed to determine the salient factors among Hispanic parents for vaccinating their children against HPV and for designing a future HPV prevention intervention for Hispanics. DESIGN AND METHODS A descriptive qualitative design was used. Saturation was reached after conducting four focus groups with 23 Hispanic parents from rural communities in South Florida. Directed content analysis using the Theory of Planned Behavior (TPB) constructs was used to analyze the transcripts. RESULTS All TPB constructs were identified as salient factors for HPV vaccination including background factors, attitudes towards the behavior, perceived norms, perceived behavioral control, actual control, intention, and behavior. CONCLUSIONS Addressing HPV vaccination by developing educational programs based on the TPB and tailored to meet the needs of Hispanic parents is urgently needed to prevent HPV among Hispanics in rural US communities. This approach can also serve as a directive to target HPV vaccination among Hispanics in other rural areas in the US. PRACTICE IMPLICATIONS Pediatric nurses must proactively promote and recommend the HPV vaccine (HPVV), educate parents on having sex-related discussions with their children, include children in the HPVV education and decision, bundle the HPVV with other child vaccines, and utilize reminder systems to ensure completion of the vaccine series.
Collapse
Affiliation(s)
| | - Rosina Cianelli
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA.
| | - Natalia Villegas
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA.
| | - Yui Matsuda
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA.
| | | | | |
Collapse
|
3
|
Reiter PL, Pennell ML, Martinez GA, Perkins RB, Katz ML. HPV vaccine coverage across Hispanic/Latinx subgroups in the United States. Cancer Causes Control 2020; 31:905-914. [PMID: 32748100 DOI: 10.1007/s10552-020-01331-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/24/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Research on HPV vaccine coverage in the United States has typically aggregated Hispanic/Latinx individuals into a single group for analyses, an approach that has potentially masked variation between Hispanic/Latinx subgroups. To address this limitation, we examined HPV vaccine coverage across Hispanic/Latinx subgroups. METHODS We analyzed data on Hispanic/Latinx adolescents ages 13-17 (n = 16,335) from the 2012-2016 National Immunization Survey-Teen. Each adolescent was categorized into a subgroup: Mexican, Cuban, Puerto Rican, Central American, South American, other Spanish origin, or multi-subgroup. We examined HPV vaccine initiation (receipt of one or more doses) and completion (receipt of three doses) for males and females separately. Analyses used weighted logistic regression. RESULTS Vaccine coverage among males was highest among Central Americans (initiation: 57.5%; completion: 31.1%) and lowest among multi-subgroup males (initiation: 46.3%; completion: 19.9%). Among females, initiation ranged from 63.4% among Cubans to 71.2% among Puerto Ricans, and completion ranged from 33.6% among multi-subgroup females to 48.7% among South Americans. Hispanic/Latinx subgroups were similar on these outcomes in regression models. However, within several subgroups, vaccine coverage was higher among adolescents whose parents' preferred language was Spanish (i.e., potentially less acculturated) compared to those whose parents' preferred language was English. CONCLUSIONS Modest variation in HPV vaccine coverage exists across Hispanic/Latinx subgroups, with differences found by preferred language within several subgroups. Findings provide insight into HPV vaccine coverage among Hispanic/Latinx subgroups and can help guide future surveillance efforts and vaccination interventions.
Collapse
Affiliation(s)
- Paul L Reiter
- College of Public Health, The Ohio State University, Columbus, OH, USA.
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
| | - Michael L Pennell
- College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Glenn A Martinez
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Spanish and Portuguese, The Ohio State University, Columbus, OH, USA
| | | | - Mira L Katz
- College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
4
|
Btoush R, Brown DR, Tsui J, Toler L, Bucalo J. Knowledge and Attitudes Toward Human Papillomavirus Vaccination Among Latina Mothers of South American and Caribbean Descent in the Eastern US. Health Equity 2019; 3:219-230. [PMID: 31289782 PMCID: PMC6608702 DOI: 10.1089/heq.2018.0058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose: The purpose of this study was to examine knowledge, attitudes, barriers, and facilitators for human papillomavirus (HPV) vaccination among Latina mothers of HPV vaccine-eligible children in low-income urban areas, as well as useful strategies to improve HPV vaccination. Methods: The study included 132 Latina mothers of HPV vaccine-eligible children, interviewed in 14 focus groups. Using semi-structured discussions, mothers were asked about their knowledge about HPV infection and vaccine, views toward HPV vaccination, barriers for HPV vaccine initiation as well as completion, and opinions on strategies to improve HPV vaccination. Results: Only 55% of mothers reported having ever heard of the HPV vaccine, 27% of mothers indicated initiating the HPV vaccine, and 14% indicated completing the multi-dose series. Mothers generally lacked knowledge about HPV infection and vaccination, with varying degrees by Latino descent. Health care provider (HCP) recommendation was the strongest barrier/facilitator for HPV vaccination. Useful strategies to improve HPV vaccine initiation and completion that the mothers suggested included strong recommendation from HCPs and addressing side effects and safety concerns. Other useful strategies included community and school-based approaches and the use of text messaging and smartphone technology to educate mothers and send vaccine reminders. Conclusion: The findings provide insight for the development of interventions targeting low-income Latina mothers and the need to improve HCP communication on HPV vaccination.
Collapse
Affiliation(s)
- Rula Btoush
- School of Nursing, Rutgers University, Newark, New Jersey
| | - Diane R Brown
- School of Public Health, Rutgers University, Newark, New Jersey
| | - Jennifer Tsui
- Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Lindsey Toler
- School of Public Health, Rutgers University, Piscataway, New Jersey
| | - Jennifer Bucalo
- School of Graduate Studies, Rutgers University, Newark, New Jersey
| |
Collapse
|
5
|
Rodriguez SA, Savas LS, Baumler E, Nyitray AG, Mullen PD, Vernon SW, Fernandez ME. Parental predictors of HPV vaccine initiation among low-income Hispanic females aged 11-17 years. Vaccine 2018; 36:5084-5090. [PMID: 29980388 DOI: 10.1016/j.vaccine.2018.06.071] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Hispanic women experience a disproportionate burden of cervical cancer morbidity and mortality compared to non-Hispanic women. Increasing HPV vaccination among Hispanic adolescents can help alleviate disparities. This study aimed to identify parental psychosocial predictors associated with HPV vaccine initiation and correlates of parental intentions to obtain the vaccine for their Hispanic adolescent daughters aged 11-17 years. METHODS This study is part of a larger three-arm randomized controlled trial testing the effectiveness of interventions to increase HPV vaccination. Parents of adolescent females were recruited in community clinics where we conducted baseline surveys. We obtained electronic medical records six months after baseline to assess vaccination status. Multilevel logistic regression was used to identify correlates of parental intentions to vaccinate and predictors of HPV vaccine initiation. Analyses with initiation as the outcome also controlled for intervention study arm. The Integrated Behavioral Model guided selection of psychosocial and outcome variables. RESULTS Our sample (n = 765) consisted mostly of mothers with less than a high school education born outside of the U.S. Forty-one percent had a household income less than $15,000. Most daughters had public or private insurance. Twenty-one percent initiated the HPV vaccine series. Correlates of intention to vaccinate intention included subjective norms related to daughter's doctor (AOR = 1.04; 95% CI 1.01-1.07), belief that the vaccine is safe (AOR = 1.38; 95% CI 1.06-1.78), self-efficacy to obtain the vaccine for their daughter (AOR = 2.39; 95% CI 1.52-3.77), and parental concern about vaccine side effects (AOR = 0.73; 95% CI 0.60-0.89). Intentions predicted initiation (AOR = 2.01; 95% CI 1.10-5.26); concern about sexual disinhibition decreased the odds of having a vaccinated daughter at follow-up (AOR = 0.66; 95% CI 0.47-0.92). DISCUSSION Parental intention and concerns about sexual disinhibition predict vaccine initiation. Further research is needed to explore the role of intention as a potential mediator between psychosocial variables and vaccination status.
Collapse
Affiliation(s)
- Serena A Rodriguez
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States; Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., E5.506S, Dallas, TX 75390, United States.
| | - Lara S Savas
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| | - Elizabeth Baumler
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| | - Alan G Nyitray
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX 77030, United States.
| | - Patricia Dolan Mullen
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| | - Sally W Vernon
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| | - Maria E Fernandez
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| |
Collapse
|
6
|
Juntasopeepun P, Thana K. Parental acceptance of HPV vaccines in Chiang Mai, Thailand. Int J Gynaecol Obstet 2018; 142:343-348. [DOI: 10.1002/ijgo.12539] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/29/2018] [Accepted: 05/30/2018] [Indexed: 11/07/2022]
Affiliation(s)
| | - Kanjana Thana
- Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| |
Collapse
|
7
|
Chakraborty P, Colditz JB, Silvestre AJ, Friedman MR, Bogen KW, Primack BA. Observation of public sentiment toward human papillomavirus vaccination on Twitter. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2017.1390853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Priam Chakraborty
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, USA
- Center for Research on Media, Technology and Health, University of Pittsburgh, 230 McKee Place Suite 600, Pittsburgh, PA, 15213 USA
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Jason B. Colditz
- Center for Research on Media, Technology and Health, University of Pittsburgh, 230 McKee Place Suite 600, Pittsburgh, PA, 15213 USA
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Anthony J. Silvestre
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - M. Reuel Friedman
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Katherine W. Bogen
- Center for Research on Media, Technology and Health, University of Pittsburgh, 230 McKee Place Suite 600, Pittsburgh, PA, 15213 USA
| | - Brian A. Primack
- Center for Research on Media, Technology and Health, University of Pittsburgh, 230 McKee Place Suite 600, Pittsburgh, PA, 15213 USA
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
8
|
Socioeconomic and Attitudinal Variables Associated with Acceptance and Willingness to Pay Towards Dengue Vaccine: A Systematic Review. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2017. [DOI: 10.5812/archcid.13914] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
9
|
Chen ACC, Lightfoot M, Szalacha LA, Lindenberg CS. A Pilot, Web-Based HIV/STI Prevention Intervention Targeting At-Risk Mexican American Adolescents: Feasibility, Acceptability, and Lessons Learned. ACTA ACUST UNITED AC 2017; 4:86-92. [PMID: 33313361 DOI: 10.5176/2345-718x_4.2.149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Information technology provides new avenues to increase opportunities to deliver HIV/STI prevention interventions in a confidential, sensitive, and engaging manner for youth. While technology-based HIV/STI interventions show promise in preventing HIV/STI among different populations, few have targeted young Latinas. This pilot study examined the feasibility and acceptability of a bilingual, web-based HIV/STI prevention intervention among Latino females aged 15-19. We used a mix-method approach, including a prospective 2-group design with 3 repeated measures, and a post-intervention focus group discussion. We recruited 14 participants from an alternative high school and randomized into each study condition. Participants took 5 structurally equivalent modules focusing on either HIV/STI prevention (intervention) or nutrition/exercise (comparison) and completed assessments before the intervention, immediately post-intervention, and 2 months post-intervention. The findings suggested that the intervention had high levels of feasibility and acceptability. We discuss the keys to success, challenges encountered, and future directions.
Collapse
Affiliation(s)
| | | | - Laura A Szalacha
- Research Methods and Statistics, University of Arizona College of Nursing, USA
| | | |
Collapse
|
10
|
Courtney-Long EA, Romano SD, Carroll DD, Fox MH. Socioeconomic Factors at the Intersection of Race and Ethnicity Influencing Health Risks for People with Disabilities. J Racial Ethn Health Disparities 2017; 4:213-222. [PMID: 27059052 PMCID: PMC5055843 DOI: 10.1007/s40615-016-0220-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 02/19/2016] [Accepted: 03/09/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES People with disabilities are known to experience disparities in behavioral health risk factors including smoking and obesity. What is unknown is how disability, race/ethnicity, and socioeconomic status combine to affect prevalence of these health behaviors. We assessed the association between race/ethnicity, socioeconomic factors (income and education), and disability on two behavioral health risk factors. METHODS Data from the 2007-2010 Behavioral Risk Factor Surveillance System were used to determine prevalence of cigarette smoking and obesity by disability status, further stratified by race and ethnicity as well as income and education. Logistic regression was used to determine associations of income and education with the two behavioral health risk factors, stratified by race and ethnicity. RESULTS Prevalence of disability by race and ethnicity ranged from 10.1 % of Asian adults to 31.0 % of American Indian/Alaska Native (AIAN) adults. Smoking prevalence increased with decreasing levels of income and education for most racial and ethnic groups, with over half of white (52.4 %) and AIAN adults (59.3 %) with less than a high school education reporting current smoking. Education was inversely associated with obesity among white, black, and Hispanic adults with a disability. CONCLUSION Smoking and obesity varied by race and ethnicity and socioeconomic factors (income and education) among people with disabilities. Our findings suggest that disparities experienced by adults with disabilities may be compounded by disparities associated with race, ethnicity, and socioeconomic factors. This knowledge may help programs in formulating health promotion strategies targeting people at increased risk for smoking and obesity, inclusive of those with disabilities.
Collapse
Affiliation(s)
- Elizabeth A Courtney-Long
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop E-88, Atlanta, GA, 30341-3717, USA.
| | - Sebastian D Romano
- Oak Ridge Institute for Science and Education Fellowship with the National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
- Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE MS E-97, Atlanta, GA, 30333, USA
| | - Dianna D Carroll
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop E-88, Atlanta, GA, 30341-3717, USA
- Commissioned Corps, U.S. Public Health Service, Atlanta, GA, USA
| | - Michael H Fox
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop E-88, Atlanta, GA, 30341-3717, USA
| |
Collapse
|
11
|
Albright K, Barnard J, O’Leary ST, Lockhart S, Jimenez-Zambrano A, Stokley S, Dempsey A, Kempe A. Noninitiation and Noncompletion of HPV Vaccine Among English- and Spanish-Speaking Parents of Adolescent Girls: A Qualitative Study. Acad Pediatr 2017; 17:778-784. [PMID: 28359835 PMCID: PMC5846096 DOI: 10.1016/j.acap.2017.03.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 03/17/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) vaccination for female adolescents aged 11 to 12 years, yet vaccination rates remain low. We conducted a qualitative study to understand English- and Spanish-speaking parents' reasons for noninitiation or noncompletion of the HPV vaccine series for their daughters. METHODS Parents of female adolescents aged 12 to 15 years who had not initiated or not completed the HPV vaccine series were identified through administrative data in 2 large urban safety net health care systems in Colorado. Focus groups and in-depth interviews were conducted with English-speaking parents and in-depth interviews were conducted with Spanish-speaking parents. All data were recorded, transcribed, and analyzed for thematic content by experienced analysts using established qualitative content analysis techniques. RESULTS Forty-one parents participated in the study. Thirty parents participated in individual interviews and 11 parents participated in 1 of 2 focus groups. The most common reasons for noninitiation and noncompletion among English-speaking parents included a low perceived risk of HPV infection, vaccine safety concerns, and distrust of government and/or medicine. In contrast, Spanish-speaking parents most often reported that providers had either not encouraged initiation of the HPV vaccine series or had not explained the necessity of completing the series. Some noninitiating parents, particularly Spanish-speaking ones, also cited concerns that vaccination would encourage sexual activity. CONCLUSIONS The reasons for noninitiation and noncompletion of the HPV vaccine series differed substantially between English- and Spanish-speaking parents. To maximize uptake of HPV vaccine, varying approaches might be needed to effectively target specific populations.
Collapse
Affiliation(s)
- Karen Albright
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colo; Department of Sociology and Criminology, University of Denver, Denver, Colo.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Ashing KT, Chávez NR, Serrano M. HPV Vaccine-Related Knowledge, Beliefs, Acceptability, and Uptake Among Latinas Who Prefer English and Those Who Prefer Spanish. JOURNAL OF HEALTH COMMUNICATION 2016; 21:1209-1216. [PMID: 27858522 PMCID: PMC5521174 DOI: 10.1080/10810730.2016.1240266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Latinas compose almost 10% of the U.S. population and suffer the highest incidence of and one of the highest mortality rates from cervical cancer. Human papillomavirus (HPV) vaccination can prevent most HPV infections that cause more than 90% of cervical cancer. Unfortunately, limited knowledge and low rates of HPV vaccination persist among Latinas. The current study compared awareness, knowledge, beliefs, acceptability, uptake, and 3-dose series completion of HPV vaccination between Latinas who prefer English (EPL) and those who prefer Spanish (SPL), ages 18-62, living in Southern California. (The 3-dose series completion was based on HPV vaccine completion guidelines at the time of the study. HPV vaccination guidelines do change over time to improve coverage.) More EPL (n = 57) than SPL (n = 150) reported significantly (a) more HPV vaccine awareness and more knowledge of where to access the vaccine and additional vaccine information and (b) greater endorsement of vaccine effectiveness and safety (p < .05). Regardless of language preference, Latinas reporting knowledge of where to access the vaccine and additional information endorsed greater acceptability of the vaccine and more favorable beliefs regarding vaccine safety and effectiveness (p < .05). In multivariate analyses, language and income predicted the outcomes of knowledge regarding accessing the vaccine and additional information. Only 15.6% of all eligible Latinas (n = 45) initiated the HPV vaccine, with 8.9% completion. Interventions seeking to improve HPV vaccination should address linguistic and socioecological differences within Latinas to enhance effectiveness.
Collapse
Affiliation(s)
- Kimlin Tam Ashing
- Center of Community Alliance for Research and Education, Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, United States
| | - Noé Rubén Chávez
- Center of Community Alliance for Research and Education, Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, United States
| | - Mayra Serrano
- Center of Community Alliance for Research and Education, Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, United States
| |
Collapse
|
13
|
Denman DC, Baldwin AS, Marks EG, Lee SC, Tiro JA. Modification and validation of the Treatment Self Regulation Questionnaire to assess parental motivation for HPV vaccination of adolescents. Vaccine 2016; 34:4985-4990. [PMID: 27595447 PMCID: PMC5028302 DOI: 10.1016/j.vaccine.2016.08.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND According to Self-Determination Theory, the extent to which the motivation underlying behavior is self-determined or controlled influences its sustainability. This is particularly relevant for behaviors that must be repeated, such as completion of the human papillomavirus (HPV) vaccine series. To date, no measures of motivation for HPV vaccination have been developed. METHODS As part of a larger study, parents (N=223) whose adolescents receive care at safety-net clinics completed a telephone questionnaire about HPV and the vaccine. We modified the Treatment Self-Regulation Questionnaire to assess parents' motivation for HPV vaccination in both Spanish and English. We used confirmatory factor analysis to test a three-factor measurement model. RESULTS The three-factor model fit the data well (RMSEA=0.04, CFI=0.98, TLI=0.96), and the scales' reliabilities were adequate (autonomous: α=0.87; introjected: α=0.72; external: α=0.72). The factor loading strength for one item was stronger for Spanish- than English-speaking participants (p<0.05); all others were equivalent. The intercorrelations among the scales ranged from -0.17 to 0.32, suggesting discriminant factors. The scales displayed the expected pattern of correlations with other psychosocial determinants of behavior. Vaccination intentions showed a strong correlation with autonomous motivation (r=0.52), but no correlation with external motivation (r=0.02), suggesting autonomous motivation may be particularly important in vaccine decision-making. CONCLUSION Findings support the use of three subscales to measure motivation in HPV vaccination and suggest possible cultural differences in motivation.
Collapse
Affiliation(s)
| | | | - Emily G Marks
- University of Texas Southwestern Medical Center and Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, United States
| | - Simon C Lee
- University of Texas Southwestern Medical Center and Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, United States
| | - Jasmin A Tiro
- University of Texas Southwestern Medical Center and Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, United States
| |
Collapse
|
14
|
Mann L, Tanner AE, Sun CJ, Erausquin JT, Simán FM, Downs M, Rhodes SD. Listening to the voices of Latina women: Sexual and reproductive health intervention needs and priorities in a new settlement state in the United States. Health Care Women Int 2016; 37:979-994. [PMID: 27050775 PMCID: PMC5053913 DOI: 10.1080/07399332.2016.1174244] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Latina women in the United States are disproportionately affected by negative sexual and reproductive health outcomes. Our community-based participatory research partnership conducted in-depth interviews exploring sexual and reproductive health needs and priorities with 25 Latinas in North Carolina and identified themes through constant comparison, a grounded theory development approach. Participants described individual-, interpersonal-, and clinic-level factors affecting their sexual and reproductive health as well as potentially successful intervention characteristics. Our findings can be used to inform culturally congruent interventions to reduce sexual and reproductive health disparities among Latinas, particularly in new settlement states in the southeastern United States.
Collapse
Affiliation(s)
- Lilli Mann
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Christina J. Sun
- School of Community Health, Portland State University, Portland, Oregon, USA
| | - Jennifer Toller Erausquin
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | | | - Mario Downs
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Scott D. Rhodes
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
15
|
Alligood-Percoco N, Kesterson JP. Addressing the Barriers to Cervical Cancer Prevention Among Hispanic Women. J Racial Ethn Health Disparities 2016; 3:489-95. [PMID: 27294745 DOI: 10.1007/s40615-015-0166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/31/2015] [Accepted: 09/08/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Cervical cancer in the USA has transformed from a leading cause of cancer death, to a now largely preventable disease. Despite these advances, however, certain segments of the population, including Hispanic women, continue to be at increased risk. METHODS A literature review was performed to summarize epidemiologic trends and barriers to care affecting Hispanic women. RESULTS Hispanic women suffer a disproportionate burden of cervical cancer in the USA. The reasons why Hispanic women remain at increased risk are multifactorial and include resource limitations within the healthcare system. Language, cultural, and knowledge barriers also play a significant role. CONCLUSIONS The greatest modifiable risk factor for the development of cervical carcinoma is non-compliance with recommended preventative care, yet the reasons why women fail to receive this care are varied. A multi-faceted approach to risk reduction is needed, including improved health care access, population-targeted outreach, language-appropriate services, and culturally competent care.
Collapse
Affiliation(s)
- Natasha Alligood-Percoco
- Department of Obstetrics and Gynecology, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
| | - Joshua P Kesterson
- Division of Gynecologic Oncology, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| |
Collapse
|
16
|
Burlamaqui JCF, Cassanti AC, Borim GB, Damrose E, Villa LL, Silva L. Human Papillomavirus and students in Brazil: an assessment of knowledge of a common infection - preliminary report. Braz J Otorhinolaryngol 2016; 83:120-125. [PMID: 27170346 PMCID: PMC9442715 DOI: 10.1016/j.bjorl.2016.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 02/02/2016] [Indexed: 11/19/2022] Open
Abstract
Introduction Human Papillomavirus (HPV) infection is the most prevalent sexually transmitted disease worldwide. One of the barriers to the implementation of prevention programs against the disease is the limited knowledge possessed by most populations regarding the virus and its possible consequences. Objective The purpose of this study was to evaluate the knowledge of Brazilian college students on transmission, clinical manifestations, and diseases correlated with HPV, highlighting the poor knowledge of a very common infection. Methods A total of 194 students answered a questionnaire about transmission, clinical features and the possible consequences of persistent HPV infection. The questionnaire was self-applied under the supervision of the authors. Results The clinical manifestations of HPV infection were not clear to most students. Incorrect assumptions of the clinical manifestations of HPV infection included: bleeding (25%), pain (37%) and rashes (22%). Twelve per cent of respondents did not recognize warts as an HPV-related disease. Regarding potential consequences of persistent infection, students did not recognize a relationship between HPV and laryngeal carcinoma (80.9%), pharyngeal carcinoma (78.9%), anal carcinoma (73.2%), vulvar carcinoma (65.4%) and vaginal carcinoma (54.6%). Large portions of the population evaluated were unaware of modes of HPV transmission beyond genital contact. Conclusion Knowledge of HPV by the population evaluated in this study is partial and fragmented. Lack of knowledge may contribute to the further spread of the disease. Public health policies for education and guidance of the population should be implemented in Brazil.
Collapse
Affiliation(s)
| | | | | | | | - Luisa Lina Villa
- Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Radiologia e Oncologia, São Paulo, SP, Brazil
| | - Leonardo Silva
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
| |
Collapse
|
17
|
Wilson RM, Brown DR, Carmody DP, Fogarty S. HPV Vaccination Completion and Compliance with Recommended Dosing Intervals Among Female and Male Adolescents in an Inner-City Community Health Center. J Community Health 2016; 40:395-403. [PMID: 25312867 DOI: 10.1007/s10900-014-9950-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Human papillomavirus (HPV) vaccination continues to lag behind other adolescent vaccines, especially in areas with pervasive disparities in HPV-related cancers. The purpose of this study was to examine HPV vaccine completion and dosing intervals among low-income adolescents in urban areas. The study included electronic health record data on HPV vaccination for 872 adolescents who received at least one dose of the HPV vaccine. Only 28.4% completed the 3-dose series. For the whole sample, HPV vaccine completion was higher for non-English speakers and among adolescents seen at Newark-South and East Orange sites. Completion was higher among non-English speaking female and Hispanic adolescents, females seen in Newark-South and East Orange sites, and insured Black adolescents. Completion was also dramatically lower among non-English speaking Black adolescents seen at Newark-North, Irvington, and Orange sites (12.5%) compared to other Black adolescents (22.0-44.4%). The mean dosing intervals were 5.5 months (SD = 4.6) between dose 1 and 2 and 10 months (SD = 6.1) between dose 1 and 3. Longer durations between vaccine doses were found among uninsured adolescents and those seen at Newark-North, Irvington, and Orange sites. Non-English speakers had longer duration between dose 1 and 3. Further, durations between dose 1 and 3 were dramatically longer among insured adolescents seen at Newark-North, Irvington, and Orange locations for the whole sample (M = 11.70; SD = 7.12) and among Hispanic adolescents (M = 13.45; SD = 8.54). Understanding how the study predictors facilitate or impede HPV vaccination is critical to reducing disparities in cervical and other HPV-related cancer, especially among Black, Hispanic, and low-income populations.
Collapse
Affiliation(s)
- Rula M Wilson
- Rutgers School of Nursing, 65 Bergen St., Newark, NJ, 07101, USA,
| | | | | | | |
Collapse
|
18
|
Mansfield LN, Onsomu EO, Merwin E, Hall NM, Harper-Harrison A. Association Between Parental HPV Knowledge and Intentions to Have Their Daughters Vaccinated. West J Nurs Res 2016; 40:481-501. [PMID: 28322641 DOI: 10.1177/0193945916682953] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Human papillomavirus (HPV) 16 and 18 causes 66% of cervical cancers (Dunne et al., 2014). Vaccination during adolescence can prevent HPV-associated cervical cancers, yet less than half of adolescent girls are vaccinated. This study examined the association between HPV knowledge and parental intentions to vaccinate daughters against HPV. A retrospective, cross-sectional, national data set from the 2006-2007 Health Information National Trends Survey (HINTS) was used. A multivariate multinomial logistic regression analysis was used to estimate the association between intent to vaccinate and HPV knowledge. After controlling for other covariates, parents who were knowledgeable were more likely to intend to have their daughters vaccinated compared with those who were not knowledgeable (adjusted relative risk ratio [aRRR] = 3.96, p = .004). Having HPV knowledge would significantly increase parents' intent for vaccination against the disease for their daughters. Health care providers should integrate HPV-related education for parents within their services, and policymakers should consider requiring HPV vaccination for school attendance.
Collapse
Affiliation(s)
- Lisa N Mansfield
- 1 Winston-Salem State University, Winston-Salem, NC, USA.,2 Duke University, Durham, NC, USA
| | | | | | - Naomi M Hall
- 1 Winston-Salem State University, Winston-Salem, NC, USA
| | | |
Collapse
|
19
|
Btoush RM, Brown DR, Fogarty S, Carmody DP. Initiation of Human Papillomavirus Vaccination Among Predominantly Minority Female and Male Adolescents at Inner-City Community Health Centers. Am J Public Health 2015; 105:2388-96. [PMID: 25973828 DOI: 10.2105/ajph.2015.302584] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the prevalence and correlates of human papillomavirus (HPV) vaccine initiation among adolescents in low-income, urban areas. METHODS The study consisted of electronic health record data on HPV vaccination for 3180 adolescents (aged 10-20 years) at a multisite community health center in 2011. RESULTS Only 27% initiated the HPV vaccine. The adjusted odds ratio (AOR) of HPV vaccination was lower among older adolescents (AOR = 0.552; 95% confidence interval [CI] = 0.424, 0.718) and those seen by nonpediatric health care providers (HCPs; AOR = 0.311; 95% CI = 0.222, 0.435), and higher among non-English speakers (AOR = 1.409; 95% CI = 1.134, 1.751) and those seen at 2 site locations (AOR = 1.890; 95% CI = 1.547, 2.311). Insurance status was significant only among female and Hispanic adolescents. Language was not a predictor among Hispanic adolescents. Across all analyses, the interaction of age and HCP specialty was associated with HPV vaccination. Dramatically lower HPV vaccination rates were found among older adolescents seen by nonpediatric HCPs (3%-5%) than among other adolescents (23%-45%). CONCLUSIONS Improving HPV vaccination initiation in low-income urban areas is critical to reducing disparities in cervical and other HPV-related cancer, especially among Black, Hispanic, and low-income populations.
Collapse
Affiliation(s)
- Rula M Btoush
- Rula M. Btoush and Dennis P. Carmody are with Rutgers School of Nursing, Newark, NJ.,Diane R. Brown and Sushanna Fogarty are with Rutgers School of Public Health, Newark
| | - Diane R Brown
- Rula M. Btoush and Dennis P. Carmody are with Rutgers School of Nursing, Newark, NJ.,Diane R. Brown and Sushanna Fogarty are with Rutgers School of Public Health, Newark
| | - Sushanna Fogarty
- Rula M. Btoush and Dennis P. Carmody are with Rutgers School of Nursing, Newark, NJ.,Diane R. Brown and Sushanna Fogarty are with Rutgers School of Public Health, Newark
| | - Dennis P Carmody
- Rula M. Btoush and Dennis P. Carmody are with Rutgers School of Nursing, Newark, NJ.,Diane R. Brown and Sushanna Fogarty are with Rutgers School of Public Health, Newark
| |
Collapse
|
20
|
Hadland SE, Long WE. A systematic review of the medical home for children without special health care needs. Matern Child Health J 2014; 18:891-8. [PMID: 23784614 DOI: 10.1007/s10995-013-1315-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To conduct a systematic review of the evidence associating the medical home with beneficial health outcomes in healthy children. The English-language pediatric literature 1975-2011 was searched via PubMed, Embase and CINAHL. Inclusion criteria (the medical home as an independent variable, individual-level quantitative analysis, outpatient setting in the US, healthy children) and exclusion criteria (age >18, medical home operationalized with only one American Academy of Pediatrics component) were determined a priori. Presence of a medical home was examined in relation to three outcome measures: primary care services, health care utilization, and child well-being. Of 4,856 unique citations, 9 studies were included in the final systematic review, amassing 290,180 children from 6 data sources. Two drew on prospective cohort data; the remainder, on cross-sectional design. Children with a medical home were more likely to receive preventive medical care (2 studies), anticipatory guidance (1 study), and developmental screening (1 study); to have higher health-related quality of life (1 study); and were less likely to seek care in the emergency department (2 studies). The medical home was associated with full immunization status in only 1 of 4 studies examining this outcome. No protective effect of the medical home was found with regard to preventable hospitalization (1 study). The medical home is associated with beneficial health outcomes among healthy children. However, the evidence is limited in comparison with that for children with special health care needs. As healthy children represent the majority of the pediatric population, this lack of evidence represents a significant knowledge gap.
Collapse
Affiliation(s)
- Scott E Hadland
- Division of General Pediatrics, Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, 88 East Newton Street, Vose Hall 3rd Floor, Boston, MA, 02118, USA
| | | |
Collapse
|
21
|
Abstract
PURPOSE OF REVIEW Kidney transplantation remains the optimal treatment for children with end-stage renal disease; yet, in the United States, profound differences in access to transplant persist, with black children experiencing significantly reduced access to transplant compared with white children. The reasons for these disparities remain poorly understood. Several recent studies provide new insights into the interplay of socioeconomic status, racial/ethnic disparities and access to pediatric kidney transplantation. RECENT FINDINGS New evidence suggests that disparities are more pronounced in access to living vs. deceased donors. National allocation policies have mitigated racial differences in pediatric deceased donor kidney transplant (DDKT) access after waitlisting. However, disparities in access to DDKT are stark for minority emerging adults, who lose pediatric priority allocation. Although absence of health insurance poses an important barrier to transplant, even after adjustment for insurance status and neighborhood poverty, disparities persist. Differential access to care and unjust social structures are posited as important modifiable barriers to achieving equity in pediatric transplant access. SUMMARY Future approaches to overcome disparities in pediatric kidney transplant access must focus on the continuum of the transplant process, including equitable health care access. Public health advocacy efforts to promote national policies that address disparate multilevel socioeconomic factors are essential.
Collapse
|
22
|
Reiter PL, Brewer NT, Gilkey MB, Katz ML, Paskett ED, Smith JS. Early adoption of the human papillomavirus vaccine among Hispanic adolescent males in the United States. Cancer 2014; 120:3200-7. [PMID: 24948439 DOI: 10.1002/cncr.28871] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/19/2014] [Accepted: 05/22/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) infection is common among Hispanic males, but to the authors' knowledge little is known regarding HPV vaccination in this population. The authors examined the early adoption of the HPV vaccine among a national sample of Hispanic adolescent males. METHODS The authors analyzed provider-verified HPV vaccination data from the 2010 through 2012 National Immunization Survey-Teen (NIS-Teen) for Hispanic males aged 13 years to 17 years (n = 4238). Weighted logistic regression identified correlates of HPV vaccine initiation (receipt of ≥ 1 doses). RESULTS HPV vaccine initiation was 17.1% overall, increasing from 2.8% in 2010 to 31.7% in 2012 (P < .0001). Initiation was higher among sons whose parents had received a provider recommendation to vaccinate compared with those whose parents had not (53.3% vs 9.0%; odds ratio, 8.77 [95% confidence interval, 6.05-12.70]). Initiation was also higher among sons who had visited a health care provider within the previous year (odds ratio, 2.42; 95% confidence interval, 1.39-4.23). Among parents with unvaccinated sons, Spanish-speaking parents reported much higher intent to vaccinate compared with English-speaking parents (means: 3.52 vs 2.54; P < .0001). Spanish-speaking parents were more likely to indicate lack of knowledge (32.9% vs 19.9%) and not having received a provider recommendation (32.2% vs 17.7%) as the main reasons for not intending to vaccinate (both P < .05). CONCLUSIONS HPV vaccination among Hispanic adolescent males has increased substantially in recent years. Ensuring health care visits and provider recommendation will be key for continuing this trend. Preferred language may also be important for increasing HPV vaccination and addressing potential barriers to vaccination.
Collapse
Affiliation(s)
- Paul L Reiter
- Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, Ohio; Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio; College of Public Health, The Ohio State University, Columbus, Ohio
| | | | | | | | | | | |
Collapse
|
23
|
Navarro-Illana P, Diez-Domingo J, Navarro-Illana E, Tuells J, Alemán S, Puig-Barberá J. "Knowledge and attitudes of Spanish adolescent girls towards human papillomavirus infection: where to intervene to improve vaccination coverage". BMC Public Health 2014; 14:490. [PMID: 24885391 PMCID: PMC4061915 DOI: 10.1186/1471-2458-14-490] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 04/24/2014] [Indexed: 11/12/2022] Open
Abstract
Background HPV vaccine coverage is far from ideal in Valencia, Spain, and this could be partially related to the low knowledge about the disease and the vaccine, therefore we assessed these, as well as the attitude towards vaccination in adolescent girls, and tried to identify independently associated factors that could potentially be modified by an intervention in order to increase vaccine coverage. Methods A cross sectional study was conducted in a random selection of schools of the Spanish region of Valencia. We asked mothers of 1278 girls, who should have been vaccinated in the 2011 campaign, for informed consent. Those that accepted their daughters’ participation, a questionnaire regarding the Knowledge of HPV infection and vaccine was passed to the girls in the school. Results 833 mothers (65.1%) accepted participation. All their daughters’ responded the questionnaire. Of those, 89.9% had heard about HPV and they associated it to cervical cancer. Only 14% related it to other problems like genital warts. The knowledge score of the girls who had heard about HPV was 6.1/10. Knowledge was unrelated to the number of contacts with the health system (Pediatrician or nurse), and positively correlated with the discussions with classmates about the vaccine. Adolescents Spanish in origin or with an older sister vaccinated, had higher punctuation. 67% of the girls thought that the vaccine prevented cancer, and 22.6% felt that although prevented cancer the vaccine had important safety problems. 6.4% of the girls rejected the vaccine for safety problems or for not considering themselves at risk of infection. 71.5% of the girls had received at least one vaccine dose. Vaccinated girls scored higher knowledge (p = 0.05). Conclusion Knowledge about HPV infection and vaccine was fair in adolescents of Valencia, and is independent to the number of contacts with the health system, it is however correlated to the conversations about the vaccine with their peers and the vaccination status. An action to improve HPV knowledge through health providers might increase vaccine coverage in the adolescents.
Collapse
Affiliation(s)
- Pedro Navarro-Illana
- Facultad de Enfermería, Universidad Católica de Valencia "San Vicente Mártir", C/Jesús, 10, 46007 Valencia, Spain.
| | | | | | | | | | | |
Collapse
|
24
|
Bruno DM, Imperato PJ, Szarek M. The correlation between global health experiences in low-income countries on choice of primary care residencies for graduates of an urban US medical school. J Urban Health 2014; 91:394-402. [PMID: 24091733 PMCID: PMC3978151 DOI: 10.1007/s11524-013-9829-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study sought to determine whether medical students who participate in a global health elective in a low-income country select residencies in primary care at higher rates compared with their classmates and US medical graduates in general. Given the projected increase in demand for primary care physicians, particularly in underserved areas, understanding possible factors that encourage training in primary care or enhance interest in the care of underserved populations may identify opportunities in medical school training. The authors used data from the Office of Student Affairs, SUNY Downstate College of Medicine and the National Residency Matching Program to compare rates of primary care residency selection from 2004 to 2012. Residency selections for students who participated in the SUNY Downstate School of Public Health Global Health Elective were compared with those of their classmates and with residency match data for US seniors. In 7 of the 8 years reviewed, students who participated in the SUNY Downstate School of Public Health Global Health Elective selected primary care residencies at rates higher than their classmates. Across years, 57% of the students who completed the elective matched to primary care residences, which was significantly higher than the 44% for the remainder of Downstate's medical student class (p = 0.0023). In 6 of the 8 years, Downstate students who participated in the Global Health Elective selected primary care residencies at rates higher than US medical school seniors in general; rates were the same for both Downstate Global Health Elective students and US medical school seniors in 2009. Students who participated in a global health experience in a low-income country selected primary care residencies at higher rates than their classmates and US medical school graduates in general. Understanding how these experiences correlate with residency selection requires further investigation; areas of future study are discussed.
Collapse
Affiliation(s)
- Denise Marie Bruno
- Department of Community Health Sciences, State University of New York, Downstate Medical Center, School of Public Health, 450 Clarkson Avenue, , Box 43, , Brooklyn, NY, 11203, USA,
| | | | | |
Collapse
|
25
|
Reiter PL, Gupta K, Brewer NT, Gilkey MB, Katz ML, Paskett ED, Smith JS. Provider-verified HPV vaccine coverage among a national sample of Hispanic adolescent females. Cancer Epidemiol Biomarkers Prev 2014; 23:742-54. [PMID: 24633142 DOI: 10.1158/1055-9965.epi-13-0979] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hispanic females have the highest cervical cancer incidence rate of any racial or ethnic group in the United States, yet relatively little research has examined human papillomavirus (HPV) vaccination among this fast-growing population. We examined HPV vaccination among a national sample of Hispanic adolescent females. METHODS We analyzed provider-verified vaccination data from the 2010-2011 National Immunization Survey-Teen for Hispanic females ages 13 to 17 years (n = 2,786). We used weighted logistic regression to identify correlates of HPV vaccine initiation (receipt of one or more doses), completion (receipt of three doses), and follow-through (receipt of three doses among those who initiated the series). RESULTS HPV vaccine initiation was 60.9%, completion was 36.0%, and follow-through was 59.1%. Initiation and completion were more common among older daughters and those whose parents had received a provider recommendation to vaccinate (all P < 0.05). Completion was less common among daughters who had moved from their birth state (P < 0.05). All vaccination outcomes were less common among daughters without health insurance (all P < 0.05). Vaccination did not differ by parents' preferred language (all P > 0.05), although intent to vaccinate was higher among Spanish-speaking parents (P < 0.01). Spanish-speaking parents were more likely to indicate lack of provider recommendation (20.2% vs. 5.3%) and cost (10.9% vs. 1.8%) as main reasons for not intending to vaccinate (both P < 0.05). CONCLUSIONS Many Hispanic females have not received HPV vaccine. Several factors, including provider recommendation and health insurance, are key correlates of vaccination. IMPACT HPV vaccination programs targeting Hispanics are needed and should consider how potential barriers to vaccination may differ by preferred language.
Collapse
Affiliation(s)
- Paul L Reiter
- Authors' Affiliations: Division of Cancer Prevention and Control, College of Medicine; Comprehensive Cancer Center; College of Public Health, The Ohio State University, Columbus, Ohio; UNC Gillings School of Global Public Health; and Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
| | | | | | | | | | | | | |
Collapse
|
26
|
Patzer RE, Sayed BA, Kutner N, McClellan WM, Amaral S. Racial and ethnic differences in pediatric access to preemptive kidney transplantation in the United States. Am J Transplant 2013; 13:1769-81. [PMID: 23731389 PMCID: PMC3763919 DOI: 10.1111/ajt.12299] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 03/20/2013] [Accepted: 03/31/2013] [Indexed: 01/25/2023]
Abstract
Preemptive kidney transplantation is the optimal treatment for pediatric end stage renal disease patients to avoid increased morbidity and mortality associated with dialysis. It is unknown how race/ethnicity and poverty influence preemptive transplant access in pediatric. We examined the incidence of living donor or deceased donor preemptive transplantation among all black, white, and Hispanic children (<18 years) in the United States Renal Data System from 2000 to 2009. Adjusted risk ratios for preemptive transplant were calculated using multivariable-adjusted models and examined across health insurance and neighborhood poverty levels. Among 8,053 patients, 1117 (13.9%) received a preemptive transplant (66.9% from LD, 33.1% from DD). In multivariable analyses, there were significant racial/ethnic disparities in access to LD preemptive transplant where blacks were 66% (RR = 0.34; 95% CI: 0.28-0.43) and Hispanics 52% (RR = 0.48; 95% CI: 0.35-0.67) less likely to receive a LD preemptive transplant versus whites. Blacks were 22% less likely to receive a DD preemptive transplant versus whites (RR = 0.78, 95% CI: 0.57-1.05), although results were not statistically significant. Future efforts to promote equity in preemptive transplant should address the critical issues of improving access to pre-ESRD nephrology care and overcoming barriers in living donation, including obstacles partially driven by poverty.
Collapse
Affiliation(s)
- Rachel E Patzer
- Emory University, Department of Surgery, Emory Transplant Center, Atlanta, GA,Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA
| | - Blayne A Sayed
- Emory University, Department of Surgery, Emory Transplant Center, Atlanta, GA
| | - Nancy Kutner
- Emory University, USRDS Rehabilitation/QoL Special Studies Center, Atlanta, GA
| | - William M McClellan
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA,Emory University, Division of Nephrology, WMB, Room 338, 1639 Pierce Dr., Atlanta, GA 30322
| | - Sandra Amaral
- The Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics and Department of Biostatistics and Epidemiology, Philadelphia, PA
| |
Collapse
|