Challenges and Lessons Learned From a Mobile Health, Web-Based Human Papillomavirus Intervention for Female Korean American College Students: Feasibility Experimental Study

A qualitative study of ethnic Korean women and men's experiences of HPV and HPV vaccination in the United States

INTRODUCTION

Approximately 42.5% of adults aged 18-59 in the United States is estimated to be affected by human papillomavirus (HPV) infection. However, Asian Americans have the lowest HPV vaccination initiation rate compared to other racial groups. This study aims to explore the experiences of HPV and the HPV vaccination among ethnic Korean women and men in the United States.

METHODS

A total of 33 ethnic Korean and Korean Americans aged 27-45 years living in the U.S. were recruited via word-of-mouth and social media using a purposive sampling strategy. They participated in an online survey. Of the 33 participants, 29 (14 females and 15 males) participated in in-depth interviews via password-protected Zoom. A content analysis approach was used to analyze the interviews.

RESULTS

Only 32% of participants had received the HPV vaccine at least once (female: 35.3%, male: 12.5%). Six major themes emerged from data analysis: (1) awareness of HPV, HPV vaccine, and HPV-associated cancers; (2) attitudes toward the HPV vaccine; (3) barriers to HPV vaccination; (4) women's experiences and preferences for pap smear testing; (5) experiences with HPV diagnosis; and (6) HPV and HPV vaccination education preferences.

CONCLUSION

The findings highlight cultural factors that may impede the discussion about and uptake of HPV vaccination and HPV-associated cancer screening, which emphasize the need for culturally appropriate interventions to overcome stigma around HPV and enhance vaccination rates. Healthcare providers should consider ethnic and cross-cultural differences perceptions to effectively HPV-related health information. This study provides insight into the experiences and understanding of HPV and vaccination among ethnic Korean men and women, laying the groundwork for developing culturally-tailored programs that sim to increase HPV vaccination rates and mitigate the stigma and impact of HPV-related disease in this community.

Residents as Research Subjects: Balancing Resident Education and Contribution to Advancing Educational Innovations

BACKGROUND

Research in education advances knowledge and improves learning, but the literature does not define how to protect residents' rights as subjects in studies or how to limit the impact of their participation on their clinical training.

OBJECTIVE

We aimed to develop a consensual framework on how to include residents as participants in education research, with the dual goal of protecting their rights and promoting their contributions to research.

METHODS

A nominal group technique approach was used to structure 3 iterative meetings held with the pre-existing residency training program committee and 7 invited experts between September 2018 and April 2019. Thematic text analysis was conducted to prepare a final report, including recommendations.

RESULTS

Five themes, each with recommendations, were identified: (1) Freedom of participation: participation, non-participation, or withdrawal from a study should not interfere with teacher-learner relationship (recommendation: improve recruitment and consent forms); (2) Avoidance of over-solicitation (recommendation: limit the number of ongoing studies); (3) Management of time dedicated to participation in research (recommendations: schedule and proportion of time for study participation); (4) Emotional safety (recommendation: requirement for debriefing and confidential counseling); and (5) Educational safety: data collected during a study should not influence clinical assessment of the resident (recommendation: principal investigator should not be involved in the evaluation process of learners in clinical rotation).

CONCLUSIONS

Our nominal group technique approach resulted in raising 5 specific issues about freedom of participation of residents in research in medical education, over-solicitation, time dedicated to research, emotional safety, and educational safety.