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Vamos CA, Puccio JA, Griner SB, Logan RG, Piepenbrink R, Richardson Cayama M, Lovett SM, Mahony H, Daley EM. Health literacy needs and preferences for a technology-based intervention to improve college students' sexual and reproductive health. J Am Coll Health 2024; 72:477-486. [PMID: 35298353 DOI: 10.1080/07448481.2022.2040517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 01/13/2022] [Accepted: 02/06/2022] [Indexed: 06/14/2023]
Abstract
Objective: To explore health literacy needs and preferences for a technology-based intervention (app) to improve sexual and reproductive health (SRH) among college students. Participants: In Spring 2019, in-depth interviews were conducted with 20 participants (10 male, 10 female) from a large, public university. Methods: Interview guide was developed based on Integrated Model of Health Literacy domains and Diffusion of Innovation constructs. Data were analyzed in MaxQDA using applied thematic analysis. Results: Dominant themes included accessing health information and services, evaluating options to make decisions, intervention utility and characteristics, and the emergent theme of credibility. Specific topics included accessing STI testing, contraceptive decision making, information on human papillomavirus (HPV) and the HPV vaccine, patient-provider communication, app design and function elements, and modifying the app to meet the SRH needs of diverse college students. Conclusions: Findings identified areas where an app could address college students' SRH literacy, ultimately improving SRH outcomes among this population.
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Affiliation(s)
- Cheryl A Vamos
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Joseph A Puccio
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Stacey B Griner
- University of North Texas Health Science Center at Fort Worth, School of Public Health, Fort Worth, TX, USA
| | | | | | | | - Sharonda M Lovett
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Helen Mahony
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Ellen M Daley
- University of South Florida, College of Public Health, Tampa, FL, USA
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2
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Garg A, Galvin AM, Griner SB, Rosberger Z, Daley EM, Thompson EL. HPV self-sampling among women in the United States: preferences for implementation. Cancer Causes Control 2024; 35:167-176. [PMID: 37633857 DOI: 10.1007/s10552-023-01778-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/09/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE With the inclusion of primary HPV testing in 2018 U.S. Preventive Services Taskforce guidelines, at-home HPV self-sampling may provide a future option for cervical cancer screening, especially among hard-to-reach populations in the U.S. This study evaluated the association of implementation preferences with the willingness of at-home HPV self-sampling. METHODS We conducted a cross-sectional study in 2018 among U.S. women ages 30-65 years, without a hysterectomy (n = 812). The outcome was willingness to have at-home HPV self-sampling (yes/no). Primary predictor variables (i.e., information source, methods of payment, methods of sending or receiving self-sampling kits) measured self-sampling implementation preferences. Adjusted logistic regression identified associations with willingness to have at-home HPV self-sampling. RESULTS Participants who preferred receiving information from healthcare providers (OR = 2.64; 95% CI 1.54,4.52) or from media or other sources (OR = 2.30; 95% CI 1.51,3.48) had higher HPV self-sampling willingness than participants who did not prefer those sources. Participants who did not want to pay for self-sampling (OR = 0.21; 95% CI 0.14,0.32) or did not know if they would pay for self-sampling (OR = 0.35; 95% CI 0.22,0.54) had lower odds of HPV self-sampling willingness compared to participants willing to pay. Participants who did not know which method they preferred for receiving a self-sampling kit (OR = 0.15, 95% CI 0.07,0.31) or preferred delivering the sample to the lab themselves (OR = 0.59; 95% CI 0.36,0.96) had lower odds for self-sampling willingness compared to participants who preferred the mail. CONCLUSION Understanding the preferences of women regarding the implementation of HPV self-sampling can improve uptake in cervical cancer screening, especially among hard-to-reach populations.
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Affiliation(s)
- Ashvita Garg
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Annalynn M Galvin
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Zeev Rosberger
- Department of Oncology, Psychiatry and Psychology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika L Thompson
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
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Kline NS, Webb NJ, Griner SB. Transgender Incarceration and Law Enforcement as a Source of Harm: Upstream and Primordial Prevention Perspectives. Violence Vict 2023; 38:897-909. [PMID: 37989527 DOI: 10.1891/vv-2022-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
In the United States (US), transgender individuals are more likely to experience violence and sexual assault in jails and prisons compared with cisgender peers. Harms of incarceration on transgender individuals include limited access to medical care and hormone therapy, as well as being housed in facilities based on biological sex instead of gender identity. However, there has been insufficient research on addressing factors that lead to transgender individuals being incarcerated in the first place. In this article, we argue the need to focus on law enforcement interactions with transgender individuals in the US to reduce incarceration-related harms. Using the perspectives of primordial prevention and focusing on upstream factors that create health-related harms, we assert that focusing on law enforcement is a necessary component in addressing how the criminal justice system harms transgender individuals.
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Affiliation(s)
- Nolan S Kline
- University of North Texas Health Science Center School of Public Health, Fort Worth, TX, USA
- University of Central Florida College of Medicine, Orlando, FL, USA
| | - Nathaniel J Webb
- University of North Texas Health Science Center School of Public Health, Fort Worth, TX, USA
| | - Stacey B Griner
- University of North Texas Health Science Center School of Public Health, Fort Worth, TX, USA
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Vamos CA, Cayama MR, Mahony H, Griner SB, Quinonez RB, Boggess K, Beckstead J, Daley EM. Oral health during pregnancy: an analysis of interprofessional guideline awareness and practice behaviors among prenatal and oral health providers. BMC Pregnancy Childbirth 2023; 23:721. [PMID: 37821843 PMCID: PMC10566079 DOI: 10.1186/s12884-023-06032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Poor oral health during pregnancy has significant implications across the life course, including increased risk for adverse pregnancy, birth outcomes, and the development of early childhood caries. In efforts to improve perinatal oral health in the United States, a set of national interprofessional guidelines were developed that include recommended practice behaviors for both oral health providers and prenatal providers. The purpose of this study was to examine guideline awareness, familiarity, beliefs, and practice behaviors among both provider types. METHODS Prenatal providers and oral health providers in Florida were recruited via random and convenience sampling to complete an online survey guided by the Consolidated Framework for Implementation Research (CFIR) and the Cabana Framework. The present analysis focused on the Individuals Involved domain (CFIR), awareness and familiarity with the guidelines (Cabana Framework), confidence, and practice behaviors as recommended by prenatal oral health guidelines (assess, advise, refer, share/coordinate). Data were analyzed using chi-square tests, independent samples t-tests, Pearson correlation coefficients, and one-way analysis of variance (ANOVA) and analyses were conducted in SPSS. RESULTS Prenatal and oral health providers did not differ significantly in their awareness of the guidelines, but awareness was significantly associated with three of the four practice behaviors for prenatal providers. Familiarity with the guidelines was significantly higher among oral health providers and was associated with all four practice behaviors for both provider types. Five out of ten oral health belief items were significantly associated with practicing the guidelines among prenatal providers, but only two among oral health providers. Confidence in performing the practice behaviors was significantly associated with guideline implementation among both groups. Years in practice was significantly associated with performing practice behaviors for prenatal providers, but not for oral health providers. CONCLUSIONS Our findings highlight the importance of professional organizations and the role of clinical guidelines on practice behaviors. Although provider education is a key implementation strategy, organizational and policy-level system changes could also be critical in supporting practice behaviors.
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Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA.
| | - Morgan Richardson Cayama
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
| | - Helen Mahony
- College of Social Sciences and Public Policy, Florida State University, 113 Collegiate Loop, Tallahassee, FL, 32304, USA
| | - Stacey B Griner
- School of Public Health, The University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd Fort Worth, Fort Worth, TX, 76107, USA
| | - Rocio B Quinonez
- Division of Pediatric Dentistry and Public Health, Department of Pediatrics, Schools of Dentistry and Medicine, University of North Carolina at Chapel Hill, 385 S. Columbia St., Chapel Hill, NC, 27599, USA
| | - Kim Boggess
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, 3009 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599, USA
| | - Jason Beckstead
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
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Griner SB, Johnson KC, Neelamegam M, Webb NJ, Kinard A, Kline N. Direct-to-Consumer Sexually Transmitted Infection Screening Methods: Preferred Communication Sources and Channels Among Young Adult Women. Sex Transm Dis 2023; 50:619-624. [PMID: 37195283 DOI: 10.1097/olq.0000000000001829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Direct-to-consumer (DTC) sexually transmitted infection (STI) screening methods use self-collected samples in a nonclinical setting. Direct-to-consumer methods may reach a population of women who avoid screening because of stigma and privacy concerns, or who lack access to clinical care. Little is known about the salient dissemination approaches to promote these methods. The study's purpose was to identify preferred sources and communication channels for information about DTC methods among young adult women. METHODS Participants were sexually active 18- to 24-year-old college women at one university, recruited via purposive sampling using campus email, list-servs, and campus events to participate in an online survey (n = 92). Interested participants were invited to participate in in-depth interviews (n = 24). Both instruments were guided by the Diffusion of Innovation theory to identify relevant communication channels. RESULTS Survey participants ranked healthcare providers as their preferred source of information, followed by the Internet and college- and university-based resources. Race was significantly associated with the ranking of partners and family members as information sources. Interview themes focused on healthcare providers legitimizing DTC methods, using the Internet and social media to increase awareness, and linking DTC method education to other services provided by the college. CONCLUSIONS This study revealed common information sources that college-aged women may use when researching DTC method information and potential channels and strategies for DTC uptake and dissemination. Using trusted sources including healthcare providers, trusted Web sites, and established college resources as dissemination channels may be beneficial to increase the awareness and use of DTC methods for STI screening.
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Affiliation(s)
| | | | | | | | - Ashlyn Kinard
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX
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6
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Moore JD, Nguyen USDT, Ojha RP, Griner SB, Thompson EL. Physician-level determinants of HCV screening during pregnancy in a U.S. sample. Arch Gynecol Obstet 2023:10.1007/s00404-023-07146-x. [PMID: 37454352 DOI: 10.1007/s00404-023-07146-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The purpose of this study was to assess the association between select determinants and HCV screening guideline adherence among physicians who provide prenatal care. RESEARCH QUESTION What factors may act as determinants of guideline adherence to HCV screening among physicians who provide prenatal care? METHODS We surveyed a national sample of physicians who provided prenatal care in 2021. The survey included questions from the Clinician Guideline Determinant (CGD) questionnaire, demographic characteristics, and medical practice characteristics. We estimated odds ratios and 95% confidence intervals (CIs) using semi-Bayesian logistic regression for the association between determinants and guideline adherence. RESULTS Participants included 224 physicians in the United States who reported providing prenatal care. Most physicians practiced in private practice (65%) and the majority were members of the American College of Obstetricians and Gynecologists (ACOG; 91%). Less than half (43%; 95% CI: 36%-49%) of physicians reported regular use of the HCV screening guideline. Physicians who reported general knowledge about HCV (OR = 9.0, 95% CI 3.1-30) or endorsed agreement with ease of implementation (OR = 8.0, 95% CI 2.7-25) had higher odds of adherence to the HCV screening guideline. CONCLUSION Our study suggests that less than half of practicing prenatal care physicians adhere to HCV screening guidelines for pregnant patients. Our results may be useful as a preliminary screening of select determinants of guideline use for further investigation.
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Affiliation(s)
- Jonathan D Moore
- School of Public Health, Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, USA.
| | - Uyen-Sa D T Nguyen
- School of Public Health, Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, USA
| | - Rohit P Ojha
- School of Public Health, Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, USA
- Center for Epidemiology and Healthcare Delivery Research, JPS Health Network, Fort Worth, USA
| | - Stacey B Griner
- School of Public Health, Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, USA
| | - Erika L Thompson
- School of Public Health, Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, USA
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7
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Mendez AD, Neelamegam M, Griner SB. Health Care Provider Discussions Regarding HIV/Sexually Transmitted Infection Risk Factors and Associations with HIV/Sexually Transmitted Infection Screening Among Men. Arch Sex Behav 2023:10.1007/s10508-023-02629-z. [PMID: 37296333 DOI: 10.1007/s10508-023-02629-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 04/11/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023]
Abstract
Little is known regarding the specific discussions health care providers (HCP) have with their patients and how these discussions may increase rates of HIV/STI screening. The main objective of this study was to examine the content of HCP-patient discussions and associations with HIV/STI screening while adjusting for patient characteristics. Using the 2017-2019 National Survey of Family Growth data, seven survey-weighted multivariable multinomial/binary logistic regression models were analyzed in men ages 15-49 years old (N = 4260). Patients had significantly higher odds of a lifetime HIV test when their HCP asked about number of sexual partners (adjusted odds ratio [aOR] = 2.325; 95% CI 1.379-3.919) and discussed HIV/AIDS (aOR = 4.149; 95% CI 2.877-5.983). Odds of a recent STI screening were higher among patients with HCP that asked about: sexual orientation (aOR = 1.534; 95% CI 1.027-2.291), number of sexual partners (aOR = 2.123; 95% CI 1.314-3.430), use of condoms (aOR = 2.295 95% CI 1.484-3.548), type of sexual intercourse (aOR = 1.900; 95% CI 1.234-2.925), and discussed HIV/AIDS (aOR = 1.549; 95% CI 1.167-2.056). Results may provide insight on how HCPs may potentially promote HIV/AIDS and STI screening among men and which patient groups are more likely to receive a discussion of risks factors from their HCPs.
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Affiliation(s)
- Armando D Mendez
- Department of Molecular Microbiology and Immunology, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA.
| | - Malinee Neelamegam
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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8
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Thompson EL, Galvin AM, Garg A, Diener A, Deckard A, Griner SB, Kline NS. A socioecological perspective to contraceptive access for women experiencing homelessness in the United States. Contraception 2023; 122:109991. [PMID: 36841461 PMCID: PMC10281709 DOI: 10.1016/j.contraception.2023.109991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE Although persons who are pregnancy-capable and experiencing homelessness may have a strong desire to avoid pregnancy, they face unique barriers to contraception. This multimethod qualitative study aimed to identify preferences for, barriers to, and facilitators of contraceptive access and use among women experiencing homelessness in the United States using a systems perspective. STUDY DESIGN We conducted semistructured interviews with women experiencing homelessness (n = 19), healthcare providers (n = 6), and social service providers (n = 6). We recruited participants from community-based, housing, and medical organizations in North Texas in the United States. Two coders conducted thematic analysis and reached consensus for codes. RESULTS Women participants were in emergency shelter, unsheltered, or transitional/rapid rehousing. We stratified themes using the Socioecological Framework to illustrate factors affecting contraception access at individual, interpersonal, organizational and community, and societal levels. Notable results include women's preferences for long-acting reversible contraception, difficulties healthcare providers face in initiating contraceptive counseling, and the underutilized role of social service providers in reproductive healthcare. Insurance policies, connections between health clinics and community organizations, and organizational priorities both facilitated and hindered women experiencing homelessness's access to women's healthcare services. CONCLUSION This study identified opportunities throughout the healthcare and social service systems to support contraceptive access for women experiencing homelessness. Future interventions should strengthen and leverage these connections to promote access among this vulnerable population with the goal of supporting reproductive autonomy. IMPLICATIONS This study explored the reproductive health needs of women experiencing homelessness. Multilevel interventions, such as interdisciplinary care, patient-centered approaches, and an emphasis on health literacy, are needed to adequately provide the preferred methods of contraception for women experiencing homelessness, thus enabling reproductive autonomy for this population.
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Affiliation(s)
- Erika L Thompson
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, USA.
| | - Annalynn M Galvin
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, USA
| | - Ashvita Garg
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, USA
| | - Anelise Diener
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, USA
| | - Amber Deckard
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, USA
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, USA
| | - Nolan S Kline
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, USA
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Kline NS, Webb NJ, Johnson KC, Yording HD, Griner SB, Brunell DJ. Mapping transgender policies in the US 2017-2021: The role of geography and implications for health equity. Health Place 2023; 80:102985. [PMID: 36804680 DOI: 10.1016/j.healthplace.2023.102985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
Transgender individuals globally face varying policy contexts that can influence their health. In the United States (US), a patchwork of exclusionary and inclusive policies exists, creating potentially different social and political contexts that shape transgender health depending on the state. In this article, we consider how recent legislation introduced in US states focused on transgender people may be a political determinant of health and affect health equity goals. To advance this aim, we employed the perspective of legal epidemiology to systematically search a US legal database (Westlaw) for policies focused on transgender individuals proposed between January of 2017 and September of 2021.698 policies were analyzed as affirming or exclusionary of transgender identities and categorized by content. We calculated a ratio of affirming versus exclusionary bills to create "exclusionary density" and "affirming density" measures. Those measures were used to calculate an inclusivity score and corresponding maps of inclusivity and exclusionary contexts by US state. Exclusionary and affirming density measures showed deeply polarized policy responses to transgender individuals depending on US state. Further, we observed differences in magnitude regarding the laws being proposed. Exclusionary laws largely focused on criminalization while inclusionary laws focused on representation in government agencies. These findings highlight that transgender individuals in the US can experience vastly different political contexts depending on where they live.
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Affiliation(s)
- Nolan S Kline
- University of North Texas Health Science Center, School of Public Health, Department of Health Behavior and Health Systems, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA.
| | - Nathaniel J Webb
- University of North Texas Health Science Center, School of Public Health, Department of Health Behavior and Health Systems, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Kaeli C Johnson
- University of North Texas Health Science Center, School of Public Health, Department of Health Behavior and Health Systems, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Hayley D Yording
- University of North Texas Health Science Center, Gibson D. Lewis Library, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Stacey B Griner
- University of North Texas Health Science Center, School of Public Health, Department of Health Behavior and Health Systems, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - David J Brunell
- University of North Texas Health Science Center, School of Public Health, Department of Health Behavior and Health Systems, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
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10
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Galvin AM, Garg A, Griner SB, Moore JD, Thompson EL. Health Literacy Correlates to HPV Vaccination Among US Adults Ages 27-45. J Cancer Educ 2023; 38:349-356. [PMID: 35022987 PMCID: PMC8754534 DOI: 10.1007/s13187-021-02123-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 06/01/2023]
Abstract
Human papillomavirus (HPV) vaccination is now available for adults aged 27-45 as a shared clinical decision. Health literacy skills (i.e., accessing, understanding, appraising, applying information) may facilitate vaccine decision-making for adults with a provider recommendation. This study assessed associations between health literacy skills and willingness to get a provider-recommended HPV vaccine among newly eligible US adults. In 2020, US participants (51% women), aged 27-45 years, were surveyed online (n = 691). The outcome was willingness (willing/not willing) to get the HPV vaccine with provider recommendation. Measures were adapted from Sørensen's multidimensional European Health Literacy Scale, which assesses health literacy among four domains (i.e., access, understanding, appraisal, application). Adjusted odds ratios were calculated for the outcome and each health literacy domain, adjusting for personal health determinants (e.g., age, sex). The sample consisted of primarily non-Hispanic (91.2%), White (74.4%), and married (60.7%) adults. Approximately 65% of participants were willing to get a provider-recommended HPV vaccine. Higher willingness to vaccinate with provider recommendation was significantly associated with increased HPV knowledge (understanding; aOR = 1.13, 95% CI 1.04, 1.24), ability to understand HPV information (understanding; aOR = 1.96, 95% CI 1.09, 3.52), increased perceived vulnerability to HPV-related cancer (appraising; aOR = 3.22, 95% CI 1.83, 5.69), and the need for more information on vaccine safety to seek vaccination (applying; aOR = 3.25; 95% CI 2.05, 5.16). Utilizing a multidimensional health literacy framework to evaluate facilitators to HPV vaccination uptake among adults aged 27-45 can help guide future interventions by targeting accurate, easy-to-understand HPV information that connects vaccination efficacy to reduction in HPV cancer risk.
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Affiliation(s)
- Annalynn M. Galvin
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107 USA
| | - Ashvita Garg
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX USA
| | - Stacey B. Griner
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107 USA
| | - Jonathan D. Moore
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX USA
| | - Erika L. Thompson
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX USA
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11
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Griner SB, Beckstead JW, Vamos CA, Puccio JA, Perrin K, Daley EM. Characteristics associated with the adoption of consumer-based -self-sampling methods for sexually transmitted infection screening. J Am Coll Health 2023:1-8. [PMID: 36701488 DOI: 10.1080/07448481.2022.2162823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 09/22/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Objective: To identify theory-based innovation characteristics associated with the adoption of consumer-based self-sampling methods for sexually transmitted infection screening. Participants: Guided by the Diffusion of Innovation, survey data from people assigned female at birth (AFAB) (n = 92) were analyzed. Methods: Forward regression models and a path analysis were used to predict adoption by characteristics, using maximum likelihood estimation. Measures included acceptability, comfort, addresses healthcare needs, willingness to adopt self-sampling methods, and innovation characteristics. Results: Predictors of willingness to adopt were no clinic visit (relative advantage), convenient pick-up (relative advantage), and low cost. Variables with direct effects on adoption included: addresses healthcare needs, comfort, acceptability, and no clinic visit. Conclusions: Relative advantage was a salient factor and prioritizing this construct in intervention development may facilitate adoption. Results can guide the development of an innovative, theory-based intervention that promotes adoption of self-sampling methods, ultimately improving STI screening rates.
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Affiliation(s)
- Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Jason W Beckstead
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Joseph A Puccio
- Division of Adolescent Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
- University of South Florida Student Health Services, Tampa, Florida, USA
| | - Kay Perrin
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, Florida, USA
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Griner SB, Vamos CA, Phillips AC, Puccio JA, Thompson EL, Daley EM. Assessing college students' interest in university-based oral health information and services. J Am Coll Health 2023; 71:5-9. [PMID: 33577423 DOI: 10.1080/07448481.2021.1876706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/18/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Objective: To assess US college students' (1) oral health behaviors and (2) interest in university-based oral health information and services. Participants: Students at a large public university in the southeast participated in the survey (n = 102). All participants were over the age of 18 and able to speak and read English. Methods:An online quantitative survey was administered to collect information on oral health behaviors, interest in university-based oral health information and services, and sociodemographic factors. Frequencies, descriptive statistics, and bivariate analyses were utilized for this study. Results: Approximately 11% of students rated their oral health as fair/poor and 27% currently had a dental problem. Over half (53%) were interested in receiving oral health information from the university, 87% felt campus-based dental services were important, and 79% were likely to use campus-based dental services. Conclusions: College students may benefit from information and services to promote oral health within the college context.
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Affiliation(s)
- Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Amelia C Phillips
- Director of Wellbeing, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Joseph A Puccio
- Division of Adolescent Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA
- Executive and Medical Director, University of South Florida Student Health Services, Tampa, FL, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
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13
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Vamos CA, Griner SB, Daley EM, Cayama MR, Beckstead J, Boggess K, Quinonez RB, Damschroder L. Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews. Implement Sci Commun 2022; 3:126. [PMID: 36443891 PMCID: PMC9703729 DOI: 10.1186/s43058-022-00363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Pregnancy presents an opportune time for oral health promotion and intervention; however, implementation of the prenatal oral health guidelines remains a challenge among prenatal and oral health providers. The purpose of this study was twofold: To employ a theory-based approach to identify high-priority Consolidated Framework for Implementation Research (CFIR) constructs with the greatest potential to impact prenatal oral health guideline implementation, and to operationalize and pre-test survey items based on the prioritized CFIR constructs. Identifying barriers and facilitators to guideline implementation will inform the development of targeted interventions that address gaps in adherence which can positively impact oral-systemic health. METHODS The online survey development process employed three rounds of a modified-Delphi technique with prenatal (i.e., MD/DO, CNM) and oral health (i.e., DMD) Practice Advisory Board Members, cognitive interviews with prenatal and oral health providers, and deliberations among the research team and a Scientific Advisory Board (OBGYN, pediatric dentist, and researchers). High-impact CFIR constructs were identified and translated into survey items that were subsequently piloted and finalized. RESULTS During three modified-Delphi rounds, a total of 39 CFIR constructs were evaluated with final input and deliberations with the Practice Advisory Board, Scientific Advisory Board, and the research team achieving consensus on 19 constructs. The instrument was pre-tested with four prenatal and two oral health providers. Overall, participants reported that the survey items were feasible to respond to, took an appropriate length of time to complete, and were well-organized. Participants identified specific areas of improvement to clarify CFIR items. The final survey instrument included 21 CFIR items across four domains, with five constructs included from the intervention characteristics domain, two from the process domain, two from the outer setting domain, and 12 from the inner setting domain. CONCLUSIONS Lessons learned from the survey development process include the importance of soliciting diverse scientific and practice-based input, distinguishing between importance/impact and direction of impact (barrier/facilitator), and the need for additional qualitative methods during interdisciplinary collaborations. Overall, this study illustrated an iterative approach to identifying high-priority CFIR constructs that may influence the implementation of the prenatal oral health guidelines into practice settings.
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Affiliation(s)
- Cheryl A. Vamos
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Stacey B. Griner
- grid.266871.c0000 0000 9765 6057School of Public Health, The University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
| | - Ellen M. Daley
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Morgan Richardson Cayama
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Jason Beckstead
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Kim Boggess
- grid.10698.360000000122483208Department of Obstetrics and Gynecology, School of Medicine, University of North, Carolina at Chapel Hill, CB 7516, Chapel Hill, NC 27599 USA
| | - Rocio B. Quinonez
- grid.10698.360000000122483208Department of Pediatric Dentistry, Schools of Dentistry, Pediatrics and Public Health, University of North Carolina at Chapel Hill, CB 7450, Chapel Hill, NC 27599 USA
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14
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Kline NS, Griner SB, Neelamegam M, Webb NJ, Morales JJ, Rhodes SD. Responding to "Don't Say Gay" Laws in the US: Research Priorities and Considerations for Health Equity. Sex Res Social Policy 2022; 19:1397-1402. [PMID: 36406660 PMCID: PMC9666954 DOI: 10.1007/s13178-022-00773-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Despite increased legal rights for lesbian, gay, bisexual, transgender, and queer-identifying (LGBTQ +) people in the USA over the past 30 years, there has been an increasing number of anti-LGBTQ + laws proposed and passed at the state level. One of the most notorious laws, Florida's HB 1557, also known as the "Don't Say Gay" law, garnered substantial national attention for prohibiting discussions of sexual orientation or gender identity in public school classrooms. Other states quickly proposed similar laws, but little scholarship exists on the potential impacts of these laws. METHODS We explore the potential health equity ramifications of laws like Florida's HB 1557, focusing on the individual, interpersonal, and broader policy and practice implications. Examining these policies through the lens of political determinants of health, we identify theoretical and methodological approaches needed to address recent "Don't Say Gay" policies. RESULTS Theoretical approaches emphasizing power, intersectionality, and the role of politics in health should guide research examining the impacts of recent anti-LGBTQ + policies. Laws like Florida's HB 1557 emphasize the need for methodological approaches that emphasize collaborative engagement between researchers and community members, and future research may be needed to understand how stressors created by law and policy can have individual and interpersonal consequences. CONCLUSIONS Public health researchers have a role to play in reversing policies that negatively affect LGBTQ + individuals and undermine health equity. Research combating harmful policies may require theoretical approaches attentive to power differences and methodological approaches that squarely focus on disrupting power imbalances.
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Affiliation(s)
- Nolan S. Kline
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107 USA
| | - Stacey B. Griner
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107 USA
| | - Malinee Neelamegam
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107 USA
| | - Nathaniel J. Webb
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107 USA
| | | | - Scott D. Rhodes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27101 USA
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Abstract
Literature has established that men with non-consensual sexual experiences exhibit a higher likelihood of engaging in high-risk sexual behaviors; however, previous research does not explore men with unwanted sexual experiences, nor their sexual and general health outcomes. Weighted data from the 2011-2017 National Survey of Family Growth included men aged 18-49 years who ever experienced oral, vaginal, or anal sex by partners of any gender (N = 10,763). The Pearson χ2 test compared the sociodemographic of men with or without a history of unwanted or non-consensual sex. Logistic regressions were used to examine the association of this history to sexual health and general health outcomes, while controlling for age, race/ethnicity, and education level. Approximately 1 in 10 (10.3%) American men reported experiencing unwanted or non-consensual sex in their lifetime. Men with these experiences were more likely to rate their health as fair or poor (aOR = 1.5, 95% CI = [1.1, 2.0]) and have difficulty concentrating, remembering, or making decisions due to a physical, mental, or emotional condition (aOR = 2.1, 95% CI = [1.7, 2.7]). Men with forced sex experiences reported higher odds of gonorrhea (aOR = 5.4; 95% CI = [3.0, 10.0]) or chlamydia diagnoses (aOR = 2.5; 95% CI = [1.5, 4.4]) in the past year, and a diagnosis of genital herpes (aOR = 2.7; 95% CI = [1.6, 4.6]), genital warts (aOR = 1.7; 95% CI = [1.0, 5.6]), and syphilis (aOR = 2.4; 95% CI = [1.0, 5.6]) in their lifetime than men who did not report these experiences. The association of sexually transmitted infections and general health outcomes to unwanted and non-consensual sex validates the demand for clinicians to integrate trauma-informed care into their practice with male patients.
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Affiliation(s)
- Julia Aiken
- Epidemiology Specialist, Tarrant County Public Health, Texas, United States
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Texas, United States
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16
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Griner SB, Yockey RA, Forschner CN. Oral healthcare visits among sexual minority adolescents ages 14-18, 2019, USA. J Public Health Dent 2022. [PMID: 36207283 DOI: 10.1111/jphd.12546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/28/2022] [Accepted: 07/26/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Health disparities persist among sexual minority (SM) adolescents (i.e., bisexual, lesbian/gay) compared to heterosexual adolescents, however, research is limited on oral health. The purpose of this study was to examine reported recency of dental visits by sexual orientation among a national sample of adolescents. METHODS Data from the 2019 Youth Risk Behavior Surveillance Survey (n = 12,673 adolescents, 14-18 years old) were analyzed. We assessed dental care in the past 12 months or more based on sexual orientation ("lesbian/gay," "bisexual," "not sure"). Adjusted, sex-stratified, multinomial logistic regression analyses were used to determine conditional associations. RESULTS Bisexual boys (aRR:2.50), "not sure" boys (aRR:3.55), and "not sure" girls (aRR:2.32) were at increased relative risk for not going to the dentist compared to heterosexual adolescents. CONCLUSIONS Findings indicate gaps in oral healthcare access among SM adolescents, specifically bisexual and not sure youth. Results can be used to increase access to preventive dental care among SM adolescents.
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Affiliation(s)
- Stacey B Griner
- School of Public Health, Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Robert A Yockey
- School of Public Health, Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Caylee N Forschner
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
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17
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Griner SB, Footman A, Van Der Pol B. Mentoring Relationships in the Field of Sexually Transmitted Infections: Experiences, Observations, and Recommendations. Health Behavior Research 2022. [DOI: 10.4148/2572-1836.1142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Garg A, Wheldon CW, Galvin AM, Moore JD, Griner SB, Thompson EL. The Development and Psychometric Evaluation of the Mid-adult Human Papillomavirus Vaccine Knowledge Scale in the United States. Sex Transm Dis 2022; 49:423-428. [PMID: 35608097 DOI: 10.1097/olq.0000000000001615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous human papillomavirus (HPV) and HPV vaccine knowledge scales have focused on young adults in the vaccination catch-up age range or parents of vaccine eligible adolescents. Previous scales are not specific to the new guidelines for HPV vaccination in mid-adults. The study aimed to develop and validate a mid-adult HPV vaccine knowledge scale informed by the latest vaccine recommendations. METHODS Self-reported data were collected using a cross-sectional survey of adults aged 27 to 45 years with no history of HPV vaccination (n = 706). Exploratory and confirmatory factor analyses identified latent constructs in a 13-item mid-adult HPV vaccine knowledge scale. Sociodemographic differences in the HPV vaccine knowledge were also assessed. RESULTS The mean of correct responses across all items was 5.9 (SD, 2.8; range, 0-13). Exploratory and confirmatory factor analyses revealed a 3-factor structure best explained the data with a good construct validity and reliability. The first factor contained 6 items about HPV infection, the second factor contained 3 items about HPV prevention through vaccination, and the third factor contained items about HPV vaccination misinformation. Analysis of variance and t test found significant group level differences in knowledge among sex, race, educational level, annual income, health insurance, and marital status. CONCLUSIONS Our study supports the use of a knowledge scale for US mid-adults to assess HPV and HPV vaccination knowledge because the patient requires some baseline knowledge of this recommendation to discuss the vaccine with their health care provider. The mid-adult HPV vaccine knowledge scale can measure basic HPV knowledge important to informed decision making.
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Affiliation(s)
- Ashvita Garg
- From the Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA
| | - Annalynn M Galvin
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX
| | - Jonathan D Moore
- From the Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX
| | - Erika L Thompson
- From the Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
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19
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Kline N, Webb NJ, Thompson EL, Griner SB, Schrimshaw EW. Latinx COVID-19 Disparities and Work As a Social Determinant of Health: A Research and Policy Agenda. Popul Health Manag 2022; 25:284-287. [PMID: 35442792 DOI: 10.1089/pop.2021.0368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nolan Kline
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Nathaniel J Webb
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Erika L Thompson
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Eric W Schrimshaw
- Department of Population Health, University of Central Florida College of Medicine, Orlando, Florida, USA
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20
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Galvin AM, Garg A, Griner SB, Diener AK, Thompson EL. ‘The chances are zero’: a qualitative study on perceived susceptibility to pregnancy among women experiencing homelessness. Sex Health 2022; 19:164-171. [DOI: 10.1071/sh21241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/10/2022] [Indexed: 11/23/2022]
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21
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Griner SB, Spears EC, Maskey S. Advancing Cultural Competency Toward Sexual and Gender Minorities: Innovation in Maternal and Child Health Pedagogy. Matern Child Health J 2021; 26:42-48. [PMID: 34854026 PMCID: PMC8635312 DOI: 10.1007/s10995-021-03309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/25/2022]
Abstract
Purpose The purpose of this project was to develop and disseminate an innovative teaching activity to increase cultural competency toward sexual and gender minority (SGM) populations within the maternal and child health (MCH) context. Description Over 4.5% of the population (16 million people in the US) identify as SGM, and this population is an often-overlooked group within the traditional MCH context. SGM individuals have specific healthcare needs, including reproductive healthcare needs, that are currently left unaddressed. Given these gaps, the future MCH workforce should be prepared with cultural competency skills to address reproductive health inequities from many perspectives, including SGM populations. An innovative SGM activity was developed and disseminated to supplement the MCH and Reproductive Health curricula. Assessment The objectives of this SGM Reproductive Health activity were: (1) to understand SGM populations, terminology, culture, and health inequities within an MCH context; (2) enhance cultural competency and the communication skills appropriate for this population; and (3) develop culturally competent resources for practice. The teaching activity includes a lesson plan, lecture with script, recorded lecture, assignment description, and grading rubric, designed for a U.S. based curriculum. The activity was evaluated and modified based on feedback from students, and pilot tested in practice in a graduate-level reproductive health course. Conclusion Future MCH leaders must have the skills to provide culturally competent care to the populations they serve, including SGM populations. Through teaching about SGM populations and cultural competence, educators can equip future MCH leaders with a culturally competent skillset to prepare them to work in cross-cultural situations.
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Affiliation(s)
- Stacey B. Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
| | - Erica C. Spears
- Monitoring, Evaluation, and Learning, Louisiana Public Health Institute, 1515 Poydras Street, Suite 1200, New Orleans, LA 70112 USA
| | - Smriti Maskey
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
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22
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Exten C, Pinto CN, Gaynor AM, Meyerson B, Griner SB, Van Der Pol B. Direct-to-Consumer Sexually Transmitted Infection Testing Services: A Position Statement from the American Sexually Transmitted Diseases Association. Sex Transm Dis 2021; 48:e155-e159. [PMID: 34030157 PMCID: PMC8505153 DOI: 10.1097/olq.0000000000001475] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/27/2022]
Abstract
ABSTRACT Direct-to-consumer test services have gained popularity for sexually transmitted infections in recent years, with substantially increased use as a result of the SARS-CoV-2 (CoVID-19) global pandemic. This method of access has been variously known as "self-testing," "home testing," and "direct access testing." Although these online services may be offered through different mechanisms, here we focus on those that are consumer-driven and require self-collected samples, and sample shipment to a centralized laboratory without involvement of health care providers and/or local health departments. We provide the American Sexually Transmitted Diseases Association's position on utilization of these services and recommendations for both consumers and health care providers.
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Affiliation(s)
- Cara Exten
- From the The Pennsylvania State University College of Nursing, University Park
| | - Casey N. Pinto
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA
| | - Anne M. Gaynor
- Association of Public Health Laboratories, Silver Spring, MD
| | - Beth Meyerson
- College of Social and Behavioral Sciences, Southwest Institute for Research on Women, University of Arizona, Tucson, AZ
| | - Stacey B. Griner
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
| | - Barbara Van Der Pol
- Schools of Medicine
- Public Health, University of Alabama at Birmingham, Birmingham, AL
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23
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Abstract
Sexual scripts and consent communication methods are seldom explored outside of heterosexual, cisgender relationships. To date, little research has been conducted to determine how sexual and gender minority (SGM) students conceptualize and communicate consent. This study explored SGM undergraduate students' (n = 81) sexual consent communication scripts using open-ended survey items. We conducted a thematic freelisting analysis to assess the domains of consent and non-consent scripts using Smith's Salience Score (S). Salient indicators of consent were verbal communication (S = .31; 38%); however, more specific forms of verbal communication were listed as a spectrum, including: asking (a request, S = .16; 23%), saying (a statement, S = .16; 20%), and telling (a command, S = .10; 13%). The most salient indicators of verbal non-consent were on a similar spectrum: saying no (S = .42; 9%), verbal communication broadly (S = .23; 27%), and telling no (S = .06; 7%). Salient physical indicators of both consent and non-consent also followed a spectrum in their descriptions. Future research among SGM college students should explore the meanings, patterns, and differences in consent communication and sexual scripts.
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Affiliation(s)
- Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center
| | | | - Edward Monroy
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center
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24
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Thompson EL, Garg A, Head KJ, Griner SB, Galvin AM, Barnett TE. Who Should Decide? Decision-Making Preferences for Primary HPV Testing for Cervical Cancer Screening Among U.S. Women. Health Behavior Research 2021. [DOI: 10.4148/2572-1836.1106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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25
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Abstract
The purpose of this study was to examine sex cognitions and behavioral strategy correlates for chlamydia, gonorrhea, and HIV testing among a national sample of young adults ages 18-20. Young adults (18-20 years) were recruited nationally (n = 1144). The sample was restricted (n = 817) based on inclusion/exclusion criteria for analysis. The outcome variables were gonorrhea, chlamydia, and HIV testing, respectively, in the last 12 months. Covariates included demographic variables, alcohol use, perceived vulnerability, protective behavioral strategies, and sexual behavior in the last 3 months. Adjusted logistic regression models were estimated in SAS 9.4. Approximately 24% of respondents were tested for chlamydia and gonorrhea, and 21% were tested for HIV in the past year. Women were more likely than men to be tested for chlamydia (OR = 1.67, 95% CI 1.13, 2.46) and gonorrhea (OR = 1.55, 95% CI 1.05, 2.28). Persons who were worried about an STI after a sexual encounter and who engaged in casual sex were more than two times as likely to be tested for all three STIs. Similarly, persons who used more non-condom-related protective behavioral strategies were more likely to be tested. Future studies may consider these correlates as potential intervention points for promoting STI testing among young adults.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Annalynn M Galvin
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Ashley D Lowery
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
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26
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Maness SB, Merrell L, Thompson EL, Griner SB, Kline N, Wheldon C. Social Determinants of Health and Health Disparities: COVID-19 Exposures and Mortality Among African American People in the United States. Public Health Rep 2020. [PMID: 33176112 DOI: 10.1177/0033-3549-20969169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Affiliation(s)
- Sarah B Maness
- 2343 Department of Health and Human Performance, College of Charleston, Charleston, SC, USA
| | - Laura Merrell
- 3745 Department of Health Sciences, James Madison University, Harrisonburg, VA, USA
| | - Erika L Thompson
- 12376 Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Stacey B Griner
- 12376 Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Nolan Kline
- 8678 Department of Anthropology, Rollins College, Winter Park, FL, USA
| | - Christopher Wheldon
- 6558 Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
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27
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Stockbridge EL, Dhakal E, Griner SB, Loethen AD, West JF, Vera JW, Nandy K. Dental visits in Medicaid-enrolled youth with mental illness: an analysis of administrative claims data. BMC Health Serv Res 2020; 20:1138. [PMID: 33308226 PMCID: PMC7730780 DOI: 10.1186/s12913-020-05973-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/25/2020] [Indexed: 12/03/2022] Open
Abstract
Background State Medicaid plans across the United States provide dental insurance coverage to millions of young persons with mental illness (MI), including those with attention deficit hyperactivity disorder (ADHD), depression, anxiety, bipolar disorder, and schizophrenia. There are significant oral health challenges associated with MI, and providing dental care to persons with MI while they are young provides a foundation for future oral health. However, little is known about the factors associated with the receipt of dental care in young Medicaid enrollees with MI. We aimed to identify mental and physical health and sociodemographic characteristics associated with dental visits among this population. Methods We retrospectively analyzed administrative claims data from a Medicaid specialty health plan (September 2014 to December 2015). All enrollees in the plan had MI and were ≥ 7 years of age; data for enrollees aged 7 to 20 years were analyzed. We used two-level, mixed effects regression models to explore the relationships between enrollee characteristics and dental visits during 2015. Results Of 6564 Medicaid-enrolled youth with MI, 29.0% (95% CI, 27.9, 30.1%) had one or more visits with a dentist or dental hygienist. Within youth with MI, neither anxiety (Adjusted odds ratio [AOR] = 1.15, p = 0.111), post-traumatic stress disorder (AOR = 1.31, p = 0.075), depression (AOR = 1.02, p = 0.831), bipolar disorder (AOR = 0.97, p = 0.759), nor schizophrenia (AOR = 0.83, p = 0.199) was associated with dental visits in adjusted analyses, although having ADHD was significantly associated with higher odds of dental visits relative to not having this condition (AOR = 1.34, p < 0.001). Age, sex, race/ethnicity, language, and education were also significantly associated with visits (p < 0.05 for all). Conclusions Dental utilization as measured by annual dental visits was lower in Medicaid-enrolled youth with MI relative to the general population of Medicaid-enrolled youth. However, utilization varied within the population of Medicaid-enrolled youth with MI, and we identified a number of characteristics significantly associated with the receipt of dental services. By identifying these variations in dental service use this study facilitates the development of targeted strategies to increase the use of dental care in – and consequently improve the current and long-term wellbeing of – the vulnerable population of Medicaid-enrolled youth with MI.
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Affiliation(s)
- Erica L Stockbridge
- Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA. .,Department of Advanced Health Analytics and Solutions, Magellan Health, Inc., 4800 N Scottsdale Rd #4400, Scottsdale, AZ, 85251, USA.
| | - Eleena Dhakal
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Stacey B Griner
- Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Abiah D Loethen
- Department of Advanced Health Analytics and Solutions, Magellan Health, Inc., 4800 N Scottsdale Rd #4400, Scottsdale, AZ, 85251, USA
| | - Joseph F West
- Florida Institute for Health Innovation, 2701 N. Australian Avenue Suite 204, West Palm Beach, Florida, 33407, USA.,Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1600 NW 10th Ave #1140, Miami, Florida, 33136, USA
| | - Joseph W Vera
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Karabi Nandy
- Department of Population and Data Sciences, UT Southwestern Medical Center, South Campus, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
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Maness SB, Merrell L, Thompson EL, Griner SB, Kline N, Wheldon C. Social Determinants of Health and Health Disparities: COVID-19 Exposures and Mortality Among African American People in the United States. Public Health Rep 2020; 136:18-22. [PMID: 33176112 DOI: 10.1177/0033354920969169] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Sarah B Maness
- 2343 Department of Health and Human Performance, College of Charleston, Charleston, SC, USA
| | - Laura Merrell
- 3745 Department of Health Sciences, James Madison University, Harrisonburg, VA, USA
| | - Erika L Thompson
- 12376 Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Stacey B Griner
- 12376 Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Nolan Kline
- 8678 Department of Anthropology, Rollins College, Winter Park, FL, USA
| | - Christopher Wheldon
- 6558 Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
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29
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Griner SB, Vamos CA, Thompson EL, Logan R, Vázquez-Otero C, Daley EM. The Intersection of Gender Identity and Violence: Victimization Experienced by Transgender College Students. J Interpers Violence 2020; 35:5704-5725. [PMID: 29294863 DOI: 10.1177/0886260517723743] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
College students disproportionately experience victimization, stalking, and relationship violence when compared with other groups. Few studies explore victimization by the gender identity of college students, including those who identify as transgender. The purpose of this study is to explore the rates of violence experienced by transgender students compared with male and female college students. This study utilized the National College Health Assessment-II (NCHA-II) and included data from students (n = 82,538) across fall 2011, 2012, and 2013. Bivariate statistics and binary logistic regression were conducted to test the relationships between gender identity and victimization. Transgender students (n = 204) were compared with male (n = 27,322) and female (n = 55,012) students. After adjusting for individual factors, transgender students had higher odds of experiencing all nine types of violence when compared with males and higher odds of experiencing eight types of violence than females. Transgender students experienced the highest odds in crimes involving sexual victimization, including attempted sexual penetration (adjusted odds ratio [aOR]: 9.49, 95% confidence interval [CI] = [6.17, 14.59], d = 1.00), sexual penetration without consent (aOR: 9.06, 95% CI = [5.64, 14.53], d = 0.94), and being in a sexually abusive relationship (aOR: 6.48, 95% CI = [4.01, 10.49], d = 0.48), than did male students. Findings reveal increased odds of victimization among transgender students when compared with male and female students. Results demonstrate the need for more comprehensive violence prevention efforts in college settings.
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Affiliation(s)
- Stacey B Griner
- Department of Community and Family Health, University of South Florida, Tampa, USA
| | - Cheryl A Vamos
- Department of Community and Family Health, University of South Florida, Tampa, USA
| | - Erika L Thompson
- Department of Community and Family Health, University of South Florida, Tampa, USA
| | - Rachel Logan
- Department of Community and Family Health, University of South Florida, Tampa, USA
| | | | - Ellen M Daley
- Department of Community and Family Health, University of South Florida, Tampa, USA
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Thompson EL, Litt DM, Griner SB, Lewis MA. Cognitions and behaviors related to risk for alcohol-exposed pregnancies among young adult women. J Behav Med 2020; 44:123-130. [PMID: 32944846 DOI: 10.1007/s10865-020-00183-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 09/05/2020] [Indexed: 10/23/2022]
Abstract
This study assessed alcohol and sex-related cognitions and behaviors, including alcohol-related sexual expectancies, descriptive norms, and protective behavioral strategies, associated with women's risk for an alcohol-exposed pregnancy. A national sample of young adults ages 18-20 years was subset to women who were capable of pregnancy and sexually active (n = 422). The outcome was risk of alcohol-exposed pregnancy as determined by contraceptive status and heavy-episodic drinking. SAS version 9.4 was used to estimate logistic regression models. Alcohol-related sexual expectancies related to enhancement were significantly associated with increased odds of alcohol-exposed pregnancy risk. In contrast, women who reported the use of more safe sex (non-condom related) protective behavioral strategies (e.g., talk to partner about birth control use) were at decreased odds of alcohol-exposed pregnancy risk. Future interventions to reduce the risk of alcohol-exposed pregnancies should consider alcohol-related sexual expectancies and safer sex protective behavioral strategies as leverage points.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Dana M Litt
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
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Vamos CA, Thompson EL, Logan RG, Griner SB, Perrin KM, Merrell LK, Daley EM. Exploring college students' sexual and reproductive health literacy. J Am Coll Health 2020; 68:79-88. [PMID: 30388946 DOI: 10.1080/07448481.2018.1515757] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/03/2018] [Accepted: 08/20/2018] [Indexed: 06/08/2023]
Abstract
Objective: To assess college students' sexual and reproductive health (SRH) literacy experiences, specific to contraception use and STI prevention. Participants: In Spring 2015, participants (n = 43) from a large institution participated in six focus groups (two male and four females groups). Methods: Focus groups were guided by the health literacy domains (access; understand; appraise; apply); data were analyzed in MaxQDA using the constant comparative method. Results: The Internet was the most commonly accessed source for SRH information. Participants discussed facilitators (eg, use of visuals) and barriers (eg, medical jargon) to understanding information; and personal lifestyle, advice from family/friends, symptoms, and sexual partners as appraisal factors. Participants applied information by communicating with friends/providers and seeking healthcare. However, findings were not linear nor mutually exclusive, representing the interaction of health literacy skills. Conclusion: Findings suggest that a patient-centered intervention capitalizing on technology and trusted individuals (providers/peer educators) may facilitate college students' SRH literacy.
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Affiliation(s)
- Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Rachel G Logan
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Karen M Perrin
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Laura K Merrell
- Department of Health Sciences, James Madison University, Harrisonburg, VA, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
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Vamos CA, Griner SB, Kirchharr C, Green SM, DeBate R, Daley EM, Quinonez RB, Boggess KA, Jacobs T, Christiansen S. The development of a theory-based eHealth app prototype to promote oral health during prenatal care visits. Transl Behav Med 2019; 9:1100-1111. [PMID: 31009536 PMCID: PMC6875649 DOI: 10.1093/tbm/ibz047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Poor maternal oral health during pregnancy is associated with adverse maternal and child outcomes, including preterm birth and early childhood caries. Subsequently, professional associations have developed prenatal oral health guidelines, but significant gaps exist in implementing guidelines into clinical practice. The purpose of this study was to develop and test the usability of an innovative, theory-driven, eHealth application ("app") to facilitate prenatal providers' (nurse practitioners and midwives) implementation of oral health promotion during prenatal care visits. App development was guided by previous research, an integrated conceptual framework, Scientific Advisory Board input, and consumer-engaged iterative processes utilizing mixed-methods (observations, surveys, in-depth interviews) among providers (n = 4) during 10 unique prenatal care visits at a federally qualified health care center. Triangulation of quantitative and qualitative data analysis produced descriptive frequencies and salient themes. Concepts and principles from the following theoretical frameworks informed intervention development and testing: Consolidated Framework for Implementation Research; Information-Motivation-Behavioral Skills Model; Health Literacy; and Brief Motivational Interviewing. Overall, providers reported the app was effective at providing the information, motivation, and behavioral skills needed to integrate oral health promotion (e.g., easy to use; provided cues to action via scripts and tailored education; and documented findings into the patient's record). Although providers reported high usability, time constraints and detailed patient counseling scripts were identified areas for improvement. Findings suggest that the eHealth app could serve as an innovative mechanism to assist providers in implementing the prenatal oral health guidelines into practice. Future research is needed to continue app development efforts and to determine efficacy and effectiveness in practice settings.
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Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Stacey B Griner
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Claire Kirchharr
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Shana M Green
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rita DeBate
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rocio B Quinonez
- Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Kim A Boggess
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Tom Jacobs
- Custom Thinking Media, LLC, Eugene, OR, USA
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Thompson EL, Vamos CA, Jones J, Liggett LG, Griner SB, G Logan R, Daley EM. Perceptions of Zika Virus Prevention Among College Students in Florida. J Community Health 2019; 43:673-679. [PMID: 29380211 DOI: 10.1007/s10900-018-0468-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Zika virus in Florida prompted a strong public health response, due to its causal association with birth defects. While primarily spread by mosquitos, Zika can be transmitted sexually. The spread of Zika may influence reproductive behaviors among sexually active persons in Florida. This study examined factors associated with willingness to change birth control method use in response to Zika virus among college women and men in Florida. Women and men ages 18-44 at a Florida university (N = 328) were surveyed about Zika knowledge, beliefs about Zika, use of contraceptives and condoms, and socio-demographics between November 2016-April 2017. The outcome variable was willingness to change birth control method were Zika in their area. Logistic regression models in SAS 9.4 were used. Most participants were women (80%), and 47% were 20-22 years old. Only 27% of participants said they would change their birth control method if Zika were in their area. Participants who knew that Zika was sexually transmitted were more likely to be willing to change their birth control method (aOR = 1.71, 95%CI 1.01-2.91). Participants who agreed or strongly agreed that they were fearful of being infected with Zika virus were more likely to be willing to change their birth control methods (aOR = 1.98, 95%CI 1.07-3.67). This study found that, among Florida college students, Zika beliefs and knowledge were associated with a willingness to change birth control method in response to Zika. Understanding the factors that motivate individuals to change reproductive behaviors during an emerging health issue can help tailor preventative messages.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA. .,Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Julianna Jones
- Department of Global Health and Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Langdon G Liggett
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Rachel G Logan
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
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Abstract
While Pap testing has significantly reduced the burden of cervical cancer, not all women follow prevention recommendations of cervical cancer screening every 3 years. Health literacy regarding Pap testing may influence the adoption of this behavior. The objective of this study was to assess the health literacy-related factors associated with Pap testing among a nationally representative sample of women in the USA. The Health Information National Trends Survey Cycles 4.4 and 5.1 were restricted to women 21-65 years of age (N = 2992). Questions were selected using the Integrated Model of Health Literacy domains: access (i.e., seeking cancer information), understand (i.e., HPV awareness, HPV knowledge), appraise (i.e., prevention not possible, chance of getting cancer), and apply (i.e., received a Pap in last 3 years [outcome]). Survey-weighted, logistic regression models estimated how the health literacy domains were associated with Pap testing, using SAS 9.4. In the sample, 81.1% of women received a Pap test within the last 3 years. The analysis revealed women who knew HPV is an STD (aOR = 1.64, 95% CI 1.20-2.26) were more likely to have received a Pap test in the last 3 years, while controlling for sociodemographic factors. These findings indicate that knowledge about HPV may be associated with Pap testing behavior among US women. Continued research is needed to examine the impact of health literacy on Pap testing given the changes in screening guidelines, with the ultimate goal of decreasing cervical cancer.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, EAD 709M, Fort Worth, TX, 76107, USA.
| | - Christopher W Wheldon
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
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Abstract
Purpose Describe the development of an innovative teaching activity that applies organizational health literacy to maternal and child health (MCH). Description Health literacy is a strong predictor of health behavior and outcomes. While the study of health literacy has traditionally been confined to skills and capacities of individuals, the significant role of the social and physical environmental contexts in facilitating or hindering one's ability to obtain, understand, and make informed decision about their health has been recognized. MCH organizations play a critical role in influencing health literacy across system levels. This teaching activity aims to equip students with knowledge and skills needed to foster organizational health literacy. Assessment The teaching activity is assembled within a toolkit which includes the following: (1) instructor lesson plan; (2) interactive PowerPoint presentation with instructor notes; (3) field assignment description; (4) health literacy attribute assessment worksheets; and (5) grading rubric. The teaching tool was pilot tested by a student research team member to assess the educational value and assignment logistics, resulting in minor edits (i.e., addition of interviewer probes, and option of a group project-format to permit triangulation of multiple organizational interviews). Conclusion The field of MCH is expanding in complexity, and the demands of health systems on women, children, and families must be mediated by conscious efforts within organizations. Through teaching the importance and function of organizational health literacy to students in MCH, educators can prepare an emerging workforce to improve health literacy, and ultimately the quality of healthcare for women, children, and families.
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Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA. .,The Chiles Center, College of Public Health, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL, 33613, USA.
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Stacey B Griner
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Langdon G Liggett
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA.,The Chiles Center, College of Public Health, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL, 33613, USA
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Rapkin RB, Griner SB, Godcharles CL, Vamos CA, Neelamegam M, Thompson EL, Daley EM. Obstetrics and Gynecology and Family Medicine Residents' Training and Knowledge on Emergency Contraception. J Womens Health (Larchmt) 2019; 28:794-801. [PMID: 30939069 DOI: 10.1089/jwh.2018.7297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Emergency contraception (EC) has the potential to play a vital role in preventing unintended pregnancies after unprotected sexual intercourse or contraceptive failure. Residency training can influence practice behaviors, however, the extent to which EC-related information is taught in training programs remains unknown. This study examined where residents obtain information about EC and whether knowledge differs by resident program characteristics. Materials and Methods: Program coordinators of Obstetrics and Gynecology (OB/GYN) and Family Medicine residency programs (n = 689) were emailed and requested to forward the survey link to residents. The survey included measures of EC education (hours, sources, including lectures, grand rounds), and EC-related knowledge. EC knowledge items assessed the three methods of EC (copper intrauterine device, ulipristal acetate, and oral levonorgestrel), effectiveness, mechanism of action, contraindications, and side effects. t-Tests and analysis of variances were used to compare mean knowledge scores (maximum = 20; higher scores indicating higher knowledge). Results: Among participants (n = 676), 61% were Family Medicine residents, 66% were white, and 72% were female. Overall, 34% received <1 hour of EC education, with OB/GYN residents receiving significantly more hours than Family Medicine residents. OB/GYN residents (mean = 14.40, standard deviation [SD] = 2.69) had a significantly higher mean knowledge score than Family Medicine residents (12.12, SD = 2.63; p < 0.000). Mean knowledge score differences were found by region of residency program, with residents in the Northeast reporting higher knowledge. Conclusions: Overall, residents received very little EC education, with OB/GYN residents receiving more training and having higher knowledge than their Family Medicine counterparts. Additional training is needed to ensure that residents are knowledgeable about this effective method to decrease unintended pregnancies.
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Affiliation(s)
- Rachel Becker Rapkin
- 1 Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, Florida
| | - Stacey B Griner
- 2 College of Public Health, University of South Florida, Tampa, Florida
| | - Cheryl L Godcharles
- 3 Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Cheryl A Vamos
- 2 College of Public Health, University of South Florida, Tampa, Florida
| | | | - Erika L Thompson
- 4 Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas
| | - Ellen M Daley
- 2 College of Public Health, University of South Florida, Tampa, Florida
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Daley EM, Vamos CA, Thompson E, Vázquez-Otero C, Griner SB, Merrell L, Kline N, Walker K, Driscoll A, Petrila J. The Role of Dental Providers in Preventing HPV-Related Diseases: A Systems Perspective. J Dent Educ 2019; 83:161-172. [PMID: 30709991 DOI: 10.21815/jde.019.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/08/2018] [Indexed: 01/22/2023]
Abstract
Successfully educating dental providers and patients about the link between human papillomavirus (HPV) and oropharyngeal cancer requires coordinated efforts to increase HPV-related prevention practices. The aim of this study was to identify, using a systems perspective, the multi-level determinants related to how dental providers can promote HPV prevention in dental practices. Data for this qualitative study were collected in 2015-16 from focus groups with dentists (four focus groups, n=33), focus groups with dental hygienists (four focus groups, n=48), and in-depth interviews with dental opinion leaders (n=13). Results were triangulated and mapped along micro, meso, and macro system levels. At the micro level, participants identified patient characteristics and low self-efficacy as influential determinants when discussing HPV prevention. At the meso level, relationships among dentists, dental hygienists, and the physical practice environment were factors affecting dental providers' HPV prevention efforts. At the macro level, professional organizations impacted how dental providers interacted with their patients on this topic. These results suggest that improving HPV prevention among dental providers requires a multi-level approach that considers the distinctive context of dental settings, dental training, and perceptions of professional roles. The findings suggested that the macro- and meso-level determinants may be challenging to modify due to the distinctive culture and practice models of dentistry. Nevertheless, the association between HPV and oral cancer requires an expansion of prevention strategies used in dental practices. Improving dental providers' self-efficacy to communicate HPV prevention through continuing education and integration of skill-guided training in dental and dental hygiene curricula could facilitate this process.
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Affiliation(s)
- Ellen M Daley
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX.
| | - Cheryl A Vamos
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Erika Thompson
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Coralia Vázquez-Otero
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Stacey B Griner
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Laura Merrell
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Nolan Kline
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Kimberly Walker
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Annelise Driscoll
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - John Petrila
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
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Griner SB, Thompson EL, Vamos CA, Chaturvedi AK, Vazquez-Otero C, Merrell LK, Kline NS, Daley EM. Dental opinion leaders' perspectives on barriers and facilitators to HPV-related prevention. Hum Vaccin Immunother 2019; 15:1856-1862. [PMID: 30735476 DOI: 10.1080/21645515.2019.1565261] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Evidence suggests a causal connection between the Human Papillomavirus (HPV) and oropharyngeal cancers. HPV-related oropharyngeal cancers are increasing and are the most common HPV-associated cancer. Previous research suggests that dental professionals recognize a role in the prevention of HPV and oropharyngeal cancers. As an initial step to investigating effective mechanisms of incorporating HPV prevention into dental practices, including the HPV vaccine, this qualitative study explored dental opinion leaders' perspectives on barriers and facilitators to HPV-related prevention in the dental profession. Dental opinion leaders were identified through: (1) national professional organizations and advocacy groups, (2) by indication of an expert panel, and (3) focus groups conducted with oral health providers. Thirteen participants representing 11 organizations were interviewed via telephone. Interview recordings were transcribed verbatim and thematically coded using a priori and emergent codes. Opinion leaders described multi-level factors influencing dental providers' HPV-related prevention practice behaviors. Barriers included HPV as a sensitive topic and the need for HPV-related education and skills. Facilitators included perceptions of HPV prevention as part of the dental providers' role and the potential development of passive educational methods to provide HPV-related information to patients. Opinion leaders reported dental providers have a role in the prevention of HPV and oropharyngeal cancer; yet, to fully incorporate this topic into their practice, dental providers need further education and skill-based training. Opinion leaders have significant role in shaping this topic as a priority and identifying potential interventions to assist dental providers' HPV-related prevention. Future research should maximize the role of opinion leaders as key change agents.
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Affiliation(s)
- Stacey B Griner
- a College of Public Health, University of South Florida , Tampa , FL , USA
| | - Erika L Thompson
- b Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center , Fort Worth , TX , USA
| | - Cheryl A Vamos
- a College of Public Health, University of South Florida , Tampa , FL , USA
| | - Anil K Chaturvedi
- c National Cancer Institute, Division of Cancer Epidemiology & Genetics, Infections and Immunoepidemiology Branch, NCI Shady Grove , Bethesda , MD , USA
| | | | - Laura K Merrell
- d Department of Health Sciences, James Madison University , Harrisonburg , VA , USA
| | - Nolan S Kline
- e Department Anthropology, Rollins of College , Winter Park , FL , USA
| | - Ellen M Daley
- a College of Public Health, University of South Florida , Tampa , FL , USA
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Daley EM, Thompson EL, Vamos CA, Griner SB, Vazquez-Otero C, Best AL, Kline NS, Merrell LK. HPV-Related Knowledge Among Dentists and Dental Hygienists. J Cancer Educ 2018; 33:901-906. [PMID: 28039675 DOI: 10.1007/s13187-016-1156-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Dental providers, such as dentists and dental hygienists, play an important role in HPV-related oropharyngeal cancer prevention. Dental professional organizations recommend dental providers educate patients about HPV and oral cancers. The objective of this study was to assess HPV knowledge among dental providers. Dentists (n = 36) and dental hygienists (n = 146) attending a professional conference completed a continuing education post-test survey, which included socio-demographics, an HPV knowledge scale, and measure of HPV discussion with patients ("no," "yes," and "yes, but only with some patients"). Chi-square tests, t tests, and ANOVA tests were used for this analysis. Although dental hygienists (35.4%) reported less discussion with patients about HPV than dentists (52.8%), these differences were not significant. The mean knowledge score was 24.7 (SD = 3.8) with no significant differences by profession. Among dentists, knowledge did not significantly differ by discussion category (p = 0.28). In contrast, dental hygienists who did not discuss HPV with patients had significantly lower mean knowledge scores (mean = 23.4) than those who discussed with patients (mean = 26.5, p < 0.01) or discussed only with some patients (mean = 26.0, p = 0.01). Knowledge deficits included outcomes associated with HPV, HPV in men, and curability. Specifically, participants incorrectly answered that HPV can affect a women's ability to get pregnant (81.9%), that one can never get rid of HPV once they have it (69.2%), and that HPV can cause herpes (43.4%). This study identified HPV knowledge deficits among dental providers. Given the recommendation for dental providers to discuss HPV prevention with their patients, additional education and training on this emerging topic may benefit these professionals.
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Affiliation(s)
- Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Coralia Vazquez-Otero
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Alicia L Best
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Nolan S Kline
- Department of Anthropology, Rollins College, 1000 Holt Avenue, Winter Park, FL, 32789, USA
| | - Laura K Merrell
- Department of Health Sciences, James Madison University, 800 S. Main St., Harrisonburg, VA, 22807, USA
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Thompson EL, Vamos CA, Liggett LG, Griner SB, Daley EM. Using a Health Literacy Analytic Framework to Explore Zika Virus and Reproductive Health. Health Lit Res Pract 2018; 2:e78-e87. [PMID: 31294280 PMCID: PMC6607804 DOI: 10.3928/24748307-20180226-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/07/2018] [Indexed: 12/02/2022] Open
Abstract
Background: The emergence of Zika virus as sexually transmissible and associated with birth defects may affect reproductive planning and contraception use for people in Florida. Objective: This exploratory study employed a health literacy analytic framework to explore knowledge, attitudes, beliefs, and behaviors related to reproductive health in the context of Zika among reproductive-age women and men in Florida. Methods: Reproductive-age people in Florida (N = 40) were interviewed between September and December 2016 about their knowledge, attitudes, beliefs, and behaviors regarding Zika and reproductive health. Thematic analysis using a health literacy framework was employed. Key Results: Participants reported they would use reputable online sources to access Zika information. Whereas participants generally understood Zika outcomes, transmission, and symptoms, they reported hearing more prevention messages on mosquito transmission compared to sexual transmission. Overall, participants reported Zika was not concerning given their appraisal of personal circumstances. Participants were confident they could prevent Zika via sexual transmission despite not following the recommended guidelines. Participants discussed how their understanding of Zika changed their behaviors related to mosquito control but not through sexual transmission. Conclusions: This study illustrated a disconnect between reproductive-age people's understanding of Zika-related prevention information and their reproductive decision-making behavior. Strategies to promote appraisal of risk for sexual transmission of Zika, infection, and unintended pregnancy are needed. [HLRP: Health Literacy Research and Practice. 2018;2(2):e78–e87.] Plain Language Summary: Men and women of reproductive age in Florida may be at risk for Zika virus and related negative health outcomes. This study assessed how Florida men and women find, understand, and evaluate Zika-related health information, and how that applies to their prevention behaviors. This study used health literacy as an analytic framework for an emerging health issue.
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Affiliation(s)
- Erika L. Thompson
- Address correspondence to Erika L. Thompson, PhD, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107;
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Abstract
The human papillomavirus (HPV) can cause anogenital cancers and genital warts; however, it can be prevented through the HPV vaccine, which has been available since 2006. While this vaccine is targeted toward 11-to-12-year-olds, 18-to-26-year-old young adult women are eligible for "catch-up" vaccination. Knowledge of HPV may impact HPV vaccine uptake among this population. The purpose of this study was to assess changes in HPV knowledge and HPV vaccine information sources among young adult college women over a 7-year period. Two independent samples (N = 223 for 2008; N = 323 for 2015) completed a 23-item knowledge scale and survey regarding HPV. Adjusted logistic regression models compared the odds of correctly answering each knowledge item between each time period. The study found that HPV knowledge increased significantly over time (p < 0.01). The participants in 2015 were more likely than the 2008 participants to accurately report that a condom can decrease the chance of HPV transmission; there is a vaccine for women that prevents certain types of HPV; HPV can cause genital warts; HPV can be passed to a newborn at birth; and even if you do not see a wart, you can transmit HPV. Recent participants were also more likely to correctly report only women can get HPV as false. While improvements in HPV knowledge were found over time, misperceptions regarding outcomes associated with HPV persist. In order to promote HPV vaccination among this population, health literacy skills, in addition to knowledge, should be improved.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
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Vázquez-Otero C, Vamos CA, Thompson EL, Merrell LK, Griner SB, Kline NS, Catalanotto FA, Giuliano AR, Daley EM. Assessing dentists' human papillomavirus-related health literacy for oropharyngeal cancer prevention. J Am Dent Assoc 2017; 149:9-17. [PMID: 29031503 DOI: 10.1016/j.adaj.2017.08.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/30/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Oropharyngeal cancers related to human papillomavirus (HPV) are on the rise. Dentists may be the next group of providers participating in the prevention of HPV. The aim of this study was to assess dentists' health literacy regarding the connection of HPV and oropharyngeal cancer. METHODS The authors conducted 4 focus groups with dentists (N = 33) during a regional dental conference in 2016. Guided by the health literacy competencies (that is, access, understand, appraise, and apply), the authors used constant comparison methods for data analysis. RESULTS Dentists mentioned a variety of informational sources (for example, dental journals and colleagues). Knowledge about the link between HPV and oropharyngeal cancer varied among participants. Participants appraised multiple patient and practice factors when deciding to have the discussion with patients. Some dentists discussed the HPV and oropharyngeal cancer connection with patients, and most conducted secondary screenings. CONCLUSIONS Findings indicate areas for intervention, including creating awareness of trusted informational sources, as well as increasing HPV knowledge and understanding the multiple patient (for example, age) and practice (for example, open operatories) appraisal factors. Moreover, enhancing the communication skills of dentists with patients is needed to improve HPV-related cancer prevention education. PRACTICAL IMPLICATIONS Addressing dentists' HPV-related health literacy has the potential to improve dentists' HPV-related prevention practices, including expanding patient education about this topic and increasing HPV vaccination knowledge, ultimately contributing to the reduction of oropharyngeal cancers.
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Thompson EL, Daley EM, Vamos CA, Horowitz AM, Catalanotto FA, DeBate RD, Merrell LK, Griner SB, Vazquez-Otero C, Kline NS. Health Literacy Approaches to Improving Communication between Dental Hygienists and Patients for HPV-Related Oral Cancer Prevention. J Dent Hyg 2017; 91:37-45. [PMID: 29118082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/30/2017] [Indexed: 06/07/2023]
Abstract
Purpose: Human Papillomavirus (HPV) has been identified as a causal agent for oropharyngeal cancers, suggesting a new role for dental hygienists in HPV-related cancer prevention strategies. Health literacy assessment is an approach that can be used to understand providers' informational assets and needs for educating and discussing HPV prevention with patients. This study aimed to understand dental hygienists' level of health literacy regarding HPV-related oropharyngeal cancers.Methods: Four focus group sessions with dental hygienists (n=48) were conducted at a national conference. The constant comparison method, with a priori codes for health literacy competencies (i.e., access/understand/appraise/apply), was utilized for this qualitative study.Results: Participants mentioned a variety of modes (e.g., magazines, journals) for accessing HPV-information; however, descriptions of understanding HPV and its relationship to oropharyngeal cancer varied. Participants considered patients' personal characteristics, the dental practice environment, and professional factors to appraise HPV-related information. Additionally, participants self-described themselves as being "prevention specialists." These factors influenced how dental hygienists applied primary and secondary prevention of HPV-related care issues with their patients (e.g., education and oral-cancer screenings).Conclusions: Dental hygienists recognized the importance of HPV and oropharyngeal cancer prevention efforts, including oral-cancer screenings and promotion of the HPV vaccine. The study findings identified opportunities for intervention focusing on primary prevention.
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Griner SB. Colorectal cancer testing. Am Pharm 1993; NS33:6, 8. [PMID: 8213484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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