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Ghazy RM, Hussein M, Abdu SMM, El-Sayed Ellakwa D, Tolba MM, Youssef N, Mahboob AS, Abd ElHafeez S. The intention of Egyptian healthcare workers to take the monkeypox vaccine: is urgent action required? BMC Health Serv Res 2024; 24:1204. [PMID: 39379920 PMCID: PMC11462741 DOI: 10.1186/s12913-024-11147-0] [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: 03/29/2023] [Accepted: 05/24/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND In light of the ongoing monkeypox (MPOX) epidemic, healthcare workers (HCWs) have been in contact with various diseases. Therefore, they should take appropriate preventive and control measures to maintain their health. This study assessed Egyptian HCWs' intentions to take MPOX vaccines. METHODS A cross-sectional survey was conducted using social media platforms between September 27 and November 4, 2022. An anonymous online survey using the 5C scale was conducted using convenience and snowball sampling methods to assess the five psychological antecedents of vaccination (i.e., confidence, constraints, complacency, calculation, and collective responsibility). RESULTS A total of 399 HCWs with a mean age of 32.6 ± 5.7 participated in this study. Of them, 89.7% were female. The five C psychological antecedents of vaccination were as follows: 55.9% were confident about vaccination, 50.6% were complacent, 56.6% experienced constraints, 60.7% calculated the risk and benefit, and 58.4% had collective responsibility. Multivariate analysis showed that high income level and having information about MPOX were significant predictors of confidence in the MPOX vaccines (adjusted odds ratio ((AOR) = 4.19, 95% CI (1.12- 15.59), P = 0.032). Participants aged 31-45 years and 19-30 years showed significant association (AOR = 2.46, 95% CI (0.85-7.15), P = 0.096) and (AOR = 4.19, 95% CI (1.39-12.64), P = 0.011), respectively. Having an idea about the MPOX vaccines significantly predicted the complacency domain (AOR = 3.77, 95%CI (1.47-9.65, P = 0.006). Moreover, precollege/undergraduate education and having an idea about MPOX vaccination were significant predictors of the constraint domain (AOR = 1.81.95% CI (1.09-2.99, P = 0.020), (AOR = 2.70, 95% CI (1.05-6.95, P = 0.038), respectively). Female sex, having a diploma, postgraduate studies, and having an idea about MPOX vaccine significantly predicted calculation domain (AOR = 2.06, 95% CI (1.05-4.04, P = 0.035), (AOR = 3.98,95% CI (1.33-11.87, P = 0.013), (AOR = 2.02, 95% CI (1.25-3.26, P = 0.004) & (AOR = 2.75. 95% CI (1.05-7.18, P = 0.039), respectively. The only significant predictor of collective responsibility was having a diploma and postgraduate studies (AOR = 3.44, 95% CI (1.21-9.78, P = 0.020), (AOR = 1.90,95% CI (1.17-3.09, P = 0.009). CONCLUSIONS Efforts to control MPOX should focus on promoting protective measures such as the vaccination of HCWs as well as raising their awareness about the updated information regarding the virus and the approved vaccines.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Mai Hussein
- Alexandria Clinical Research Administration, Alexandria Health Affairs Directorate, Alexandria, Egypt.
- Ministry of Health and Population, Cairo, Egypt.
| | | | - Doha El-Sayed Ellakwa
- Biochemistry Department Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
- Department of Biochemistry, Faculty of Pharmacy, Sinai University, Kantara Branch, Ismailia, Egypt
| | - Mahmoud M Tolba
- Pharmaceutical Division, Ministry of Health and Population, Cairo, Egypt
| | - Naglaa Youssef
- Medical-Surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
| | - Amira Saad Mahboob
- Department of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Samar Abd ElHafeez
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Fernandez-Pineda M, Melendez CR, Fernandez M, Cianelli R, Roman J, Villegas N, Matsuda Y, Montano NP. Predictors of Human Papillomavirus Vaccine Intention and Uptake Among US Hispanic Parents: A Cross-Sectional Study. HISPANIC HEALTH CARE INTERNATIONAL 2024; 22:142-149. [PMID: 38321763 DOI: 10.1177/15404153241229688] [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] [Indexed: 02/08/2024]
Abstract
Introduction: This study explored the influence of the Theory of Planned Behavior constructs on human papillomavirus (HPV) vaccine (HPVV) intentions and uptake among Hispanic parents in South Florida for their children aged 9-21. Method: A descriptive exploratory analysis was conducted using 39 surveys completed by Hispanic parents. These surveys encompassed demographic data and questions about HPVV uptake, intention, attitudes, subjective norms, knowledge, self-efficacy, and awareness. Results: Most participants were uninsured (77%), unemployed (59%), and had low Americanism acculturation (74%). A little over half were aware of the HPVV (54%), yet most had high positive HPVV attitudes (95%) and self-efficacy (85%). HPVV intentions within the year were also high (82%); however, HPVV uptake (45%) and HPVV knowledge (40%) were low at the time of the study. Most parents reported physicians (72%) and nurses/nurse practitioners (59%) as the most influential individuals in their decision-making. A statistically significant relationship between HPVV intention and HPVV attitude (X_Wald^2 (1) = 5.71, p = 0.02., OR = 5.11) and between HPVV uptake and HPVV awareness (X_Wald^2 (1) = 4.63, p = 0.03., OR = 12) were observed. Conclusion: This study recommends further research and targeted interventions to improve HPVV awareness among Hispanic communities. The participants' highly positive attitudes and self-efficacy provide a hopeful outlook for future vaccination efforts within this demographic.
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Affiliation(s)
| | - Carlos R Melendez
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, NC, USA
| | | | - Rosina Cianelli
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Jessica Roman
- College of Nursing, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Natalia Villegas
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
| | - Yui Matsuda
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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Prokopovich K, Braunack-Mayer A, Street J, Stanoevska B, Pitts L, Phillipson L. Applying a Participatory Action Research Approach to Engage an Australian Culturally and Linguistically Diverse Community around Human Papillomavirus Vaccination: Lessons Learned. Vaccines (Basel) 2024; 12:978. [PMID: 39340010 PMCID: PMC11436009 DOI: 10.3390/vaccines12090978] [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: 07/15/2024] [Revised: 08/20/2024] [Accepted: 08/23/2024] [Indexed: 09/30/2024] Open
Abstract
Globally, migrant and culturally and linguistically diverse (CALD) communities are known to have inequitable access to HPV vaccination. One participatory research approach used to engage CALD communities around vaccination is participatory action research (PAR), but we know little about the use of PAR to engage priority migrant and CALD communities around school and HPV vaccination. To address this gap, we partnered with our local Multicultural Health Service to understand how the largest CALD group in our region of New South Wales, Australia, engages with their local school and HPV vaccination program. Through a long-standing PAR relationship, we used a participatory research method (World Café) approach to explore the level of awareness and engagement a multi-generational community member had concerning HPV vaccination. We acted by sharing a co-designed information website to answer the community's questions about HPV vaccination. We then evaluated these engagements with surveys, focus groups and online analytic platforms. Last, we reflected with project partners and health service stakeholders on the overall project outcomes and shared our learnings. In our discussion, we shared our lessons learned and contributed to a wider conversation about the benefits, challenges, and practicalities of using PAR to engage a priority CALD community around HPV vaccination.
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Affiliation(s)
- Kathleen Prokopovich
- Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia
| | - Annette Braunack-Mayer
- Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia
| | - Jackie Street
- Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Level 4, Rundle Mall Plaza, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Biljana Stanoevska
- Multicultural and Refugee Health Service-Illawarra Shoalhaven Local Health District, 67 King St., Warrawong, NSW 2502, Australia
| | - Leissa Pitts
- Multicultural and Refugee Health Service-Illawarra Shoalhaven Local Health District, 67 King St., Warrawong, NSW 2502, Australia
| | - Lyn Phillipson
- Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia
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Kuru Alici N, Arikan Donmez A, Oguncer A. Knowledge, Attitudes, and Cultural Beliefs of Afghan Refugee Women Toward Gynecological Cancer: A Qualitative Study. Clin Nurs Res 2024:10547738241267089. [PMID: 39066618 DOI: 10.1177/10547738241267089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Gynecological cancers constitute an important global health problem with increasing incidence and prevalence. The aim of this study was to explain gynecologic cancer knowledge, attitudes, and cultural beliefs of Afghan refugee women living in Türkiye. This research was carried out as a descriptive phenomenological design for qualitative research. The study was conducted at the Refugee Support Center Association in Eskişehir, Türkiye, and data were collected between January and April 2023, guided by a semi-structured interview guide. Nineteen Afghan refugee women were interviewed. A purposive sampling method was used to recruit participants. Content analysis method was used for data analysis. Four overarching themes that described Afghan women's gynecologic cancer knowledge, attitudes, and cultural beliefs were identified: (a) limited awareness and knowledge of gynecological cancer among women, (b) women's attitudes toward gynecological cancers, (c) women's cultural beliefs regarding gynecological cancer, and (d) healthcare system factors. In line with the main themes, subthemes were created for each main theme. Afghan refugee women, who were in the double risk group as both women and refugees, had insufficient knowledge of gynecological cancers, and their cultural beliefs and attitudes played an essential role in their access to gynecological cancer-related preventive healthcare services. It is recommended that training be planned to increase the awareness and knowledge of Afghan women on gynecological cancers, considering their cultural characteristics.
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Affiliation(s)
| | | | - Ali Oguncer
- Refugee Support Association, Eskişehir Provincial Office, Ankara, Türkiye
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Bittew SM, Masresha SA, Mulaw GF, Yimam MA, Zimamu AA, Abriham AA, Kidie AA. Parental willingness to vaccinate their daughters against human papilloma virus and its associated factors in Woldia town, Northeast Ethiopia. Front Glob Womens Health 2024; 5:1243280. [PMID: 39049935 PMCID: PMC11266047 DOI: 10.3389/fgwh.2024.1243280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
Background The cells of the cervical epithelial wall are the source of the malignant tumor caused by the human papilloma virus (HPV) known as cervical cancer. In 2018, Ethiopia implemented the HPV vaccine specifically targeting girls aged 9-14 years. This vaccination initiative serves as an effective preventive measure against cervical cancer, provided that parents express a positive inclination to have their daughters vaccinated as part of the program. Objective The aim of the study was to assess parental willingness to vaccinate their daughters against human papillomavirus and its associated factors in Woldia town, Northeast Ethiopia. Methods A community-based cross-sectional study was conducted among 414 parents of daughters aged 9-14 years between 10 and 25 January 2023. Respondents were selected by a systematic sampling method and a face-to-face interview was conducted to collect data. Data were entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Multivariable analyses were used to examine the association between dependent and independent variables. The adjusted odds ratio (AOR), 95% confidence interval (CI), and p-value <0.05 were used to determine statistical significance. Results A total of 410 study participants with a response rate of 99% were included in the study, and approximately 72.9% (95% CI: 68.3-77.2) of them were willing to vaccinate their daughters. This study found that parents with a family history of cervical cancer screening (AOR = 3.27, 95%; CI = 1.38-7.74), secondary and above educational status (AOR = 2.72, 95% CI = 1.29-5.73), good knowledge of the human papilloma virus vaccination (AOR = 3.00, 95% CI = 1.70-5.28), and favorable attitude toward the human papilloma virus vaccine (AOR = 4.40, 95% CI = 2.45-7.88) were significantly associated with parental willingness to vaccinate their daughters against human papilloma virus. Recommendation In this study, most parents were willing to vaccinate their daughters against human papilloma virus. The significant determinants of parental willingness to their daughter's human papilloma virus vaccination were family history of cervical cancer screening, level of education, and knowledge and attitude toward the human papilloma virus vaccine. Therefore, health information regarding the human papillomavirus vaccination with an emphasis on raising community awareness should be designed.
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Affiliation(s)
| | | | - Getahun Fentaw Mulaw
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Mohammed Ahmed Yimam
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | | | | | - Atitegeb Abera Kidie
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
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Khoja L, Torres HG, Hak L, Aljebori M, Phung MT, Sakleh A, Stiffler M, Tariq M, Pearce CL. Cervical cancer screening and vaccination acceptability and attitudes among Arab American women in Southeastern Michigan: a qualitative study. Sci Rep 2024; 14:13624. [PMID: 38871762 PMCID: PMC11176183 DOI: 10.1038/s41598-024-64462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 06/10/2024] [Indexed: 06/15/2024] Open
Abstract
Among Arab-American women in Michigan, rates of cervical cancer screening are lower than those in non-Hispanic White and Black women in the state. A deep understanding of the Arab community's perspective on cervical cancer screening is needed to address the disparity in rates across populations in Michigan. Arab and Chaldean women across Michigan were invited to participate in Zoom-based focus groups to understand the attitudes, acceptability, and barriers of cervical cancer screening among this population. Four focus groups with a total of 19 women aged 30 to 61 were conducted. The focus groups were conducted in English, Arabic, or both languages. The guided discussion was focused on knowledge of cervical cancer and Human papillomavirus (HPV) and its transmission, attitudes towards HPV vaccination, and attitudes towards cervical cancer screening. HPV self-sampling as an alternative to traditional provider-based screening was specifically discussed as this has been proposed as a way to increase screening in hard-to-reach populations. The conversations revealed insights related to barriers at the individual and community levels for screening and vaccination, attitudes towards preventive health care including screening, a need for accessible women's health literature, and health education. The women also discussed vaccine hesitancy related to HPV and COVID-19, suggesting a need for targeted community interventions.
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Affiliation(s)
- Lilah Khoja
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Heidi G Torres
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Layla Hak
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Manar Aljebori
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Minh Tung Phung
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Andrea Sakleh
- Center for Arab Narratives at the Arab American National Museum, ACCESS, 6450 Maple St., Dearborn, MI, 48126, USA
| | - Matthew Stiffler
- Center for Arab Narratives at the Arab American National Museum, ACCESS, 6450 Maple St., Dearborn, MI, 48126, USA
| | - Madiha Tariq
- ACCESS Community Health and Research Center, 6450 Maple St., Dearborn, MI, 48126, USA
| | - Celeste Leigh Pearce
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
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Du C, Voaklander D, Meherali S, Paudel YR, MacDonald SE. Human papillomavirus vaccine coverage among immigrant adolescents in Alberta: a population-based cohort study. Int Health 2024:ihae038. [PMID: 38785316 DOI: 10.1093/inthealth/ihae038] [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: 11/24/2023] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Little is known about human papillomavirus (HPV) vaccination among immigrant children in Canada. We conducted a study in Alberta, Canada to assess HPV vaccine coverage among school-aged immigrant children compared with non-immigrant children. METHODS This cohort study analysed population-based linked administrative health data to measure HPV vaccine coverage for 346 749 school-aged children, including 31 656 immigrants. Coverage was examined at 12 y of age from 2008 to 2018 for females, and from 2014 to 2018 for males and both sexes combined; vaccine series completion was considered receipt of three doses, with initiation (one or more dose) as a supplementary analysis. Multivariable logistic regression examined the association of vaccine coverage with migration status, adjusting for sociodemographic variables. RESULTS Between 2014 and 2018, HPV vaccination coverage among immigrant children at age 12 y was significantly higher (52.58%) compared with non-immigrant children (47.41%). After controlling for place of residence, income quintile, biological sex and year, immigrant children had 1.10 greater odds (95% confidence interval 1.07 to 1.14) of receiving three doses of HPV vaccine compared with non-immigrant children. Immigrants from Asia and Africa had the highest coverage (60.25-68.78%), while immigrants from North America, Oceania and South America had the lowest coverage (39.97-48.36%). CONCLUSIONS It is encouraging that immigrant children had higher HPV vaccine coverage compared with non-immigrants. Among immigrants, routine immunization promotion strategies should be tailored based on the country of origin.
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Affiliation(s)
- Crystal Du
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Don Voaklander
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Salima Meherali
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Yuba Raj Paudel
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Shannon E MacDonald
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
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Tsige AW, Ayenew KD, Ayele SG. Assessment of knowledge and perceptions of human papillomavirus vaccine and its determinants among women who have eligible daughters in Debre Berhan City, Ethiopia: a cross-sectional study. Front Oncol 2024; 14:1348288. [PMID: 38562169 PMCID: PMC10982310 DOI: 10.3389/fonc.2024.1348288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Globally, cervical cancer(CC) is the second most commonly diagnosed cancer and the fourth leading cause of cancer-related deaths in women. Human papillomavirus (HPV) infection is the leading cause of CC. Persistent infection with HPV accounts for 90% of all CC cases. The human papillomavirus vaccine has the great potential to prevent HPV-related infections for millions of women and men. The current study aimed to assess knowledge and perceptions towards the HPV vaccine and its determinants among women who have eligible daughters in Debre Berhan City, Ethiopia. Methods A cross-sectional study was conducted from April 2, 2023, to May 15, 2023. A multistage sampling procedure was used to recruit 607 women participants. Descriptive statistics were used to summarize socio-demographic data. Univariable and multivariable binary logistic regression analyses were performed to measure the associations between the dependent and independent variables. A p-value of <0.05 was considered statistically significant. Results More than three-fourths of the participants, 479 individuals (80%) were currently married, and 243(40.1%) had a diploma or higher education level. Of 456(75.12) participants reported, they had information about cervical cancer. For 449(73.9%) of the participants, television was the main evidence. The majority of 352(59.99%) participants knew the HPV vaccine could be offered to a female child aged 9-14 years old. Only 215(35.4%) participants think the HPV vaccine was safe and effective. Women who had a degree and above educational level were about 9 times more likely to have good knowledge about the HPV vaccine than study participants who did not read and write (AOR=9.21; 95% CI=2.82-12.16; p=0.004). Women who did not have information about the HPV vaccine before this study were about 80% less likely to have a positive perception of the HPV vaccine than participants who had earlier information about the HPV vaccine (AOR=0.8; 95%CI=0.63-0.49; P=003). Conclusion Women had poor knowledge and perceptions about the HPV vaccine. Maternal marital status, age, and having information about the HPV vaccine were the only predictors of women's knowledge of the HPV vaccine.
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Affiliation(s)
- Abate Wondesen Tsige
- Department of Pharmacy, Clinical Pharmacy Unit, Debre Berhan University, Debre Berhan, Ethiopia
| | - Kassahun Dires Ayenew
- Department of Pharmacy, Clinical Pharmacy Unit, Debre Berhan University, Debre Berhan, Ethiopia
| | - Siraye Genzeb Ayele
- Department of Midwifery, College of Health Sciences, School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
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Achimaș-Cadariu T, Pașca A, Jiboc NM, Puia A, Dumitrașcu DL. Vaccine Hesitancy among European Parents-Psychological and Social Factors Influencing the Decision to Vaccinate against HPV: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2024; 12:127. [PMID: 38400111 PMCID: PMC10891840 DOI: 10.3390/vaccines12020127] [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: 12/12/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Due to low adherence to HPV vaccination programs, the European region struggles with vaccination rates lower than 30% among the targeted population. The present report investigated various socio-demographic and psychological factors influencing European parents' hesitancy towards vaccinating their children. METHODS As of September 2023, four databases were searched. After applying inclusion criteria, all articles comparing psychological and socio-demographic factors in parents who vaccinate or do not vaccinate their children were included. RESULTS Twenty-five primary publications met the criteria, totaling 385,460 responders, of which 311,803 want to or have already vaccinated their child, and 73,555 do not wish to do so. Immigrant and employment status, religion, age of parents and the child's gender seemed to influence their decision to vaccinate their child. Previous experience with vaccines, perceived safety and efficacy and the mother's previous abnormal CCS results also impacted their decision. The caregivers' education, gender, civil status, number of children, family history of neoplasia or mother's CCS attendance did not influence their hesitancy to vaccine. CONCLUSION Multiple demographic, social, economic and psychological barriers involved in the parents' hesitancy to vaccinate their children against the HPV virus were highlighted. Specific at-risk categories that need to be targeted with information, education and vaccination campaigns were identified.
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Affiliation(s)
- Teodora Achimaș-Cadariu
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (T.A.-C.); (A.P.); (D.L.D.)
| | - Andrei Pașca
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (T.A.-C.); (A.P.); (D.L.D.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | | | - Aida Puia
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (T.A.-C.); (A.P.); (D.L.D.)
| | - Dan Lucian Dumitrașcu
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (T.A.-C.); (A.P.); (D.L.D.)
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Fisher H, Denford S, Audrey S, Finn A, Hajinur H, Hickman M, Mounier-Jack S, Mohamed A, Roderick M, Tucker L, Yates J, Chantler T. Information needs of ethnically diverse, vaccine-hesitant parents during decision-making about the HPV vaccine for their adolescent child: a qualitative study. BMC Public Health 2024; 24:91. [PMID: 38178083 PMCID: PMC10768213 DOI: 10.1186/s12889-023-17540-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The English schools-based human papillomavirus (HPV) vaccination programme has the potential to eliminate HPV-related cancers if high uptake is achieved. However, unmet information needs among some parents may contribute to persisting lower uptake among minority ethnic groups. Through this study we aimed to understand the information needs of vaccine-hesitant, ethnically diverse parents during decision-making about the HPV vaccine for their adolescent child, to inform the future development of tailored communication materials. METHODS Recruitment was facilitated thorough healthcare and community organisations within London and the South West of England. Semi-structured interviews took place between April and August 2023. Thematic analysis was undertaken, assisted by NVivo software. RESULTS Of the 29 parents interviewed, the majority were mothers (79%), belonged to a minority ethnic group (88%), and had an adolescent child unvaccinated against HPV (72%). Five of the interviews were undertaken in the participants' primary language with translation support. Most parents interviewed had limited knowledge about the HPV vaccine and appeared conflicted as to whether vaccines could offer benefits to health. Misunderstanding around the potential of developing serious side-effects (e.g. fertility issues, developing cancer) were factors that could negatively impact decision-making by parents. Stigma associated with the sexual transmissibility of HPV did not always negatively impact decision-making. However, some parents chose not to vaccinate on the basis of perceptions of low risk and a preference to provide education about sexual behaviours to their adolescent child. CONCLUSIONS Tailoring communication materials to address misunderstandings could support informed decision-making by vaccine hesitant parents for their adolescent children to be vaccinated against HPV. Future communication materials about the HPV vaccine should highlight the benefits of protection against cancer to increase parents' motivation for protect their adolescent child; provide accurate convincing information in relation to the excellent safety profile; and emphasise the importance of providing HPV vaccine at the recommended age, all alongside communicating the universality and commonality of HPV infection. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Harriet Fisher
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK.
| | - Sarah Denford
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK
| | - Suzanne Audrey
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK
| | - Adam Finn
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK
- Schools of Population Health Sciences and of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
| | | | - Matthew Hickman
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK
| | - Sandra Mounier-Jack
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Vaccinations and Immunisation, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, UK
- LSHTM Vaccine Centre, London, UK
| | | | - Marion Roderick
- Department of Paediatric Immunology and Infectious Diseases, University Hospitals of Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Julie Yates
- UK Health Security Agency, Wellington House, London, UK
| | - Tracey Chantler
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Vaccinations and Immunisation, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, UK
- LSHTM Vaccine Centre, London, UK
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11
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Ou L, Chen ACC, Amresh A. The Effectiveness of mHealth Interventions Targeting Parents and Youth in Human Papillomavirus Vaccination: Systematic Review. JMIR Pediatr Parent 2023; 6:e47334. [PMID: 37988155 PMCID: PMC10698656 DOI: 10.2196/47334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/18/2023] [Accepted: 10/12/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The prevalence of human papillomavirus (HPV) and its related cancers is a major global concern. In the United States, routine HPV vaccination is recommended for youth aged 11 or 12 years. Despite HPV being the most common sexually transmitted infection and the vaccine's proven efficacy, the vaccination rate among US youth remains below the recommended 80% completion rate. Mobile health (mHealth) interventions have demonstrated promise in improving health. Examining and synthesizing the current evidence about the impact of mHealth interventions on vaccination coverage in youth and intervention characteristics could guide future mHealth interventions aimed at mitigating the vaccination gap and disease burden. OBJECTIVE This study aims to conduct a systematic review to assess the effectiveness of mHealth interventions on parental intent to vaccinate youth against HPV and youth's vaccine uptake. METHODS We searched empirical papers through databases including Google Scholar, PubMed, CINAHL, PsycINFO, and Cochrane Library. The inclusion criteria were the following: (1) published between January 2011 and December 2022; (2) using mHealth aimed to improve HPV vaccination rate; (3) targeted unvaccinated youth or their parents; and (4) measured HPV-related knowledge, vaccination intention, or vaccine uptake. Overall, 3 researchers screened and appraised the quality of the eligible papers using the Melnyk Levels of Evidence and the Cochrane Grading of Recommendations Assessment, Development, and Evaluation methodology. Disagreements in search results and result interpretation were resolved through consensus. RESULTS Overall, 17 studies that met the inclusion criteria were included in the final review. Most studies were conducted in the United States (14/17, 82%), used a randomized controlled trial design (12/17, 71%), and adopted behavior change theories or a culture-centric approach (10/17, 59%). mHealth interventions included SMS text message reminders, motivational SMS text messages, computer-tailored or tablet-tailored interventions, smartphone apps, web-based tailored interventions, social media (Facebook) campaigns, digital videos, and digital storytelling interventions. Approximately 88% (15/17) of the mHealth interventions demonstrated positive effects on knowledge, intention, or behaviors related to HPV vaccination. Overall, 12% (2/17) reported limited or no intervention impact on vaccine uptake or vaccine series completion. Effective vaccine uptake was commonly seen in interventions based on behavior change theories and those that provided culturally relevant information. CONCLUSIONS This systematic review identified the impact of mHealth interventions among unvaccinated youth and their parents, which showed improvement in HPV-related knowledge, vaccination intention, or vaccine initiation. The interventions that incorporated theories and culture-centric approaches revealed the most promising results. Although these outcomes are encouraging, future studies are needed to investigate factors associated with the success of interventions using SMS text messaging or social media. More studies are also needed for a better understanding of the intervention elements that boost the responses of age-specific and ethnicity-specific populations.
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Affiliation(s)
- Lihong Ou
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | | | - Ashish Amresh
- College of Engineering, Informatics, and Applied Sciences, Northern Arizona University, Flagstaff, AZ, United States
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12
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Sirithammaphan U, Chaisang U, Pongrattanamarn K. Barriers to measles mumps rubella vaccine acceptance in the three southern border provinces of Thailand. Clin Exp Vaccine Res 2023; 12:298-303. [PMID: 38025912 PMCID: PMC10655155 DOI: 10.7774/cevr.2023.12.4.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/19/2023] [Accepted: 08/26/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This qualitative study utilizing phenomenological methodology aimed to depict parental measles mumps rubella (MMR) vaccine acceptance through the work experiences of health personnel. Materials and Methods Twenty-two public health workers working as vaccination providers in the three southern border provinces of Thailand were recruited. In-depth, face-to-face, semi-structured interviews were conducted. Data were analyzed using thematic analysis. Results Four main themes emerged: (1) religious beliefs, (2) personal disagreements, (3) fear and mistrust regarding potential vaccine side effects, and (4) misperceptions about the potential severity of measles. Four subthemes were identified: (1) haram (prohibited), (2) the will of Allah, (3) spousal disagreement, and (4) disagreement from a religious leader. The results of this study indicated that perceived religious prohibition was the most important reason for refusing to vaccinate among Muslim parents. Vaccine-hesitant parents were concerned that the vaccine might contain gelatin derived from pig products. Also, halal certification of the vaccine was required from Muslim parents to ensure that vaccine has been approved for Muslims. Meanwhile, a lack of knowledge and positive attitudes concerning immunizations of vaccine-hesitant parents were also found as predominant reasons for incomplete childhood immunizations in the deep south of Thailand. Conclusion Health education and engagement by religious leaders to endorse the vaccination and bridge the gap between religious beliefs and vaccine acceptance is needed to overcome this issue. This study findings could be effectively applied to improve vaccination uptake in a Muslim majority context.
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Affiliation(s)
- Uraiwan Sirithammaphan
- Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Sirindhorn College of Public Health Yala, Yala, Thailand
| | - Ubontip Chaisang
- Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Sirindhorn College of Public Health Yala, Yala, Thailand
| | - Kwanjit Pongrattanamarn
- Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Sirindhorn College of Public Health Yala, Yala, Thailand
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13
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Colomé-Ceballos L, Clua-Espuny JL, Ceballos-García C, Clua-Queralt J, Pla-Farnós MJ, Fernández-Sáez J. Understanding Prognostic Factors for Human Papillomavirus Vaccination: A Rural Community Case-Control Study. Vaccines (Basel) 2023; 11:1536. [PMID: 37896940 PMCID: PMC10610576 DOI: 10.3390/vaccines11101536] [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: 07/28/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
HPV vaccination coverage rates can vary depending on several factors. The main objective of this study is to identify possible independent prognostic factors that have an impact on HPV vaccination in a rural community, specifically related to sexual and reproductive health. A case-control, retrospective, community-based study was carried out on women aged 15 to 40 in the primary health centers of Southern Catalonia's Terres de l'Ebre region, Spain, from 1 January 2020 to 31 December 2022. A random sample of 520 women with an average age of 29.3 (SD 7.8) years old was included in the study. Independent prognostic factors: age OR 0.680 (95% CI: 0.635-0.729, p < 0.001), immigrant origin OR 0.215 (95% CI: 0.109-0.422, p < 0.001), and HPV PCR OR 7.402 (95% CI: 2.504-21.880, p < 0.001). The variables that showed a barrier effect for HPV vaccination were age (OR 0.680, 95% CI 0.635-0.729, p < 0.001), and immigrant origin (OR 0.215, 95% CI 0.109-0.422, p < 0.001). The variable that showed a facilitating effect for HPV vaccination was HPV PCR (OR 7.402, 95% CI 2.504-21.880, p < 0.001).
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Affiliation(s)
- Lara Colomé-Ceballos
- Sexual and Reproductive Attention, SAP Terres de l'Ebre, Catalonian Health Institute, 43500 Catalonia, Spain
- Gynaecology Department, Hospital Verge de la Cinta de Tortosa, Catalonian Health Institute, 43500 Catalonia, Spain
| | - Josep Lluís Clua-Espuny
- EAP Tortosa Est. Primary Care, SAP Terres de l'Ebre, Catalonian Health Institute, 43500 Catalonia, Spain
- Unitat de Suport a la Recerca Terres de l'Ebre, Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Spain
| | | | - Josep Clua-Queralt
- EAP Tortosa Est. Primary Care, SAP Terres de l'Ebre, Catalonian Health Institute, 43500 Catalonia, Spain
| | - Maria Jesús Pla-Farnós
- Gynaecology Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - José Fernández-Sáez
- Unitat de Suport a la Recerca Terres de l'Ebre, Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Spain
- Faculty of Nursing, Terres de l'Ebre Campus, Rovira i Virgili University, 43500 Tortosa, Spain
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14
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Netfa F, King C, Davies C, Rashid H, Tashani M, Booy R, Rachel Skinner S. Perceived facilitators and barriers to the uptake of the human papillomavirus (HPV) vaccine among adolescents of Arabic-speaking mothers in NSW, Australia: A qualitative study. Vaccine X 2023; 14:100335. [PMID: 37409191 PMCID: PMC10318426 DOI: 10.1016/j.jvacx.2023.100335] [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: 04/18/2022] [Accepted: 06/16/2023] [Indexed: 07/07/2023] Open
Abstract
Background Australia has a large immigrant population but there is little data regarding whether human papillomavirus (HPV) vaccination coverage in adolescents varies according to parents' cultural or ethnic background. This work aims to identify facilitators and barriers to HPV vaccination of adolescents as perceived by Arabic-speaking mothers in Western Sydney, South Western Sydney and Wollongong, NSW, Australia. Methods A purposive sampling approach was applied to recruit mothers of adolescents from Arabic speaking backgrounds who had at least one child eligible for the HPV school-based vaccination program. Face-to-face semi-structured well as online interviews were conducted in Arabic between April 2021 and July 2021. The interviews were audio-recorded, transcribed, and translated into English and examined using thematic analysis. Results Sixteen mothers of adolescents from Arabic backgrounds described facilitators and barriers to HPV vaccination. A) Facilitators of HPV vaccination included: knowledge of HPV disease, trust in the school vaccination program, opportunistic recommendations from healthcare workers, information from friends. B) Barriers to accessing HPV vaccination included communication gaps: breakdown in school-parent information flow, lack of access to the Arabic language version of the information sheet, mother - GP communication barriers, mother-child communication gap; and health system gaps: missed opportunities for vaccination. C) Mothers' suggestions to improve HPV vaccination acceptance: to involve religious and cultural leadership, encourage engagement with GPs, and provide school-based education for parents and students. Conclusion Parents could benefit from assistance with HPV vaccination decision making. Interventions via schools, health professionals and religious and cultural organisations could play important roles in HPV vaccination acceptance for Arabic speaking immigrant families and in introducing their adolescent children to this vaccine.
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Affiliation(s)
- Faeza Netfa
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Catherine King
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Harunor Rashid
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Mohamed Tashani
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Faculty of Medicine, University of Tripoli, Tripoli 13275, Libya
| | - Robert Booy
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
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15
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Zhu X, Jacobson RM, MacLaughlin KL, Sauver JS, Griffin JM, Finney Rutten LJ. Parent-reported Barriers and Parental Beliefs Associated with Intentions to Obtain HPV Vaccination for Children in a Primary care Patient Population in Minnesota, USA. J Community Health 2023; 48:678-686. [PMID: 36920709 PMCID: PMC10015522 DOI: 10.1007/s10900-023-01205-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 03/16/2023]
Abstract
Human papillomavirus (HPV) vaccine uptake among adolescents remains suboptimal in the US. The COVID-19 pandemic posed new challenges to increase HPV vaccination rates. To characterize parent-reported barriers to obtain HPV vaccination for their children and to identify psychosocial factors associated with parents' intention to vaccinate their children for HPV, we administered parent surveys between April 2020 and January 2022 during a randomized pragmatic trial assessing the impact of evidence-based implementation strategies on HPV vaccination rates for adolescent patients at six Mayo Clinic primary care practices in Southeast Minnesota. A total of 342 surveys were completed (response rate 34.1%). Analyses were focused on parents of unvaccinated children (n = 133). The survey assessed the main reason the child did not receive the HPV vaccine, parental beliefs about the vaccine, and the parent's intention to vaccinate the child for HPV in the next 12 months. Frequently reported awareness and access barriers to HPV vaccination included not knowing the child was due (17.8%) and COVID-19 related delay (11.6%). Frequently reported attitudinal barriers include the belief that the child was too young for the vaccine (17.8%) and that the vaccine is not proven to be safe (16.3%). Injunctive social norm (Adjusted-OR = 3.15, 95%CI: 1.94, 5.41) and perceived harm beliefs (Adjusted-OR = 0.58, 95%CI: 0.35, 0.94) about the HPV vaccine were positively and negatively associated with HPV vaccination intention, respectively. Our findings suggest that continued efforts to overcome parental awareness, access, and attitudinal barriers to HPV vaccination are needed and underscore the importance of utilizing evidence-based health system-level interventions.
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Affiliation(s)
- Xuan Zhu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA.
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| | - Kathy L MacLaughlin
- Department of Family Medicine, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| | - Jennifer St Sauver
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| | - Joan M Griffin
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
| | - Lila J Finney Rutten
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, 55905, Rochester, Rochester, MN, USA
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16
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Charania NA, Kirkpatrick L, Paynter J, Turner N. Childhood vaccination uptake among children born in Aotearoa New Zealand based on parental nationality. Hum Vaccin Immunother 2023; 19:2240688. [PMID: 37565632 PMCID: PMC10424622 DOI: 10.1080/21645515.2023.2240688] [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: 04/28/2023] [Revised: 06/28/2023] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
Migrants and refugees generally experience immunization inequities compared to their host populations. Childhood vaccination coverage rates are influenced by a complex set of interrelated factors, including child and parental nativity. Coverage rates for MMR, pertussis, and HPV vaccines were compared among children born in Aotearoa New Zealand (NZ) of overseas-born parents or NZ-born parents. A nationwide retrospective cohort study was conducted using linked, de-identified data. Logistic regression models examined the most influential factors contributing to differences in timely vaccine uptake. Of the total study population who had received all scheduled vaccines (N = 760,269), 32.9% were children of migrant parents. Children of migrant parents had higher rates of complete and timely uptake for MMR, pertussis, and HPV vaccinations compared to non-migrant children. NZ-born children of migrant parents were significantly more likely to receive MMR and pertussis-containing vaccines on-time compared to those of non-migrants. All included factors, except for the child's gender and parents' English ability, significantly influenced vaccine uptake. Among NZ-born children of migrant parents, additional logistic modeling found significant differences based on parental duration of residence, visa group, and region of nationality. Findings point to the importance of differentiating between parent versus child nativity when examining immunization coverage. While vaccination rates were higher for NZ-born children of migrant parents, compared to non-migrant parents, timely coverage rates across both groups were below national targets. Continued efforts are needed to improve timely immunization service delivery to address suboptimal and inequitable coverage.
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Affiliation(s)
- Nadia A. Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand
- Migrant and Refugee Research Health Centre, Auckland University of Technology, Auckland, New Zealand
| | - Linda Kirkpatrick
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Janine Paynter
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Nikki Turner
- The Immunisation Advisory Centre, Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
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Yohannes E, Beyen MW, Bulto GA, Chaka EE, Debelo BT, Erena MM, Tasu TL. Knowledge and attitude toward human papillomavirus vaccination and associated factors among adolescent school girls in Ambo town, Ethiopia, 2021: A multicenter cross-sectional study. Health Sci Rep 2023; 6:e1305. [PMID: 37266064 PMCID: PMC10230424 DOI: 10.1002/hsr2.1305] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/27/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023] Open
Abstract
Background and Aims The human papillomavirus (HPV) vaccination has shown considerable promise in lowering the incidence of cervical cancer. However, there are few studies done on knowledge and attitude toward the HPV vaccine, especially in the local setting. Therefore, this study aimed to assess knowledge and attitudes regarding HPV vaccination and related factors among adolescent girls in Ambo town, Ethiopia, in 2021. Methods A cross-sectional study was conducted from May 1 to May 30, 2021, at selected schools in Ambo town among 422 adolescent girls. A structured self-administered questionnaire was used to collect the data. The collected data were coded, and entered into Epi-Info 7.2.2.6 and exported to STATA 16 for analysis. Descriptive statistics were used to compute summary statistics and proportions. Bivariate and multivariate logistic regression analyses were carried out. The adjusted odds ratio (AOR) along with a 95% confidence interval (CI) was computed to ascertain the association. Results Current study revealed that 24.9% (95% CI: 20.8-29.0) and 55.6% (95% CI: 50.5-60.4) of respondents had good knowledge and favorable attitude, respectively. The factors like being secondary school students [AOR = 2.01, 95% CI; (1.24, 3.27)], having health workers as a source of information [AOR = 2.13, 95% CI; (1.30, 3.47)], and respondents who have heard about the HPV vaccine at school [AOR = 1.66, 95% CI; (1.02, 2.71)] were significantly associated with respondent's knowledge of HPV vaccine. Moreover, the perceived severity of the diseases [AOR = 2.89, 95% CI; (1.61, 5.21)], and the perceived benefit of the vaccine [AOR = 4.26, 95% CI; (2.43, 7.48)] were factors significantly associated with an attitude of the respondents about the HPV vaccine. Conclusion There was low knowledge and unfavorable attitude toward HPV vaccination among the school adolescents in the study area. Several seemingly major deterrents of knowledge and attitude toward the HPV vaccination were identified. Therefore, all parties involved should collaborate to improve female students' knowledge and attitudes toward Human Papilloma Virus vaccination.
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Affiliation(s)
| | - Mulugeta W. Beyen
- Reproductive Health divisionSouth West Shewa Zone Health OfficeWalisoEthiopia
| | | | - Eshetu E. Chaka
- Department of Public Health, Epidimiology and Biostatistics Unit, College of Medicine and Health SciencesAmbo UniversityAmboEthiopia
| | | | | | - Tefera L. Tasu
- Department of Nursing, College of Medicine and Health SciencesAmbo UniversityAmboEthiopia
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Prokopovich K, Phillipson L, West Pitts L, Stanoevska B, Street J, Braunack-Mayer A. Using World Cafés to engage an Australian culturally and linguistically diverse community around human papillomavirus vaccination. Health Expect 2023; 26:1039-1051. [PMID: 36798035 PMCID: PMC10154861 DOI: 10.1111/hex.13703] [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: 10/14/2022] [Revised: 12/12/2022] [Accepted: 12/27/2022] [Indexed: 02/18/2023] Open
Abstract
INTRODUCTION Internationally, cultural factors are associated with vaccine uptake and completion in ethnic minority communities. Whilst Australia has achieved high human papillomavirus (HPV) vaccination, little is known about how culture or ethnicity influences HPV vaccination engagement. To address these gaps, we partnered with our Local Health District to explore how one culturally and linguistically diverse (CALD) community engages with school and HPV vaccination. METHODS We adapted a participatory research method (the World Café) to engage one local CALD community-the Macedonian community (Our bi-cultural researcher and participants preferred the term 'Macedonia' rather than The Republic of North Macedonia as outlined in the 2018 Prespa agreement) in New South Wales (Australia)-to discuss HPV and school vaccination. Our qualitative analysis combined deductive codes taken from the Tailoring Immunization Programme framework, inductive codes guided by narrative inquiry (temporality, sociality and place) and previously known vaccination 'trust' frameworks. RESULTS In late 2019, 31 local Macedonian community members were purposely recruited for two World Cafés (n = 15 mothers/grandmothers and n = 16 young adults). Our themes reveal a community narrative grounded in historical vaccine experiences, family views on vaccination and a general trust in schools. Participants collectively discussed how 'increasing knowledge' and 'tailoring health communications' could strengthen community vaccine decision-making. CONCLUSION This study demonstrates how research partnerships and participatory methods can be applied in CALD community settings to research engagement with school and HPV vaccination. Our World Café dialogues highlight a positive narrative about vaccines, where community vaccination behaviours were built on multilayer trust relationships despite low vaccine knowledge. Our findings further knowledge around 'public trust' in school vaccination, highlighting the importance of existing (or missing) trust relationships when tailoring vaccine communication to local CALD communities. PATIENT OR PUBLIC CONTRIBUTION Participants who took part in the World Cafes were all local Macedonian community parents or young adults who have been or will be exposed to the health services offered by school-based HPV vaccination. Thus, all the data collected came from their personal experiences with the school vaccination programme, or how they expect to participate in the programme. To ensure our study design was culturally appropriate and tailored to the Macedonian community, we engaged with the relevant local health stakeholders (the bi-cultural Multicultural Health Officer and Multicultural Health Service Manager Programme Director) to adapt and refine the World Café method for this context and setting. Our local health stakeholders also reviewed our preliminary findings, assisted with data interpretation and participated in manuscript editing.
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Affiliation(s)
- Kathleen Prokopovich
- Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lyn Phillipson
- School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Leissa West Pitts
- Multicultural and Refugee Health Service, Illawarra Shoalhaven Local Health District, Warrawong, New South Wales, Australia
| | - Biljana Stanoevska
- Multicultural and Refugee Health Service, Illawarra Shoalhaven Local Health District, Warrawong, New South Wales, Australia
| | - Jackie Street
- Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.,School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Annette Braunack-Mayer
- Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
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Wang Y, Chen Y, Bao S. The impact of exposure to HPV related information and injunctive norms on young women's intentions to receive the HPV vaccine in China: A structural equation model based on KAP theory. Front Public Health 2023; 10:1102590. [PMID: 36726620 PMCID: PMC9884697 DOI: 10.3389/fpubh.2022.1102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/29/2022] [Indexed: 01/18/2023] Open
Abstract
Background The HPV vaccination is a crucial line of defensing against cervical cancer. As a result of government support and positive publicity from the majority of media, a craze for HPV vaccination has occurred in China. Besides, the intentions to get the HPV vaccine among women of appropriate age is also influenced by families' and friends' attitudes and perceptions toward HPV vaccine. Therefore, the purpose of this study was to investigate how HPV related information exposure and injunctive norms affect young Chinese women's intentions to receive the HPV vaccine. Methods A structural equation model was developed based on KAP theory, and 567 effective questionnaires were collected through an online survey. We used SPSS 26.0 for the reliability and validity analysis and the differential testing of demographic characteristics, and Amos 26.0 for the goodness-of-fit analysis and paths testing of the model. Results Our findings showed that (1) intention to receive HPV vaccine differed significantly in age (P = 0.046), educational background (P = 0.001), and occupation (P = 0.004). (2) Exposure to HPV related information positively affected knowledge about HPV (β = 0.316, P < 0.001) and intention to receive HPV vaccine (β = 0.141, P < 0.001). (3) Knowledge about HPV positively affected attitude toward HPV vaccine (β=0.341, P < 0.001), but negatively affected intention to receive HPV vaccine (β = -0.148, P < 0.05), and attitude toward HPV vaccine positively affected intention to receive HPV vaccine (β = 0.594, P < 0.001). (4) Injunctive norms positively affected attitude toward HPV vaccine (β = 0.362, P < 0.001) and intention to receive HPV vaccine (β = 0.420, P < 0.001). Conclusions Exposure to HPV related information influenced young Chinese women's intentions to receive the HPV vaccine and related knowledge, that is, the more frequently they were exposed to HPV related information, the stronger their intentions to receive the vaccine and the higher their HPV knowledge. Also, the perception and support of HPV vaccination by people around them will further influence their attitudes and intentions to receive the HPV vaccine.
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20
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Shitu BF, Atnafu DD, Agumas Y. Public School Adolescents Had Increased Odds of Being Willing to Uptake HPV Vaccinations Owing to Sociodemographic and Healthcare Access Features in Bahir Dar City, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2023; 2023:2663815. [PMID: 37090189 PMCID: PMC10115532 DOI: 10.1155/2023/2663815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 04/25/2023]
Abstract
Background Cervical cancer is one of the most prevalent and fatal malignancies in women worldwide. Despite the fact that vaccination is an effective method in reducing cervical cancer, its uptake varies between public and private school adolescents and remains a challenge in low- and middle-income countries, including Ethiopia. Empirical evidence on how much variation there is among public and private school adolescent in their willingness to uptake human papillomavirus (HPV) vaccination is also limited. Thus, the aim of this study was to compare levels of willingness to uptake HPV vaccination among public and private school female adolescents and associated factors in Bahir Dar City, Ethiopia. Methods A comparative cross-sectional study was conducted on 844 adolescents aged 10 to 19 in primary schools in Bahir Dar, Ethiopia. Multistage sampling was used. A self-administered, structured, and pretested questionnaire was used to collect data. The determinants of willingness to accept HPV vaccination were identified using logistic regression, and exploratory factor analyses were performed to determine load and mean. The level of statistical significance was determined using a P - value of 0.05. Results The overall proportion of willing to uptake HPV vaccination was 50.6% (95% CI: 47.4-54), whereas in public and private primary schools, the magnitude was 61% (95% CI: 56.3-65.4%) and 40.2% (95% CI: 35.6-44.9), respectively. In terms of willingness to uptake HPV vaccination, the odds were likely to be significantly higher among those whose mothers had a postsecondary education (AOR = 2.0, 95% CI: 1.29-3.05), a high cue to action (AOR = 1.92, 95% CI: 1.20-3.05), and high self-efficacy (AOR = 2.34, 95% CI: 1.58-3.48). High perceived barriers likely decreased the willingness to uptake HPV vaccination (AOR = 0.49, 95% CI: 0.34-0.70). Conclusion Adolescent girls in public primary schools were more likely to uptake HPV vaccination than those in private provided that income status and socioeconomic factors became less important. Willingness to uptake HPV vaccination was found to be low as compared to the WHO target for Ethiopian context and was influenced by maternal education status, perceived barriers, cues to action, and self-efficacy. As a result, greater emphasis should be placed on implementing a school-based and maternal educational program on cervical cancer prevention and control focusing on the behavioral contexts.
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Affiliation(s)
- Birhanu Feleke Shitu
- Department of Public Health, Addis Continental Institute of Public Health, Bahir Dar, Ethiopia
| | - Desta Debalkie Atnafu
- Department of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Yeshambel Agumas
- Department of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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21
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Shin MB, Ko LK, Ibrahim A, Mohamed FB, Lin J, Celentano I, Shankar M, Amsalu F, Ali AA, Richardson BA, Taylor VM, Winer RL. The Impact of a Comic Book Intervention on East African-American Adolescents' HPV Vaccine-Related Knowledge, Beliefs and Intentions. J Immigr Minor Health 2022; 24:1489-1500. [PMID: 35357620 PMCID: PMC10129048 DOI: 10.1007/s10903-022-01359-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/27/2022]
Abstract
HPV vaccine uptake is low among East African-American (EAA) adolescents. We developed a comic book and evaluated the impact on HPV/HPV-vaccine knowledge, beliefs and vaccine intentions. The intervention was delivered to HPV-unvaccinated EAA adolescents attending educational dinners with their mothers. Adolescents aged 14-17 were sequentially assigned alternately to a pre- or post-test. Results were compared with chi-squared tests and generalized estimating equation models adjusted for age, gender, and mother's language. Among 136 (pre-test = 64, post-test = 72) participants (90% Somali), pre/post differences were observed for proportions of correct responses to questions on HPV (44.0% vs. 82.9%, RR:1.87[95%CI 1.54-2.27]), HPV-vaccine knowledge (42.8% vs. 75.4%, RR:1.74[95%CI 1.46-2.07]), comfort discussing HPV/HPV vaccine with parents (57.8% vs. 90.3% somewhat/very comfortable, RR:1.55[95%CI 1.24-1.94]), and willingness (37.5% vs. 83.3% probably/definitely willing, RR:2.16[95%CI 1.55-3.01]) and intention (34.4% vs. 86.1% somewhat/very likely, RR:2.38[95%CI:1.69-3.37]) to get vaccinated. The intervention improved participants' HPV/HPV-vaccine knowledge, beliefs and vaccine intentions. Similar interventions could be adapted for other racial/ethnic minorities.
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Affiliation(s)
- Michelle B Shin
- School of Nursing, University of Washington, Seattle, WA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Linda K Ko
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anisa Ibrahim
- Harborview Medical Center, Department of Pediatrics, University of Washington, Seattle, WA, USA
- Somali Health Board, Seattle, WA, USA
| | | | - John Lin
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Isabelle Celentano
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Megha Shankar
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Medicine, University of California, San Diego, CA, USA
| | - Fanaye Amsalu
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Barbra A Richardson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Victoria M Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA, 98195, USA.
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22
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Daniels D, Imdad A, Buscemi-Kimmins T, Vitale D, Rani U, Darabaner E, Shaw A, Shaw J. Vaccine hesitancy in the refugee, immigrant, and migrant population in the United States: A systematic review and meta-analysis. Hum Vaccin Immunother 2022; 18:2131168. [PMID: 36332155 PMCID: PMC9746503 DOI: 10.1080/21645515.2022.2131168] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Refugees, immigrants, and migrants (RIM) in the United States (US) have been identified as an underimmunized population prior to the COVID-19 pandemic. Vaccine acceptance is critical to combat the public health threat incited by COVID-19 and other vaccine-preventable disease. To better understand escalating vaccine hesitancy among US RIM, a comprehensive evaluation of the problem and solutions is necessary. In this systematic review, we included 57 studies to describe vaccination rates, barriers, and interventions addressing vaccine hesitancy over the past decade. Meta-analysis was performed among 22 studies, concluding that RIM represent an underimmunized population compared to the general US population. Narrative synthesis and qualitative methods were used to identify critical barriers, including gaps in knowledge, poor access to medical care, and heightened distrust of the medical system. Our results demonstrate the need for effective, evidence-based interventions to increase vaccination rates among diverse RIM populations.
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Affiliation(s)
- Danielle Daniels
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA,CONTACT Danielle Daniels 750 East Adams St. Room 5400, Syracuse, NY13210, USA
| | - Aamer Imdad
- Department of Pediatrics, Karjoo Family Center for Pediatric Gastroenterology, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Danielle Vitale
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Uzma Rani
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ellen Darabaner
- Hunter-Rice Health Sciences Library, Samaritan Medical Center, Watertown, NY, USA
| | - Andrea Shaw
- Department of Pediatrics, Department of Internal Medicine, Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jana Shaw
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA
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23
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Swift C, Dey A, Rashid H, Clark K, Manocha R, Brotherton J, Beard F. Stakeholder Perspectives of Australia's National HPV Vaccination Program. Vaccines (Basel) 2022; 10:1976. [PMID: 36423072 PMCID: PMC9692920 DOI: 10.3390/vaccines10111976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/06/2022] [Accepted: 11/17/2022] [Indexed: 10/14/2023] Open
Abstract
Australia has been a world leader in human papillomavirus (HPV) vaccination and was the first country to implement a fully funded national HPV vaccination program, from 2007 for girls and 2013 for boys. In 2018 the program changed from a 4-valent to 9-valent HPV vaccine and a 3-dose to 2-dose standard schedule. We assessed stakeholder perspectives on factors influencing program outcomes and impact as part of a comprehensive program evaluation. In late 2019 and early 2020, we conducted 26 interviews with 42 key stakeholder participants and received 1513 survey responses from stakeholders including general practice staff and school-based nurse immunisers. Findings included that the 2-dose schedule is better accepted by schools and students and has reduced program cost and resource requirements. However, course completion rates have not increased as much as anticipated due to the 6-12 month dosing interval and reduced opportunities for school-based catch-up vaccination. Major reported barriers to increased vaccine coverage were absenteeism and consent form return. Vaccine hesitancy is not currently a major issue but remains a potential threat to the program. While Australia's HPV vaccination program is perceived as highly successful, measures to further enhance the program's impact and mitigate potential threats are important.
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Affiliation(s)
- Caitlin Swift
- National Centre for Immunisation Research and Surveillance, Sydney Children’s Hospitals Network, Sydney, NSW 2145, Australia
| | - Aditi Dey
- National Centre for Immunisation Research and Surveillance, Sydney Children’s Hospitals Network, Sydney, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance, Sydney Children’s Hospitals Network, Sydney, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Katrina Clark
- National Centre for Immunisation Research and Surveillance, Sydney Children’s Hospitals Network, Sydney, NSW 2145, Australia
| | | | - Julia Brotherton
- National Centre for Immunisation Research and Surveillance, Sydney Children’s Hospitals Network, Sydney, NSW 2145, Australia
- Australian Centre for the Prevention of Cervical Cancer, Melbourne, VIC 3053, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Frank Beard
- National Centre for Immunisation Research and Surveillance, Sydney Children’s Hospitals Network, Sydney, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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24
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Lindsay AC, Delgado D, Valdez MJ, Granberry P. Latinx fathers report low awareness and knowledge of the human papillomavirus vaccine, but high willingness to vaccinate their children if recommended by a healthcare provider: A qualitative study. Glob Public Health 2022; 17:2883-2897. [PMID: 34605379 PMCID: PMC8976858 DOI: 10.1080/17441692.2021.1985580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022]
Abstract
This descriptive qualitative study explored Latinx fathers' awareness, knowledge, and acceptability of the human papillomavirus (HPV) vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analysed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Nineteen, majority foreign-born Latinx fathers participated. Four main themes and two subthemes emerged from the analyses. Results found fathers' low awareness and knowledge of HPV and the HPV vaccine. Results also identified fathers' positive attitudes toward vaccines in general. Moreover, results revealed fathers trust in healthcare providers and high willingness to vaccinate their children against HPV if recommended by their child's primary healthcare provider. Findings indicate the need for increased efforts to raise awareness and knowledge among Latinx fathers of HPV and the HPV vaccine. Given the limited research focused on Latinx fathers, the study's findings are valuable in building a knowledge foundation for developing future studies and interventions to promote the HPV vaccine targeting Latinx fathers living in the United States. Future research should quantify Latinx fathers' awareness, knowledge, and acceptability of the HPV vaccine for their sons and daughters and assess fathers' role in the decision-making process to vaccinate their children against HPV.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Denisse Delgado
- Department of Public Policy and Public Affairs, McCormack Graduate School of Policy and Global Studies, University of Massachusetts—Boston, Massachusetts, USA
| | - Madelyne J. Valdez
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Phillip Granberry
- College of Liberal Arts and The Mauricio Gastón Institute for Latino Community Development and Public Policy, University of Massachusetts—Boston, Massachusetts, USA
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25
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Galanis P, Vraka I, Siskou O, Konstantakopoulou O, Katsiroumpa A, Moisoglou I, Kaitelidou D. Predictors of Real-World Parents' Acceptance to Vaccinate Their Children Against the COVID-19. Acta Med Litu 2022; 29:33-43. [PMID: 36061935 PMCID: PMC9428642 DOI: 10.15388/amed.2021.29.1.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 01/23/2023] Open
Abstract
Background As the COVID-19 pandemic continues to threaten public health, the vaccination of children against the disease appears to be a key factor to control the pandemic. Our aim was to investigate the prevalence of parents who have vaccinated their children against the COVID-19 and the factors influencing this decision. Materials and Methods We conducted a web-based cross-sectional study in Greece during the first week of September 2021. The study questionnaire was distributed through social media and a convenience sample was obtained. Only parents with children aged 12-17 years old could participate in the study. We collected socio-demographic data of parents and we measured their attitudes towards vaccination and COVID-19 pandemic. Results Study population included 656 parents. Regarding vaccination, 27.1% of parents had their children vaccinated against the COVID-19, while almost all children had a complete vaccination history (98.9%). The most important reasons for decline of COVID-19 vaccination were doubts about the safety and effectiveness of COVID-19 vaccines (45.3%) and fear of side effects (36.6%). Regarding the information about the COVID-19 vaccines, parents showed more trust in family doctors than in scientists and the government. We found that increased parents' age, increased trust in COVID-19 vaccines, and positive attitude of parents towards vaccination had a positive effect on children's vaccination. Conclusions Understanding the factors influencing parents' decision to vaccinate their children against the COVID-19 is crucial to increase the COVID-19 vaccination coverage rate. Implementation of public health policies is necessary to spread knowledge about COVID-19 vaccines and to regain vaccine confidence.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens
| | - Irene Vraka
- Department of Radiology, P & A Kyriakou Children’s Hospital, Athens, Greece
| | | | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Aglaia Katsiroumpa
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
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26
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Shapiro GK. HPV Vaccination: An Underused Strategy for the Prevention of Cancer. Curr Oncol 2022; 29:3780-3792. [PMID: 35621693 PMCID: PMC9140027 DOI: 10.3390/curroncol29050303] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Accepted: 05/13/2022] [Indexed: 01/08/2023] Open
Abstract
Human papillomavirus (HPV) vaccination prevents cervical, head and neck, and anogenital cancers. However, global HPV vaccine coverage falls short of global targets and has seen unexpected and dramatic declines in some countries. This paper synthesizes the impact of HPV on the global burden of cancer and the potential benefit of HPV vaccination. Approximately 5% of the world's cancers are specifically attributed to HPV. While the greatest global burden of HPV is cervical cancers in low- and middle-income countries, HPV-associated head and neck cancers are increasing in high-income countries and have surpassed cervical cancer as the primary HPV-associated cancer in some countries. Therefore, it is also critical to improve gender-neutral HPV vaccination. Understanding the modifiable drivers of vaccine acceptance and uptake is important for increasing HPV vaccination. The Behavioural and Social Drivers of Vaccination framework is broadly applied to identify key factors associated with HPV vaccination including domains concerning practical issues, motivation, social processes, and thinking and feeling. Among the behavioural strategies available to reduce the incidence and mortality of cancer, increasing HPV vaccination stands out as having unrealized potential to prevent disease, financial cost, and psychological distress. An understanding of the shifting burden of HPV and the factors associated with vaccination can be leveraged to regularly measure these factors, develop interventions to promote vaccine uptake, and improve global HPV vaccine coverage. Future research in diverse contexts is necessary to investigate the barriers and facilitators of global HPV vaccination.
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Affiliation(s)
- Gilla K. Shapiro
- Department of Supportive Care, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON M5G 2C1, Canada;
- Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and Princess Margaret Cancer Centre, 700 Bay Street, Suite 2303, Toronto, ON M5G 1Z6, Canada
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27
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Kirubarajan A, Li X, Yau M, Yu C, Got T, Li Q, Huszti E, Leung S, Thangavelu N, Sobel M. Awareness, knowledge, and misconceptions of adolescents and young people regarding long-acting reversible contraceptives: a systematic review and meta-analysis. Fertil Steril 2022; 118:168-179. [DOI: 10.1016/j.fertnstert.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 11/04/2022]
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28
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Al Shdefat S, Al Awar S, Osman N, Khair H, Sallam G, Maki S. Identification Level of Awareness and Knowledge of Emirati Men about HPV. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:5340064. [PMID: 35356607 PMCID: PMC8959970 DOI: 10.1155/2022/5340064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 11/18/2022]
Abstract
One of the most frequent cancers that affects males globally is cervical cancer (CC) that kills hundreds or even thousands of women each year, particularly in underdeveloped nations. The study focuses on human papillomavirus (HPV) that contributes to cervical cancer (CC) development. In the majority of Arab nations, there seems to be no public education or vaccination programs. In research, methodological rigor is employed to find solutions to both theoretical and practical difficulties. This research aims to assess the knowledge and awareness of the HPV vaccination among Emirati men. Results of the research showed that Emirati males had a poor understanding of HPV and its vaccination. According to the findings of this research, Emirati males lack a basic understanding of HPV, which necessitates the implementation of national HPV education initiatives. We have identified several critical knowledge gaps that can be filled in the future regarding HPV infection and vaccination.
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Affiliation(s)
- Suzan Al Shdefat
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Consultant Gyn-Oncologist, King Abdullah University Hospital, Riyadh, Saudi Arabia
| | - Shamsa Al Awar
- Chair of Obstetrics & Gynecology Department, College of Medicine & Health Sciences (CMHS), United Arab Emirates University (UAEU), Al Ain, UAE
| | - Nawal Osman
- Medical Research Specialist I Obstetrics and Gynecology Department, CMHS, UAEU, Al Ain, UAE
| | - Howaida Khair
- Obstetrics & Gynecology Department, CMHS, UAEU, Al Ain, UAE
| | - Gehan Sallam
- Clinical Research Nurse Obstetrics and Gynecology Department, CMHS, UAEU, Al Ain, UAE
| | - Sara Maki
- Medical Research Assistant, CMHS, UAEU, Al Ain, UAE
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29
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Sinshaw MT, Berhe S, Ayele SG. Knowledge and Attitude Towards Human Papillomavirus Vaccine and Associated Factors Among Mothers Who Have Eligible Daughters in Debre Markos Town, Northwest Ethiopia. Infect Drug Resist 2022; 15:781-793. [PMID: 35264861 PMCID: PMC8901188 DOI: 10.2147/idr.s352440] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/25/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose This study aimed to assess knowledge and attitude towards the human papillomavirus vaccine and associated factors among mothers who have eligible daughters. Methods A community-based cross-sectional study with a total sample of 601 study participants was conducted in Debre Markos town from February to March 2021. The study participants were selected using a multistage sampling technique from mothers who have eligible daughters. The data was collected using an interview administration questionnaire. The data were entered into EPI data version 3.1 then, exported to SPSS version 25 for analysis. Variables with a p-value of < 0.25 in bivariate were a candidate for multivariate and those variables with a p-value of <0.05 in multivariate binary logistic regression were considered as a statistically significant factor for knowledge and attitude of the HPV vaccine. Results A total of 601 study participants with a response rate of 100% were included in the study. Among participants in this study, 47.6% have good knowledge and 77.4% have a positive attitude towards the HPV vaccine. Knowledge of mothers about HPV vaccine was affected by having degree and above (adjusted odds ratio (AOR) =7.687; 95% CI=1.837–32.168; p=0.005), did not hear about HPV vaccine (AOR=0.172; 95% CI=0.098–0.302; P=0.000), and positive attitude towards HPV vaccine (AOR=2.959; 95% CI=1.580–5.539; P=0.001). Attitude of mothers towards HPV vaccine was affected by did not hear about HPV vaccine (AOR=0.285; 95% CI=0.163–0.499; P=000), and good knowledge about HPV vaccine (AOR=2.705; 95% CI=1.454–5.035; 0.002). Conclusion Knowledge of mothers who have eligible daughters about HPV vaccine was low. Maternal educational level, hearing about the HPV vaccine, and attitude towards HPV vaccine were significantly associated predictors with knowledge towards HPV vaccine. However, the attitude was high and factors associated with attitudes towards the HPV vaccine were knowledge about the HPV vaccine and hearing about the HPV vaccine. An integrated work should be considered by Debre Markos town health office with other non-governmental organizations working on health and health-related issues to improve knowledge about the importance of HPV vaccine for mothers who have eligible daughters.
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Affiliation(s)
- Melkam Tesfaye Sinshaw
- Debre Markos University, College of Health Sciences, Department of Midwifery, Debre Markos, Ethiopia
| | - Semarya Berhe
- Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, Addis Ababa, Ethiopia
| | - Siraye Genzeb Ayele
- Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, Addis Ababa, Ethiopia
- Correspondence: Siraye Genzeb Ayele, Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, P.O.Box. 1176, Addis Ababa, Ethiopia, Tel +251951070730, Email
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30
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Anuforo B, McGee-Avila JK, Toler L, Xu B, Kohler RE, Manne S, Tsui J. Disparities in HPV vaccine knowledge and adolescent HPV vaccine uptake by parental nativity among diverse multiethnic parents in New Jersey. BMC Public Health 2022; 22:195. [PMID: 35093050 PMCID: PMC8800253 DOI: 10.1186/s12889-022-12573-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022] Open
Abstract
Background Suboptimal human papillomavirus (HPV) vaccination rates persist among adolescents in the United States (U.S.). New Jersey (NJ), among the top, most racially/ethnically diverse states in the U.S., had among the lowest HPV vaccine initiation rates, prior to 2018. This study examined parental HPV vaccine knowledge and adolescent HPV vaccine initiation among multiethnic parents in NJ, where access to language concordant HPV vaccine information and vaccination services may differ, for immigrant parents. Methods We surveyed parents of adolescents (ages 11–18) at community events in NJ to examine parental HPV vaccine knowledge and adolescent HPV vaccine uptake. Vaccine knowledge was assessed using an 11-item question stem that covered vaccine efficacy, gender recommendation, vaccine protection, and myths. Multivariable models assessed the association of parent nativity on HPV vaccine knowledge scores and adolescent HPV vaccine initiation, controlling for sociodemographic factors. Results Of the 77 parents, most parents (84%) were aware of the HPV vaccine. However, knowledge scores were low and differed by parent nativity. Non-U.S. born parents had significantly lower knowledge scores − 1.7 [− 3.1, − 0.4] and lower odds of adolescent children initiating the HPV vaccine 0.3 [0.1, 0.9] compared to U.S.-born parents after adjusting demographic characteristics. Conclusions Our findings reveal that parental HPV vaccine knowledge remains low among suburban dwelling, immigrant parents, even though they have higher education and access to health care. Multilevel strategies to reduce missed opportunities for HPV vaccine education among parents and HPV vaccination for adolescents are needed, including for suburban, immigrant communities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12573-7.
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An Intersectional Perspective on the Utilization of Cervical Cancer Screening among Migrants. A Cross-Sectional Analysis of Survey Data from Austria. Cancers (Basel) 2021; 13:cancers13236082. [PMID: 34885190 PMCID: PMC8657384 DOI: 10.3390/cancers13236082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/21/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Studies from several countries have shown that migrant women utilize cervical cancer screening less frequently than non-migrant women. Little is known about how disparities differ across different countries of origin. The present study addresses this limitation by means of 2019 survey data from Austria. Comparing the five largest groups of migrants residing in the country, the results show that particularly Turkish migrant women have a lower utilization than the Austrian majority population. This illustrates the heterogeneity of migrants and likely results from different obstacles some groups of migrants encounter in the health system. The findings may contribute to raising the awareness of the heterogeneity of the migrant population and to providing cancer screening interventions tailored to different cultural backgrounds, consequently improving overall access to cancer screening for particularly disadvantaged and vulnerable population groups. Abstract In most European countries, migrant women have lower rates of cervical cancer screening utilization than non-migrant women. While studies have illustrated that disparities can be partially explained by social determinants, they usually did not take into account the heterogeneity of the migrant population in terms of cultural background or country of origin. Applying an intersectional approach and using 2019 data from a representative survey from Austria on 6228 women aged 20–69 years, the present study examines differences in the utilization of cervical cancer screening in the five largest migrant groups (i.e., individuals with a nationality from or born in a Yugoslav successor state, Turkey, Romania, Hungary, or Germany) residing in Austria. By means of a multivariable analysis, amongst others adjusted for socioeconomic and health-related determinants, it is illustrated that particularly Turkish migrant women have a lower utilization than the Austrian majority population (adjusted odds ratio (OR) = 0.60; 95% confidential interval (CI): 0.40–0.91), while no significant differences between the majority population and other groups of migrants became evident. The findings are indicative of the heterogeneity of migrants and likely result from different obstacles some groups of migrants encounter in the health system. This heterogeneity must be taken into account in order to support informed decision-making and to ensure adequate preventive care.
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Islam JY, Spees L, Camacho-Rivera M, Vidot DC, Yarosh R, Wheldon CW. Disparities in Awareness of Hepatitis C Virus Among US Adults: An Analysis of the 2019 Health Information National Trends Survey. Sex Transm Dis 2021; 48:981-985. [PMID: 34030156 DOI: 10.1097/olq.0000000000001478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The U.S. Preventive Services Task Force updated hepatitis C virus (HCV) screening 2020 guidelines to target adults aged 18 to 79 years: a major shift from the prior focus on high-risk populations ("baby boomers" aged ≥55 years as of 2019). To inform efforts to maximize HCV screening coverage, our objective was to identify demographic groups reporting a lack of HCV awareness, particularly by race/ethnicity and age, and sources of health information. METHODS We used nationally representative data of adults (≥18 years) included in the 2019 Health Information National Trends Survey (n = 5438). Awareness of HCV was defined using the following question: "Have you ever heard of the hepatitis C virus (also known as Hep C or HCV)?" We estimated frequencies by demographic groups and computed risk differences (RDs) with 95% confidence intervals (CIs) to compare lack of HCV awareness by age (<55 and ≥55 years) and race/ethnicity. RESULTS Overall, 17% of adults never heard of HCV. Younger adults (<55 years; 21%) were more likely to have never heard of HCV compared with older adults (≥55 years; 12%; χ2P < 0.001). This observation was consistent across most demographic characteristics including, racial/ethnic categories, and residing in the Southern United States. More than one-third of adults with low English fluency had a lack of HCV awareness in both age groups (χ2P = 0.537). Non-Hispanic (NH) Asian (RD, 25%; 95% CI, 6.9%-43.3%) and Hispanic (RD, 10%; 95% CI, 0.01%-19.6%) adults younger than 55 years were significantly more likely to have never heard of HCV compared with their NH White counterparts after adjustment for sex, educational level, household income, English fluency, and having a regular provider. Adults younger than 55 years with a lack of HCV awareness commonly obtained their health information from the Internet across most sociodemographic characteristics. CONCLUSIONS Hispanic and NH Asian young adults should be targeted for public health messaging regarding HCV screening, potentially through social media campaigns.
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Affiliation(s)
- Jessica Yasmine Islam
- From the Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Lisa Spees
- UNC Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC
| | - Marlene Camacho-Rivera
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Denise C Vidot
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL
| | - Rina Yarosh
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA
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Davies C, Marshall HS, Zimet G, McCaffery K, Brotherton JML, Kang M, Garland S, Kaldor J, McGeechan K, Skinner SR. Effect of a School-Based Educational Intervention About the Human Papillomavirus Vaccine on Psychosocial Outcomes Among Adolescents: Analysis of Secondary Outcomes of a Cluster Randomized Trial. JAMA Netw Open 2021; 4:e2129057. [PMID: 34726749 PMCID: PMC8564580 DOI: 10.1001/jamanetworkopen.2021.29057] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE Delivery of vaccination to adolescents via a school-based program provides an opportunity to promote their involvement in health decision-making, service provision, and self-efficacy (belief in one's ability to perform a certain behavior). OBJECTIVE To examine the effect of a human papillomavirus (HPV) vaccination education and logistical intervention on adolescent psychosocial outcomes. DESIGN, SETTING, AND PARTICIPANTS In this cluster randomized trial and process and qualitative evaluation, adolescents aged 12 to 13 years (first year of high school) were recruited at high schools in Western Australia (WA) and South Australia (SA) in 2013 and 2014. Statistical analysis was performed from January 2016 to December 2020. INTERVENTIONS The complex intervention consisted of an adolescent intervention to promote knowledge and psychosocial outcomes, shared decisional support tool, and logistical strategies. MAIN OUTCOMES AND MEASURES Prespecified secondary outcomes were assessed. The HPV Adolescent Vaccination Intervention Questionnaire (HAVIQ) was used to measure changes in adolescent knowledge (6-item subscale), fear and anxiety (6-item subscale), self-efficacy (5-item subscale), and decision-making (8-item subscale). The hypothesis was that the intervention would improve adolescent involvement in vaccine decision-making (measured before dose 1 only), improve vaccine-related self-efficacy, and reduce vaccine-related fear and anxiety (measured before doses 1, 2, and 3). Mean (SD) scores for each subscale were compared between intervention and control students. In the process evaluation, focus groups were conducted. Analyses of the HAVIQ data were conducted from 2016 to 2020. Qualitative analyses of the focus groups were undertaken from 2017 to 2020. RESULTS The trial included 40 schools (21 intervention and 19 control) across sectors with 6967 adolescents (mean [SD] age, 13.70 [0.45] years). There were 3805 students (1689 girls and 2116 boys) in the intervention group and 3162 students (1471 girls and 1691 boys) in the control group. The overall response rate for the HAVIQ was 55%. In WA, where parental consent was required, the response rate was 35% (1676 of 4751 students); in SA, where parental consent was not required, it was 97% (2166 of 2216 students). The mean (SD) score for decision-making in the intervention group before dose 1 was 3.50 (0.42) of 5 points and 3.40 (0.40) in the control group, a small but significant difference of 0.11 point (95% CI, 0.06 to 0.16 point; P < .001). There was a small difference in favor of the intervention group in reduced vaccination-related anxiety (pre-dose 1 difference, -0.11 point [95% CI, -0.19 to -0.02 point]; pre-dose 2 difference, -0.18 point [95% CI, -0.26 to -0.10 point]; pre-dose 3 difference, -0.18 [95% CI, -0.24 to -0.11]) and increased vaccination self-efficacy (pre-dose 1 difference, 4.0 points; [95% CI, 1.0 to 7.0 points]; pre-dose 2 difference, 4.0 points [95% CI, 2.0 to 6.0 points]; pre-dose 3 difference, 3.0 points [95% CI, 1.0 to 5.0 points]). Focus group data from 111 adolescents in 6 intervention and 5 control schools revealed more confidence and less anxiety with each vaccine dose. CONCLUSIONS AND RELEVANCE In this cluster randomized trial, there was a small difference in adolescent decisional involvement and vaccine-related confidence and reduced vaccination-related fear and anxiety that was maintained throughout the vaccine course in the intervention vs control groups. Guidelines for vaccination at school should incorporate advice regarding how this outcome can be achieved. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry: ACTRN12614000404628.
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Affiliation(s)
- Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Helen S. Marshall
- Women’s and Children’s Hospital and School of Medicine and Robinson Research Institute, The University of Adelaide, South Australia, Australia
| | - Gregory Zimet
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Julia M. L. Brotherton
- VCS Population Health, VCS Foundation, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melissa Kang
- Specialty of General Practice, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Health, School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Suzanne Garland
- Centre for Women’s Infectious Diseases Research, The Royal Women’s Hospital, Melbourne, Victoria, Australia
- Reproductive and Neonatal Infectious Diseases, Department of Obstetrics and Gynaecology, University of Melbourne, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - John Kaldor
- The Kirby Institute for Infection and Immunity in Society, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kevin McGeechan
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Runngren E, Eriksson M, Blomberg K. Parents' reasoning about HPV vaccination in Sweden. Scand J Caring Sci 2021; 36:1113-1122. [PMID: 34672006 DOI: 10.1111/scs.13041] [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: 05/03/2021] [Accepted: 10/10/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to describe parents' reasoning in making decisions about vaccinating their daughters against human papilloma virus (HPV), a part of the Swedish vaccination programme. METHOD Twenty parents whose daughter had been offered HPV vaccination participated. Semi-structured individual interviews were conducted and analysed using thematic analysis. RESULTS The findings reveal that the decision-making process is complex. The parents trusted the vaccination programme and saw it as beneficial to society. They also described using different resources to decide about HPV vaccination, but they did not include their daughters in making the decision. DISCUSSION Parents need better vaccine and health literacy to be able to decide, based on evidence and in consultation with their daughters, on HPV vaccination. School nurses can play an important role in evidence-based decision-making about HPV vaccination and introducing children to this health-promoting intervention.
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Affiliation(s)
- Eva Runngren
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Shahbari NAE, Gesser-Edelsburg A, Davidovitch N, Brammli-Greenberg S, Grifat R, Mesch GS. Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel. Int J Equity Health 2021; 20:201. [PMID: 34493294 PMCID: PMC8423338 DOI: 10.1186/s12939-021-01523-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Parents in the Arab population of Israel are known to be “pro-vaccination” and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza. Objectives This study seeks to identify and compare variables associated with mothers’ uptake of two vaccinations, influenza and HPV, among different subgroups in Arab and Jewish society in Israel. Methods A cross-sectional study of the entire spectrum of the Israeli population was conducted using a stratified sample of Jewish mothers (n = 159) and Arab mothers (n = 534) from different subgroups: Muslim, Christian, Druse and Northern Bedouins. From March 30, 2019 through October 20, 2019, questionnaires were distributed manually to eighth grade pupils (13–14 years old) who had younger siblings in second (7–8 years old) or third (8–9 years old) grades. Results Arab mothers exhibited a higher rate of uptake for both vaccinations (p < .0001, HPV – 90%; influenza – 62%) than Jewish mothers (p = 0.0014, HPV – 46%; influenza – 34%). Furthermore, results showed that HPV vaccination uptake is significantly higher than seasonal influenza vaccination uptake in both populations. Examination of the different ethnic subgroups revealed differences in vaccination uptake. For both vaccinations, the Northern Bedouins exhibited the highest uptake rate of all the Arab subgroups (74%), followed by the Druse (74%) and Muslim groups (60%). The Christian Arab group exhibited the lowest uptake rate (46%). Moreover, the uptake rate among secular Jewish mothers was lower than in any of the Arab groups (38%), though higher than among religious/traditional Jewish mothers, who exhibited the lowest uptake rate (26%). A comparison of the variables associated with mothers’ vaccination uptake revealed differences between the ethnic subgroups. Moreover, the findings of the multiple logistic regression revealed the following to be the most significant factors in Arab mothers’ intake of both vaccinations: school-located vaccination and mothers’ perceived risk and perceived trust in the system and in the family physician. These variables are manifested differently in the different ethnic groups. Conclusions This research shows that all Arabs cannot be lumped together as one monolithic group in that they exhibit major differences according to religion, education and access to information. Ranking of variables associated with uptake of the two vaccines can provide decision-makers an empirical basis for tailoring appropriate and specific interventions to each subgroup to achieve the highest vaccine uptake rate possible. Media campaigns targeting the Arab population should be segmented to appeal to the various sub-groups according to their viewpoints, needs and health literacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01523-1.
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Affiliation(s)
- Nour Abed Elhadi Shahbari
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel.
| | - Anat Gesser-Edelsburg
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel.,School of Public Health, Founding Director of the Health and Risk Communication Research Center, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, Faculty of Health Sciences, Ben Gurion University of the Negev, 84105, Beer Sheva, Israel
| | - Shuli Brammli-Greenberg
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, P.O. Box 12272, 9112102, Jerusalem, Israel
| | - Rami Grifat
- Ziv Medical Center, 1 Derech HaRambam, 13100, Safed, Israel
| | - Gustavo S Mesch
- Department of Sociology, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel
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Netfa F, King C, Davies C, Rashid H, Tashani M, Booy R, Skinner SR. Knowledge, Attitudes, and Perceptions of the Arabic-Speaking Community in Sydney, Australia, toward the Human Papillomavirus (HPV) Vaccination Program: A Qualitative Study. Vaccines (Basel) 2021; 9:vaccines9090940. [PMID: 34579177 PMCID: PMC8473026 DOI: 10.3390/vaccines9090940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Little is known about acceptability of the human papillomavirus (HPV) vaccine among parents of adolescents from culturally and linguistically diverse backgrounds in Australia. This study aimed to explore the knowledge and attitudes of parents from Arabic backgrounds towards HPV vaccination offered to their children in the national school-based vaccination program. Methods: Qualitative interviews were conducted in Western Sydney, with parents of adolescents from Arabic backgrounds. Recruitment was via informal personal contacts and passive snowballing. Face-to-face semi-structured interviews were conducted in Arabic. These were audio-recorded, transcribed, and translated into English. Thematic analysis was used to identify emerging themes. Results: Commonly identified themes across fifteen interviews included: (1) lack of awareness and knowledge of HPV and its vaccination, (2) awareness and understanding of the government vaccination information sheet, (3) parents’ preferences for information provision, (4) the role of parents’ religious beliefs in forming attitudes about HPV vaccination, and (5) lost opportunities to educate parents about HPV vaccination during general practitioner (GP) visits. Conclusion: The findings point to the need to address cultural, language, and communication barriers to improve awareness and acceptability of HPV vaccination in the Arabic community. Educational strategies should be tailored to this community based on their specific information needs and preferences.
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Affiliation(s)
- Faeza Netfa
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Correspondence: or ; Tel.: +61-2-9351-2222; Fax: +61-29845-1418
| | - Catherine King
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Harunor Rashid
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Mohamed Tashani
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Faculty of Medicine, University of Tripoli, Tripoli 13275, Libya
| | - Robert Booy
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - S. Rachel Skinner
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
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Ebrahimi OV, Johnson MS, Ebling S, Amundsen OM, Halsøy Ø, Hoffart A, Skjerdingstad N, Johnson SU. Risk, Trust, and Flawed Assumptions: Vaccine Hesitancy During the COVID-19 Pandemic. Front Public Health 2021; 9:700213. [PMID: 34277557 PMCID: PMC8281037 DOI: 10.3389/fpubh.2021.700213] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/31/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The pace at which the present pandemic and future public health crises involving viral infections are eradicated heavily depends on the availability and routine implementation of vaccines. This process is further affected by a willingness to vaccinate, embedded in the phenomenon of vaccine hesitancy. The World Health Organization has listed vaccine hesitancy among the greatest threats to global health, calling for research to identify the factors associated with this phenomenon. Methods: The present cross-sectional study seeks to investigate the psychological, contextual, and sociodemographic factors associated with vaccination hesitancy in a large sample of the adult population. 4,571 Norwegian adults were recruited through an online survey between January 23 to February 2, 2021. Subgroup analyzes and multiple logistic regression was utilized to identify the covariates of vaccine hesitancy. Results: Several subgroups hesitant toward vaccination were identified, including males, rural residents, and parents with children below 18 years of age. No differences were found between natives and non-natives, across education or age groups. Individuals preferring unmonitored media platforms (e.g., information from peers, social media, online forums, and blogs) more frequently reported hesitance toward vaccination than those relying on information obtainment from source-verified platforms. Perceived risk of vaccination, belief in the superiority of natural immunity, fear concerning significant others being infected by the virus, and trust in health officials' dissemination of vaccine-related information were identified as key variables related to vaccine hesitancy. Conclusion: Given the heterogeneous range of variables associated with vaccine hesitancy, additional strategies to eradicate vaccination fears are called for aside from campaigns targeting the spread of false information. Responding to affective reactions in addition to involving other community leaders besides government and health officials present promising approaches that may aid in combating vaccination hesitation.
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Affiliation(s)
- Omid V. Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Miriam S. Johnson
- Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway
| | - Sara Ebling
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | | | - Øyvind Halsøy
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | | | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
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Chu H, Ko LK, Ibrahim A, Mohamed FB, Lin J, Shankar M, Amsalu F, Ali AA, Richardson BA, Taylor VM, Winer RL. The impact of an educational forum intervention on East African mothers' HPV vaccine-related knowledge, attitudes, and intentions to vaccinate their adolescent children. Vaccine 2021; 39:3767-3776. [PMID: 34053792 PMCID: PMC9984200 DOI: 10.1016/j.vaccine.2021.05.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/09/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE HPV vaccine uptake in U.S. East African adolescents is low. We developed and evaluated a culturally-targeted interactive educational intervention for East African immigrant mothers to increase HPV-vaccine-related knowledge, attitudes, and intentions to vaccinate adolescent children. METHODS Eligible mothers had ≥ 1 11-17-year-old child and reported all children's HPV vaccination status as unvaccinated or unknown. The intervention was delivered via 10 dinners in the Seattle metropolitan area (8 with the Somali community, 2 with the Ethiopian community). Educational presentations and pre/post-tests on knowledge, attitudes, and intentions were conducted in the participants' native language by a co-ethnic physician. Pre/post differences in responses were evaluated with McNemar's tests and GEE models. HPV vaccination uptake 6-months post-intervention was evaluated using state immunization registry data. RESULTS Of 115 participating mothers, most (84%) were Somali and < 40 years of age (60%). Median years of formal education was 8 (range 0-16), and 61% reported a household income <$25,000. Knowledge of HPV/HPV-vaccines was low pre-intervention, with correct responses ranging from 4% to 39% (61%-91% of responses were "not sure"); correct post-intervention responses ranged from 29% to 97%. Pre-intervention, only 12% of mothers thought they had enough information to make a decision about vaccination, compared to 90% post-intervention. Pre-intervention, only 16% of mothers reported that they were somewhat or very likely to vaccinate their child, compared to 83% post-intervention. All pre/post comparisons were statistically significantly different (p < 0.0001). Although mothers were more likely to report correct HPV-related knowledge and positive vaccine attitudes and intentions post-intervention, only two mothers' children initiated HPV vaccination within 6 months after the intervention. CONCLUSIONS Results illustrate that a culturally targeted educational intervention effectively increased East African mothers' HPV vaccine-related knowledge, attitudes, and intentions to vaccinate their adolescent children. Future research should identify additional intervention components that can bridge the gap between intention and behavior to facilitate HPV vaccine uptake.
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Affiliation(s)
- Huong Chu
- Department of Global Health, University of Washington School of Public Health, 3980 15(th) Ave NE, Box 351620, Seattle, WA 98195, USA.
| | - Linda K. Ko
- Department of Health Services, University of Washington School of Public Health, 3980 15th Ave NE Box 357660, Seattle, WA 98195 USA.,Division of Public Health Services, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-B232, Seattle, WA 98102 USA
| | - Anisa Ibrahim
- Department of Pediatrics, University of Washington, Harborview Medical Center, 325 9(th) Ave, Seattle, WA 98104, USA; Somali Health Board, 7050 32nd AVE S. Seattle, WA 98118, USA.
| | - Farah Bille Mohamed
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 981195 USA
| | - John Lin
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 98195, USA.
| | - Megha Shankar
- Department of Medicine, University of Washington, 1959 NE Pacific St, Box 356421, Seattle, WA 98195, USA.
| | - Fanaye Amsalu
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 98195, USA.
| | - Ahmed A. Ali
- Somali Health Board, 7050 32nd AVE S. Seattle, WA 98118 USA
| | - Barbra A. Richardson
- Department of Global Health, University of Washington School of Public Health, 3980 15th Ave NE, Box 351620, Seattle, WA 98195, USA.,Department of Biostatistics, University of Washington School of Public Health, 3980 15th Ave NE, Box 351617, Seattle, WA 98195 USA
| | - Victoria M. Taylor
- Division of Public Health Services, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-B232, Seattle, WA 98102 USA
| | - Rachel L. Winer
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 981195 USA
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School-based HPV vaccination positively impacts parents' attitudes toward adolescent vaccination. Vaccine 2021; 39:4190-4198. [PMID: 34127299 DOI: 10.1016/j.vaccine.2021.05.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION This qualitative study aimed to explore parental attitudes, knowledge and decision-making about HPV vaccination for adolescents in the context of a gender-neutral school-based Australian National Immunisation Program (NIP). METHODS Semi-structured interviews with parents of adolescents eligible for HPV vaccination were undertaken as part of an evaluation of a cluster-randomised controlled trial of a complex intervention in 40 schools (2013-2015). In this qualitative study, we purposively recruited a nested sample of parents from 11 schools across two Australian jurisdictions. Interviews explored parent knowledge and understanding of the HPV vaccine program; HPV vaccination decision-making; their adolescent's knowledge about HPV vaccination; and their adolescent's understanding about HPV vaccination, sexual awareness and behaviour. Transcripts were analysed using inductive and deductive thematic analysis. RESULTS Parents' of 22 adolescents had positive attitudes towards the program; the school-based delivery platform was the key driver shaping acceptance of and decision-making about HPV vaccination. They had difficulty recalling, or did not read, HPV vaccination information sent home. Some adolescents were involved in discussions about vaccination, with parents' responsible for ultimate vaccine decision-making. All parents supported in-school education for adolescents about HPV and HPV vaccination. Parents' knowledge about HPV vaccination was limited to cervical cancer and was largely absent regarding vaccination in males. CONCLUSIONS Parents' positive attitudes towards the NIP and inclusion of the HPV vaccine is central to their vaccine decision-making and acceptance. More intensive communication strategies including school education opportunities are required to improve parents' knowledge of HPV-related disease and to promote vaccine decision-making with adolescents.
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Badre-Esfahani S, Petersen LK, Tatari CR, Blaakær J, Andersen B, Seibæk L. Perceptions of cervical cancer prevention among a group of ethnic minority women in Denmark-A qualitative study. PLoS One 2021; 16:e0250816. [PMID: 34061863 PMCID: PMC8168878 DOI: 10.1371/journal.pone.0250816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 04/14/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cervical cancer screening (CCS) and human papillomavirus vaccination (HPVV) are effective measures against cervical cancer (CC). Attendance in HPVV and CCS provides the greatest protection, while combined non-attendance in HPVV and CCS provides little to no protection. It is hence concerning that some large ethnic minority groups show considerably lower HPVV and CCS attendance than other women-especially women from Middle-Eastern and North African (MENA) countries and Pakistan. Little is, however, known about the reasons for this low combined attendance pattern n. AIM To explore perceptions of and barriers to HPVV and CCS, among MENA and Pakistani women in Denmark. METHOD Focus group interviews were conducted. Data was transcribed verbatim, and analysed using systematic text condensation. FINDINGS Seventeen long-term resident women originating from six major MENA countries and Pakistan were included. Mean age was 36 years. We found that these women, across different age groups and descent, had sparse knowledge and understanding about CC, and their perceived relevance of disease prevention was low. Compared to HPVV, their barriers to CCS were more fixed and often linked to socio-cultural factors such as taboos related to female genitals and sexuality. Moreover, they presented unmet expectations and signs of mistrust in the healthcare system. However, at the end of the interviews, participants became more attentive toward CC prevention, particularly toward HPVV. CONCLUSION Elements of insufficient knowledge and understanding of CC and its prevention were found among a group of MENA and Pakistani women. Their socio-cultural background further represents a barrier particularly towards CCS. Additionally, negative experiences and unmet expectations lessen their trust in the healthcare system. All of which underlines the need for new tailored CC preventive strategies for this group. Based on our findings we suggest that future studies develop and evaluate interventions aiming to improve HPVV and CCS, including user-involvement.
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Affiliation(s)
- Sara Badre-Esfahani
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
- Department of Public Health Programmes, Randers Regional Hospital, Randers NO, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lone Kjeld Petersen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense C, Denmark
- Open Patient data Explorative Network, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Camilla Rahr Tatari
- Department of Public Health Programmes, Randers Regional Hospital, Randers NO, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jan Blaakær
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Randers NO, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lene Seibæk
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Special Issue: Travel and Tropical Medicine. Trop Med Infect Dis 2021; 6:tropicalmed6020053. [PMID: 33921618 PMCID: PMC8167769 DOI: 10.3390/tropicalmed6020053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/17/2022] Open
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