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Lin Z, Chen S, Su L, Chen H, Fang Y, Liang X, Chan KF, Chen J, Luo B, Wu C, Wang Z. Exploring mother-daughter communication and social media influence on HPV vaccine refusal for daughters aged 9-17 years in a cross-sectional survey of 11,728 mothers in China. Hum Vaccin Immunother 2024; 20:2333111. [PMID: 38530324 DOI: 10.1080/21645515.2024.2333111] [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: 12/12/2023] [Accepted: 03/15/2024] [Indexed: 03/27/2024] Open
Abstract
This study investigated the influences of mother-daughter communication and social media on mothers' HPV vaccine refusal for their daughters aged 9-17. A cross-sectional online survey among 11,728 mothers of girls aged 9-17 in Shenzhen, China was implemented between July and October 2023. Multi-level logistic regression models were fitted. Among 11,728 participants, 43.2% refused to have their daughters receive an HPV vaccination. In multivariate analysis, more openness in the mother-daughter communication (AOR: 0.99, 95%CI: 0.98, 0.99), perceived more positive outcomes of mother-daughter communication (AOR: 0.77, 95%CI: 0.75, 0.79), higher frequency of exposure to testimonials about daughters' HPV vaccination (AOR: 0.81, 95%CI: 0.78, 0.85) and information encouraging parents to vaccinate their daughters against HPV on social media (AOR: 0.76, 95%CI: 0.73, 0.79), and thoughtful consideration of the veracity of the information specific to HPV vaccines (AOR: 0.80, 95%CI: 0.77, 0.83) were associated with lower vaccine refusal. Mothers who were not the main decision-makers of daughters' HPV vaccination (AOR: 1.28 to 1.46), negative outcome expectancies of mother-daughter communication (AOR: 1.06, 95%CI: 1.04, 1.08), and mothers' HPV vaccine refusal (AOR: 2.81, 95%CI: 2.58, 3.06) were associated with higher vaccine refusal for their daughters. The level of mothers' HPV vaccine refusal for their daughters was high in China. Openness and outcome expectancies of mother-daughter communication and information exposure on social media were considered key determinants of HPV vaccine refusal for daughters. Future HPV vaccination programs should consider these interpersonal factors.
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Affiliation(s)
- Zian Lin
- Department of Vaccination Clinic, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lixian Su
- Department of Children's Group Health, Shenzhen Futian District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong SAR, China
| | - Xue Liang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kwok Fung Chan
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jianan Chen
- Department of Vaccination Clinic, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Biyun Luo
- Department of Vaccination Clinic, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Chuanan Wu
- Department of Vaccination Clinic, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Lin Z, Chen S, Su L, Cao H, Chen H, Fang Y, Liang X, Chen J, Luo B, Wu C, Wang Z. Associations of mothers' decisional conflicts and satisfaction with governmental health promotion materials with their daughters' HPV vaccination uptake in China: A cross-sectional survey. Vaccine X 2024; 19:100529. [PMID: 39161948 PMCID: PMC11331965 DOI: 10.1016/j.jvacx.2024.100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/25/2024] [Accepted: 07/16/2024] [Indexed: 08/21/2024] Open
Abstract
Background China started to implement the HPV vaccination program for females in 2016. This study investigated associations between mothers' decisional conflicts, satisfaction with governmental health promotion materials, and their daughters' HPV vaccination uptake. Methods A cross-sectional online survey was conducted between July and October 2023 among mothers of girls aged 9-17 years in Shenzhen, China. Participants were mothers having a daughter aged 9-17 years at the survey date and a smartphone with internet access. About 3 % of all primary and secondary schools in Shenzhen were randomly selected by the research team (11 primary schools and 13 secondary schools). Teachers at the selected schools invited mothers of female students aged 9-17 years to complete an anonymous online questionnaire. Multivariate logistic regression was fitted. Results Among 11,728 mothers who completed the survey, 18.9% of their index daughters received at least one dose of HPV vaccination. In multivariate analysis, less decisional conflict about the choice of HPV vaccines for their daughters (AOR: 1.07, 95%CI: 1.05, 1.10), more satisfaction with the government's health promotional materials related to HPV vaccines (AOR: 1.15, 95%CI: 1.12, 1.19), receiving more cue to action from significant others (AOR: 1.23, 95%CI: 1.19, 1.27), and perceived higher self-efficacy related to HPV vaccines (AOR: 1.79, 95%CI: 1.67, 1.92) were associated with a higher uptake of HPV vaccines. Perceived susceptibility to HPV (AOR: 0.79, 95%CI: 0.74, 0.85), perceived barriers to having the index daughter receive HPV vaccines (AOR: 0.82, 95%CI: 0.80, 0.84), and mothers who were hesitant to receive HPV vaccination (AOR: 0.75, 95%CI: 0.68, 0.84) were associated with a lower uptake. Conclusion HPV vaccination uptake was low among girls in China. Future health promotion should address mothers' decisional conflicts about the choice of HPV vaccines for their daughters and improve the health promotional materials. School-based HPV vaccination programs might be useful.
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Affiliation(s)
- Zian Lin
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lixian Su
- Shenzhen Futian District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - He Cao
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong SAR, China
| | - Xue Liang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jianan Chen
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Biyun Luo
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Chuanan Wu
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
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D'Souza GC, Pinto CN, Exten CL, Yingst JM, Foulds J, Anderson J, Allen R, Calo WA. Understanding factors associated with COVID-19 vaccination among health care workers using the Diffusion of Innovation Theory. Am J Infect Control 2024; 52:509-516. [PMID: 38218328 DOI: 10.1016/j.ajic.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND The COVID-19 vaccine was initially offered to frontline health care workers (HCWs), due to the high risk of contracting COVID-19 through occupational exposure to patients. Low HCW vaccine uptake can impact overall community-level vaccine uptake. This study used the Diffusion of Innovation (DOI) Theory to understand factors related to COVID-19 vaccine uptake in HCWs. METHODS We surveyed Pennsylvanian HCWs (excluding Philadelphia) from August 2022 to February 2023. Survey questions inquired about demographics, COVID-19 vaccination status, reasons for receiving/declining the COVID-19 vaccine, and sources of information about the vaccine. RESULTS Participants (n = 3,490) were 85% female, 89% White, and 93% (n = 3,255) reported receiving at least one dose of a COVID-19 vaccine. HCWs were categorized into adopter categories of the DOI Theory: innovators (56%), early adopters (9%), early majority (11%), late majority (7%), and laggards (17%). The major reason that prompted participants to get the vaccine was to protect them against COVID-19 infection (78%), while the major reason for declining the vaccine was due to concern about possible side effects from the vaccine (78%). CONCLUSIONS We applied the DOI Theory to characterize adopters and identify factors related to COVID-19 vaccine uptake in HCWs. As updated COVID-19 vaccines are approved for the United States market, our findings may be used to improve vaccine education and communication among HCWs to support vaccine uptake.
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Affiliation(s)
- Gail C D'Souza
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Casey N Pinto
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA; Penn State Cancer Institute, Cancer Control Program, Hershey, PA
| | - Cara L Exten
- Penn State Ross and Carol Nese College of Nursing, Penn State University, University Park, PA
| | - Jessica M Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA; Penn State Cancer Institute, Cancer Control Program, Hershey, PA
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA; Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA; Penn State Cancer Institute, Cancer Control Program, Hershey, PA
| | - Jocelyn Anderson
- Penn State Ross and Carol Nese College of Nursing, Penn State University, University Park, PA
| | - Rachel Allen
- Penn State Ross and Carol Nese College of Nursing, Penn State University, University Park, PA
| | - William A Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA; Penn State Cancer Institute, Cancer Control Program, Hershey, PA.
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Lin Z, Liang X, Su L, Peng W, Chen H, Fang Y, Chen S, Yang W, Chen W, Zhang L, Wang Z. Coverage with the First Dose of Human Papillomavirus Vaccination among Females Aged 9-50 Years in Shenzhen, China: A Surveillance Based on Administrative Health Records in 2023. Vaccines (Basel) 2024; 12:75. [PMID: 38250888 PMCID: PMC10818281 DOI: 10.3390/vaccines12010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/22/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
China started to offer human papillomavirus (HPV) vaccines to females aged 9-45 years in 2016. However, there was a lack of reports about HPV vaccination coverage in a representative sample of females in China. Therefore, this study aimed to examine the current HPV coverage and associated factors among females aged 9-50 years in Shenzhen, China, based on administrative health records kept by community health centers. A multistage random sampling approach was used. The research team randomly selected 18 community health centers in Shenzhen, and 3118 health records of females aged 9-50 years were then randomly selected from these health centers. Among all participants, 18.7% received at least one dose of HPV vaccination. The highest coverage was observed among females aged 18-26 years (23.4%), followed by those aged 27-35 years (22.0%) and 36-45 years (20.2%). Such coverage was very low among females aged 9-17 years (4.6%) and those aged 46-50 years (3.2%). Among females aged 18 years or above, higher education level, having a family doctor, and permanent residency in Shenzhen were associated with higher HPV vaccination coverage, while older age and being married/divorced were negatively associated with coverage. The HPV vaccination coverage in Shenzhen was 18.7% and there is a strong need for improvement.
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Affiliation(s)
- Zian Lin
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen 518000, China; (Z.L.); (W.Y.); (W.C.); (L.Z.)
| | - Xue Liang
- Centre for Health Behavious Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR 999077, China; (X.L.); (S.C.)
| | - Lixian Su
- Shenzhen Futian District Maternity and Child Healthcare Hospital, Shenzhen 518000, China;
| | - Weijun Peng
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen 518000, China; (W.P.); (H.C.)
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen 518000, China; (W.P.); (H.C.)
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR 999077, China;
| | - Siyu Chen
- Centre for Health Behavious Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR 999077, China; (X.L.); (S.C.)
| | - Weikang Yang
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen 518000, China; (Z.L.); (W.Y.); (W.C.); (L.Z.)
| | - Wensheng Chen
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen 518000, China; (Z.L.); (W.Y.); (W.C.); (L.Z.)
| | - Lijun Zhang
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen 518000, China; (Z.L.); (W.Y.); (W.C.); (L.Z.)
| | - Zixin Wang
- Centre for Health Behavious Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR 999077, China; (X.L.); (S.C.)
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Nsubuga EJ, Fitzmaurice AG, Komakech A, Odoi TD, Kadobera D, Bulage L, Kwesiga B, Elyanu PJ, Ario AR, Harris JR. Community dialogue meetings among district leaders improved their willingness to receive COVID-19 vaccines in Western Uganda, May 2021. BMC Public Health 2023; 23:969. [PMID: 37237258 DOI: 10.1186/s12889-023-15903-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Widespread COVID-19 vaccine uptake can facilitate epidemic control. A February 2021 study in Uganda suggested that public vaccine uptake would follow uptake among leaders. In May 2021, Baylor Uganda led community dialogue meetings with district leaders from Western Uganda to promote vaccine uptake. We assessed the effect of these meetings on the leaders' COVID-19 risk perception, vaccine concerns, perception of vaccine benefits and access, and willingness to receive COVID-19 vaccine. METHODS All departmental district leaders in the 17 districts in Western Uganda, were invited to the meetings, which lasted approximately four hours. Printed reference materials about COVID-19 and COVID-19 vaccines were provided to attendees at the start of the meetings. The same topics were discussed in all meetings. Before and after the meetings, leaders completed self-administered questionnaires with questions on a five-point Likert Scale about risk perception, vaccine concerns, perceived vaccine benefits, vaccine access, and willingness to receive the vaccine. We analyzed the findings using Wilcoxon's signed-rank test. RESULTS Among 268 attendees, 164 (61%) completed the pre- and post-meeting questionnaires, 56 (21%) declined to complete the questionnaires due to time constraints and 48 (18%) were already vaccinated. Among the 164, the median COVID-19 risk perception scores changed from 3 (neutral) pre-meeting to 5 (strong agreement with being at high risk) post-meeting (p < 0.001). Vaccine concern scores reduced, with medians changing from 4 (worried about vaccine side effects) pre-meeting to 2 (not worried) post-meeting (p < 0.001). Median scores regarding perceived COVID-19 vaccine benefits changed from 3 (neutral) pre-meeting to 5 (very beneficial) post-meeting (p < 0.001). The median scores for perceived vaccine access increased from 3 (neutral) pre-meeting to 5 (very accessible) post-meeting (p < 0.001). The median scores for willingness to receive the vaccine changed from 3 (neutral) pre-meeting to 5 (strong willingness) post-meeting (p < 0.001). CONCLUSION COVID-19 dialogue meetings led to district leaders' increased risk perception, reduced concerns, and improvement in perceived vaccine benefits, vaccine access, and willingness to receive the COVID-19 vaccine. These could potentially influence public vaccine uptake if leaders are vaccinated publicly as a result. Broader use of such meetings with leaders could increase vaccine uptake among themselves and the community.
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Affiliation(s)
| | | | - Allan Komakech
- Uganda Public Health Fellowship Program, Kampala, Uganda
| | - Tom Dias Odoi
- Baylor College of Medicine Children's Foundation, Kampala, Uganda
| | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | | | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Julie R Harris
- United States Centers for Disease Control and Prevention, Kampala, Uganda
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Smith RA, Bone C, Visco A, Calo WA, Wright J, Groff D, Lennon RP. Skeptical Health Mavens May Limit COVID-19 Vaccine Diffusion: Using the Innovation Diffusion Cycle to Interpret Results of a Cross-sectional Survey among People Who are Socially Vulnerable. JOURNAL OF HEALTH COMMUNICATION 2022; 27:375-381. [PMID: 35983888 DOI: 10.1080/10810730.2022.2111619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We sought to identify barriers to COVID-19 vaccine uptake among persons who are socially vulnerable in light of the natural cycle of innovation diffusion. Widespread adoption of a health innovation requires a cadre of opinion leaders to build on successes experienced by early adopters. One type of opinion leader in healthcare are health mavens: members of a community who maintain up-to-date health knowledge and share their knowledge others. We surveyed 139 persons who are socially vulnerable regarding their COVID-19 vaccination intention, and evaluated their responses based on psychological traits captured by two scales: innovativeness and health mavenism. Health mavenism was not strongly correlated with COVID-19 vaccine intention. Health mavens often relied on their own healthcare providers (n = 46) and health agency websites (n = 42) for vaccine information. Those who relied on their faith leaders (n = 4) reported a lower likelihood of getting vaccinated (31.5% vs. 76.0%, p < .05). The observed lack of support by health mavens represents a critical barrier to COVID-19 vaccine uptake; targeting campaigns to health mavens may increase COVID-19 vaccine uptake in socially vulnerable communities.
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Affiliation(s)
- Rachel A Smith
- Department of Communication Arts and Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Curtis Bone
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Ashley Visco
- Community Relations Department, Penn State Health, Hershey, Pennsylvania, USA
| | - William A Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jessica Wright
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Destin Groff
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Robert P Lennon
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Katsuta T, Moser CA, Feemster KA, Saitoh A, Offit PA. Comparison of immunization systems in Japan and the United States - What can be learned? Vaccine 2020; 38:7401-7408. [PMID: 33004240 DOI: 10.1016/j.vaccine.2020.09.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 10/23/2022]
Abstract
Recently, efforts have been made to fill a so-called "vaccine gap" between Japan and other countries; however, more work remains. Concerns about adverse events following immunization (AEFI) resulted in an historically passive approach to policy making in the National Immunization Program (NIP). For example, reports of AEFI following human papillomavirus vaccine (HPVV) in 2013 led the Japanese government to withdraw its proactive recommendations, resulting in a sharp drop in HPVV coverage rate to less than 1.0%. In this report, we review key historical incidents that led to the current immunization system in Japan, compare it to that in the United States, and discuss strategies for improving the Japanese immunization system. By strengthening existing policies and programs, such as National Immunization Technical Advisory Groups and AEFI reporting, compensation laws, and immunization education, the remaining vaccine gap in Japan could be filled.
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Affiliation(s)
- Tomohiro Katsuta
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan. katsuta-7-@marianna-u.ac.jp
| | - Charlotte A Moser
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Kristen A Feemster
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Immunization Program and Acute Communicable Diseases, Philadelphia Department of Public Health, Philadelphia, PA, United States; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Akihiko Saitoh
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Paul A Offit
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Social media engagement association with human papillomavirus and vaccine awareness and perceptions: Results from the 2017 US Health Information National Trends Survey. Prev Med 2020; 138:106151. [PMID: 32473273 DOI: 10.1016/j.ypmed.2020.106151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 11/23/2022]
Abstract
Due to social media's ability to publicize misinformation about vaccines, there is a need to study associations between social media engagement (SME) with human papillomavirus (HPV) and vaccine-related awareness and beliefs. Therefore, the study objectives were to (1) describe the SME of a nationally representative sample of US adults, and (2) determine the associations between SME and HPV-related awareness, HPV-related knowledge, HPV vaccine-related awareness, and perceived HPV vaccine efficacy. In 2019, we completed a secondary analysis of the 2017 Health Information National Trends Survey (Cycle 5.1). We created the SME index from 5 social media items. For each outcome variable, 3 models using binary and multinomial logistic regression were estimated. SME in the sample (n = 3171) was low (M = 0.9; range: 0-2). Respondents with higher SME had higher odds of HPV awareness (AOR = 1.56; 95% CI = 1.23, 1.99). Higher SME was associated with awareness of the HPV vaccine (AOR = 1.46; 95% CI = 1.16, 1.85). Respondents with higher SME had higher odds of perceiving HPV vaccine to be "not at all successful" (AOR = 2.22; 95% CI = 1.16, 4.24), "a little successful" (AOR = 1.99; 95% CI = 1.35, 2.94), "pretty successful" (AOR = 1.40; 95% CI = 1.04, 1.89), and "very successful" (AOR = 1.40; 95% CI = 1.02, 1.92) compared to those who selected "don't know" after adjusting for demographics and internet use. Our study highlights novel findings using a comprehensive SME index with a national sample providing insight to leverage existing consumer behaviors to better connect and disseminate accurate HPV information in a more strategic manner.
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9
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Knowledge matters and empowers: HPV vaccine advocacy among HPV-related cancer survivors. Support Care Cancer 2020; 28:2407-2413. [PMID: 31489512 DOI: 10.1007/s00520-019-05035-1] [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: 04/18/2019] [Accepted: 08/08/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE To describe knowledge about human papillomavirus (HPV), HPV-related care behavior, and advocacy intent (e.g., vaccine recommendation and willingness to become an advocate for vaccination) and to investigate associations between knowledge, HPV-related care behavior, and advocacy intent among HPV-related cancer survivors. METHODS A cross-sectional online survey was offered through Qualtrics to HPV-related cancer survivors who were either volunteers at a cancer center or patients of survivorship clinics. RESULTS A total of 200 survivors responded. Only 33.2% of respondents reported knowing their cancer was HPV-related and 56.8% reported HPV vaccine is safe. Participants who knew that their cancer was caused by HPV were more likely to have vaccinated their children (p < .001). Also, participants who knew that the vaccine is safe were more willing to recommend the vaccine (p < .001), to be a peer mentor for others with HPV-related cancers (43.2% vs. 14.0%, p < .001), and to act as an advocate for increasing vaccination rates (44.1% vs. 24.4%, p = 0.01). Finally, survivors who were aware of the vaccine's effectiveness in decreasing precancerous lesions were more likely to recommend the vaccine (45.7% vs. 12.0%, p = .002). CONCLUSIONS Raising survivor awareness of the link between HPV and cancer and HPV vaccine safety may increase their willingness to serve as powerful opinion leaders and peer mentors to promote HPV vaccination. Providers may take the simple step of informing patients that their cancer is HPV-related and HPV vaccine is safe to increase the number of informed and empowered survivors.
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Ishiwada N, Suzuki C, Hasebe S, Tsuchiya A, Takeuchi N, Hishiki H, Sato Y, Sugita K. The effects of health education on health science teachers' intention to recommend adolescent HPV vaccine for female students in Japan. Hum Vaccin Immunother 2020; 16:2752-2757. [PMID: 32159443 DOI: 10.1080/21645515.2020.1732163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The Japanese government suspended proactive recommendation of human papillomavirus (HPV) vaccination due to several reports of adverse events related to it in 2013. After that, the immunization rate of HPV vaccine quickly declined in Japan. Health science teachers (HSTs) are qualified and licensed teachers in charge of health care and health education for students in Japanese schools. HSTs have not recommended HPV vaccination to female students, since active governmental recommendation for HPV vaccination was halted for 5 y. We conducted a primary survey targeting HSTs (N = 39) and university students taking the HST training course (N = 123). In each group, awareness regarding HPV vaccine and disease burden was evaluated and factors related to and barriers to HPV vaccine recommendation were identified. The primary survey found that many HSTs and university students recognized their insufficient knowledge regarding the HPV vaccine. Based on the primary survey's results, infectious disease specialists, collaborating with Japanese HSTs, developed educational slide sets on HPV vaccine. A secondary survey was conducted before and after the lecture with HSTs (N = 162), where we evaluated their intelligibility and intention to recommend HPV vaccination for female students. In the post-lecture, secondary survey, the number of HSTs who recommended the HPV vaccine to their students had statistically increased from 76 before the lecture, to 103 (p < .05). An educational lecture using appropriate materials improved HSTs' vaccine confidence and intention to recommend the HPV vaccine to their students, verifying the study's hypothesis.
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Affiliation(s)
- Naruhiko Ishiwada
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University , Chiba-shi, Japan
| | - Chieri Suzuki
- Division of Child Health, Faculty of Education, Chiba University , Chiba-shi, Japan
| | - Sana Hasebe
- Division of Child Health, Faculty of Education, Chiba University , Chiba-shi, Japan
| | - Ayako Tsuchiya
- Division of Child Health, Faculty of Education, Chiba University , Chiba-shi, Japan
| | - Noriko Takeuchi
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University , Chiba-shi, Japan
| | - Haruka Hishiki
- Department of Pediatrics, Chiba University Hospital , Chiba-shi, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine , Tokyo, Japan
| | - Katsuo Sugita
- Division of Child Health, Faculty of Education, Chiba University , Chiba-shi, Japan
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11
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Son Y, Kang HS. [A Text Mining Analysis of HPV Vaccination Research Trends]. CHILD HEALTH NURSING RESEARCH 2019; 25:458-467. [PMID: 35004437 PMCID: PMC8650979 DOI: 10.4094/chnr.2019.25.4.458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/03/2019] [Accepted: 06/07/2019] [Indexed: 11/29/2022] Open
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Rosen BL, Rhodes D, Visker J, Cox C, Banez JC, Lasser B. Factors Associated with School Nurses' and Personnel's Professional Practice to Encourage Parents to Vaccinate Against Human Papillomavirus. THE JOURNAL OF SCHOOL HEALTH 2019; 89:569-577. [PMID: 31093985 DOI: 10.1111/josh.12783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 06/15/2018] [Accepted: 07/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND School nurses and personnel play a vital role in promoting the human papillomavirus (HPV) vaccine. The purpose of this study was to identify factors associated with school nurses' and personnel's professional practice to provide parents with HPV vaccine information and to encourage parents to vaccinate their child against HPV. METHODS School nurses and personnel from Ohio and Missouri completed a survey to assess their professional practice in providing HPV vaccine information and encouraging parents to vaccinate their child against HPV. Independent variables included demographics, HPV knowledge/attitudes, perceptions of their as an opinion leader for the HPV vaccine, self-efficacy to provide vaccine education, and perception of school district support. RESULTS Providing parents with HPV vaccine information was predicted by age, role within the school, grade-serving, knowledge, perceptions, self-efficacy, and district support; accounting for 38% of the variance (p < .000, R2 = .38). Encouraging parents to vaccinate their child against HPV was predicted by perception, self-efficacy, and grade-serving; accounting for 39% of the variance (p < .000, R2 = .39). CONCLUSIONS To enhance school nurses' and personnel's professional practice, interventions should focus on nurses' and personnel's perception of their role as opinion leaders and self-efficacy to provide HPV education and vaccine recommendation.
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Affiliation(s)
- Brittany L Rosen
- School of Human Services, University of Cincinnati, PO Box 210068, Cincinnati, OH 45221
| | - Darson Rhodes
- Department of Public Health and Health Education, The College at Brockport, State University of New York, 350 New Campus Drive, Brockport, NY 14420
| | - Joseph Visker
- Department of Health Science, Office: HCN 205, Minnesota State University, Mankato, Mankato, MN 56001
| | - Carolyn Cox
- Health Science, 2123 Pershing Building, Truman State University, Kirksville, MO 63501
| | - J Christian Banez
- 2123 Pershing Building, Truman State University, Kirksville, MO 63501
| | - Benjamin Lasser
- 2123 Pershing Building, Truman State University, Kirksville, MI 63501
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Abstract
Nurses are increasingly being called upon to lead changes within health care. How do nurses and, in particular, school nurses become leaders? School nurses lead daily in their work but often do not recognize themselves as leaders. The "Five C's of Leadership"-character, commitment, connectedness, compassion, and confidence-identified by Kowalski and Yoder-Wise are foundational to the development of leadership and are particularly relevant to school nurses and their role. Two additional attributes found in the literature-courage and capacity-also undergird school nursing practice. In this article, we describe how school nurses already embody these leadership qualities. Each leadership attribute is reviewed in light of the literature, followed by specific examples to demonstrate how school nurses provide leadership. Through these illustrations, school nurses can recognize and embrace their present leadership abilities. In addition, by using the "Seven C's" of leadership, school nurses can enhance their inherent leadership abilities.
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Affiliation(s)
- Penny C Weismuller
- Associate Professor, School of Nursing, California State University Fullerton, Fullerton, California
| | - Mayumi A Willgerodt
- Professor, University of Washington, Family and Child Nursing, Bothell, Washington
| | - Rachel McClanahan
- Assistant Professor, School of Nursing, California State University Fullerton, Fullerton, California
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14
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Rosen BL, Ashwood D, Richardson GB. School Nurses' Professional Practice in the HPV Vaccine Decision-Making Process. J Sch Nurs 2015; 32:138-48. [PMID: 25962388 DOI: 10.1177/1059840515583312] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Because U.S. human papillomavirus (HPV) vaccination rates remain low, we evaluated school nurses' knowledge, attitudes, perceptions of their role as opinion leaders, self-efficacy, intention, and professional practice regarding the HPV vaccine and determined if these variables influenced their professional practice concerning the HPV vaccine. We utilized a cross-sectional design by recruiting Ohio Association of School Nurses (OASN) members. Participants (n = 145) completed a paper survey during the OASN annual conference. Structural equation modeling was used to examine the proposed model. Our model yielded a well-fitting solution, χ2 = 1.118 (degrees of freedom = 2, p = .57). Knowledge had positive effects on intention and self-efficacy. Attitude had a positive effect on perception of role as opinion leaders. Intention to provide HPV vaccine education had a positive effect on professional practice. To develop school nurses' practice, interventions should center on increasing knowledge, attitudes, and intention toward providing HPV vaccine education.
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Affiliation(s)
| | - Daniel Ashwood
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA
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15
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Rosen BL, Goodson P, Thompson B, Wilson KL. School nurses' knowledge, attitudes, perceptions of role as opinion leader, and professional practice regarding human papillomavirus vaccine for youth. THE JOURNAL OF SCHOOL HEALTH 2015; 85:73-81. [PMID: 25564975 DOI: 10.1111/josh.12229] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 05/26/2014] [Accepted: 07/09/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Because human papillomavirus (HPV) vaccine rates remain low, we evaluated US school nurses' knowledge, attitudes, perceptions of their role as opinion leaders, and professional practice regarding HPV vaccine, and assessed whether knowledge, attitudes, and perceptions of being an opinion leader influenced their professional practice regarding the HPV vaccine. METHODS We used a cross-sectional design by recruiting members from the National Association of School Nurses. All participants (N = 505) were e-mailed a survey designed for this study. Structural equation modeling (SEM) tested direct and indirect effects. RESULTS Overall, school nurses had knowledge about HPV and the vaccine, and positive attitudes toward the vaccine. They had less-than-enthusiastic perceptions of their role as opinion leaders regarding the vaccine and implemented few activities related to providing vaccine information. The model revealed a good fit (χ(2)=20.238 [df=8, p< .01]), with knowledge directly related to attitudes, attitudes directly related to perceptions and practice, and perceptions directly affecting practice. In our model, perceptions functioned as a partial mediator. CONCLUSIONS To enhance school nurses' practice regarding the HPV vaccine, focus should be on increasing positive attitudes toward the vaccine and strengthening perceptions of their role as opinion leaders.
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Affiliation(s)
- Brittany L Rosen
- University of Cincinnati, School of Human Services, PO Box 210068, Cincinnati, OH 45221
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