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Kong WY, Oh NL, Kennedy KL, Carlson RB, Liu A, Ozawa S, Brewer NT, Gilkey MB. Identifying Healthcare Professionals With Lower Human Papillomavirus (HPV) Vaccine Recommendation Quality: A Systematic Review. J Adolesc Health 2024; 74:868-877. [PMID: 38231146 PMCID: PMC11031337 DOI: 10.1016/j.jadohealth.2023.11.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE Strengthening healthcare professionals' (HCPs) communication is an evidence-based approach to increasing human papillomavirus (HPV) vaccine uptake among adolescents. To better target future interventions, we sought to synthesize evidence on HCP subgroups who most need to improve their HPV vaccine recommendation quality. METHODS We searched five databases for quantitative studies published from 2012 to 2022 on HPV vaccine recommendation quality, including recommendation consistency and strength, for United States adolescents. Two coders independently abstracted data from each eligible study, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We summarized variation in recommendation quality by clinical and HCP characteristics. RESULTS The 28 eligible studies indicated that relatively low proportions of HCPs used higher-quality recommendation practices (median: 61% across 30 measures) and that recommendation quality varied across HCP subgroups. The most consistent findings were that more pediatric HCPs used higher-quality recommendations than family medicine HCPs (8 of 11 studies, 2-60 percentage point difference) and that HPV-related knowledge was associated with higher recommendation quality (four of seven studies). Most studies observed no differences in recommendation quality by clinical role (e.g., provider vs. nurse) or HCP demographics (e.g., gender, age, race/ethnicity). DISCUSSION Studies suggest a substantial need to improve HCPs' recommendation quality, with opportunities for targeting future interventions.
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Affiliation(s)
- Wei Yi Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Nul Loren Oh
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn L Kennedy
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rebecca B Carlson
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amy Liu
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Bruel S, Rakotomampionona Z, Gignon M, Agrinier N, Ndiaye NC, Lasset C, Giraudeau B, Michel M, Mueller JE, Gauchet A, Banaszuk AS, Thilly N, Gagneux-Brunon A. The intentions of French health university students to recommend and to receive the HPV vaccine are mainly influenced by vaccine knowledge, confidence in vaccines and personal HPV vaccination. Vaccine 2024; 42:1934-1940. [PMID: 38369391 DOI: 10.1016/j.vaccine.2024.02.033] [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: 10/28/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Despite documented effectiveness in preventing several cancers, genital warts and safety of Human Papillomavirus (HPV) vaccine, immunization coverage among French adolescents remains far from the 80 % target. University health students (HS) in France may promote HPV vaccine through a national service (Service Sanitaire des Etudiants en Santé). We aimed to evaluate intentions to recommend the HPV vaccine to friends and relatives, to receive HPV vaccine, and to identify factors associated with these attitudes. METHODS We conducted a cross-sectional survey in five French Universities from October 2019 to February 2020, using a self-administered online questionnaire. We used bivariable and multivariable logistic regression models to identify determinants of behavior around HPV vaccine: (i) individual intention for vaccination, and (ii) vaccine recommendation to friends and relatives. RESULTS Among the 732 respondents (180 men, 552 women), 305 (41.7%) reported previous HPV vaccination (54.5 % among women), 504 (68.9%) would recommend the HPV vaccine to friends and relatives, 532 (72.7%) respondents would be vaccinated today if it was recommended for them. Intentions to recommend or to receive the HPV vaccine were less frequent in nursing students compared to medical and pharmacy students. After adjustment for demographical factors, HPV vaccine knowledge was associated with intention [aOR 1.30 (95%-confidence interval, 1.15-1.47)] and recommendation [1.26 (1.10-1.45)], respectively. Additionally, adjusting for knowledge about HPV infections, and confidence in vaccines in general was associated with vaccine intention [1.55, (1.30-1.84)] and recommendation [1.52 (1.24-1.86)]. HPV-vaccinated HS were more prone to recommend the HPV vaccine to friends and relatives [10.9 (6.6-17.9)]. CONCLUSION A majority of HS would accept and/or recommend HPV vaccines. HS with greater knowledge about the HPV vaccine were more prone to recommend it. Strengthening knowledge about HPV and its vaccination is probably necessary before their Involvement in a HPV immunization program.
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Affiliation(s)
- Sébastien Bruel
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France; CIC-Inserm, 1408 CHU de Saint-Etienne, France.
| | - Zohasina Rakotomampionona
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France
| | - Maxime Gignon
- Preventions, Risks, Medical Information and Epidemiology Department, CHU Amiens-Picardie, Amiens, France; Sorbonne Paris Nord University, Education and Health Promotion Laboratory, UR3412, Sorbonne Paris Cité, France; CRP-CPO, UR UPJV 7273, Université de Picardie Jules Verne, Amiens, France
| | - Nelly Agrinier
- Université de Lorraine, APEMAC, F-54000, Nancy, France; CHRU-Nancy, Inserm, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000 Nancy, France
| | - Ndeye Coumba Ndiaye
- NGERE (Nutrition-Genetics and Exposure to Environmental Risks), INSERM, University of Lorraine, F-54000 Nancy, France
| | - Christine Lasset
- Département Prévention et Santé Publique, Centre Léon Bérard, Lyon, France
| | - Bruno Giraudeau
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France; INSERM CIC 1415, CHRU de Tours, Tours, France
| | - Morgane Michel
- Université Paris Cité, ECEVE, UMR1123, Inserm, Paris, France; Unité d'épidémiologie clinique, hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Judith E Mueller
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France; Université de Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, F-35000 Rennes, France
| | - Aurélie Gauchet
- Université Savoie Mont Blanc, Univ. Grenoble Alpes, LIP/PC2S, 73000 Chambéry, France
| | - Anne-Sophie Banaszuk
- Centre Régional de Coordination des Dépistages des cancers-Pays de la Loire, 5 Rue des Basses Fouassières, Angers 49000, France
| | - Nathalie Thilly
- Université de Lorraine, APEMAC, F-54000 Nancy, France; Université de Lorraine, CHRU-Nancy, Département Méthodologie, Promotion, Investigation, F-54000 Nancy, France
| | - Amandine Gagneux-Brunon
- CIC-Inserm, 1408 CHU de Saint-Etienne, France; Department of Infectious Diseases, CHU de Saint-Etienne, 42055 Saint-Etienne, France; Centre International de Recherche en Infectiologie, Team GIMAP, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, 42023 Saint-Etienne, France
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Meadows RJ, Gehr AW, Lu Y, Maynard G, Akpan IN, Taskin T, Fulda KG, Patel D, Matches S, Ojha RP, Thompson EL. Effectiveness of provider communication training for increasing human papillomavirus vaccine initiation at a safety-net health system. Prev Med Rep 2024; 39:102660. [PMID: 38426039 PMCID: PMC10901897 DOI: 10.1016/j.pmedr.2024.102660] [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: 10/27/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024] Open
Abstract
Background Strong provider recommendation can increase uptake of human papillomavirus (HPV) vaccination. Therefore, we developed and implemented a provider education intervention on communication strategies for recommending HPV vaccination with clinic-level audit and feedback (HPV: Communicating about HPV to Adults and Teens [HPV CHAT]). We aimed to evaluate the effect of HPV CHAT on HPV vaccine uptake in seven family medicine and pediatric clinics in a large urban health system (USA). Methods We used a quasi-experimental design, where the eligible population included people aged 9-26 years with at least one encounter in June 2020-February 2023 at one of the participating community health clinics. We used interrupted time-series analysis to assess changes in the prevalence of HPV vaccine uptake. We used segmented Poisson regression with a log link function to estimate prevalence ratios (PR) and 95% confidence limits (CL) for level (immediate) and slope (over time) changes with adjustment for seasonality using Fourier transformation. Results Our study population comprised 60,328 observations in which the median age was 17 years (interquartile range: 13-21). A majority (58%) were female and 87% were racial/ethnic minorities. Overall, we observed no sizeable effect of the intervention on HPV vaccination uptake. Nonetheless, heterogeneity was observed by age group with modest increases in individuals aged 9-12 and 13-17 years. Conclusion Our provider feedback intervention had minimal effect on increasing prevalence of HPV vaccination in seven family medicine and pediatric clinics. Novel strategies are needed to address provider barriers related to HPV vaccination.
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Affiliation(s)
- Rachel J. Meadows
- Center for Epidemiology & Healthcare Delivery Research, JPS Health Network, Fort Worth, TX, USA
| | - Aaron W. Gehr
- Center for Epidemiology & Healthcare Delivery Research, JPS Health Network, Fort Worth, TX, USA
| | - Yan Lu
- Center for Epidemiology & Healthcare Delivery Research, JPS Health Network, Fort Worth, TX, USA
| | - Grace Maynard
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Idara N. Akpan
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Tanjila Taskin
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kimberly G. Fulda
- North Texas Primary Care Practice-Based Research Network (NorTex), Department of Family Medicine and Osteopathic Manipulative Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Divya Patel
- Department of Epidemiology, Human Genetics and Environmental Science, UTHealth Houston School of Public Health in Austin, Austin, TX, USA
| | - Sarah Matches
- Department of Pediatrics & Women’s Health, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Rohit P. Ojha
- Center for Epidemiology & Healthcare Delivery Research, JPS Health Network, Fort Worth, TX, USA
| | - Erika L. Thompson
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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Kim J, Choe YJ, Park J, Cho J, Cheong C, Oh JK, Park M, Shim E, Yu SY. Comparative Effects of Bivalent, Quadrivalent, and Nonavalent Human Papillomavirus Vaccines in The Prevention of Genotype-Specific Infection: A Systematic Review and Network Meta-Analysis. Infect Chemother 2024; 56:37-46. [PMID: 38014729 PMCID: PMC10990884 DOI: 10.3947/ic.2023.0064] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/24/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is a major global disease burden and the main cause of cervical cancer. Certain HPV genotypes, with are the most common etiologic pathogens and cause a significant disease burden, are being targeted for vaccine development. However, few studies have focused on the comparative effectiveness of the bivalent HPV (2v-HPV), quadrivalent HPV (4v-HPV), and nonavalent HPV (9v-HPV) vaccines against HPV strain-specific infection. This study investigated the comparative effects of these vaccines against genotype-specific infection. MATERIALS AND METHODS We conducted a pairwise and network meta-analysis of published randomized clinical trials of HPV vaccines according to sex and HPV infection status for nine HPV genotypes (HPV 6/11/16/18/31/33/45/52/58). RESULTS Overall, 10 randomized controlled trials (12 articles) were included in this study. In the network meta-analysis, no statistically significant differences were observed in the prevention of carcinogenic HPV strains (16/18/31/33/45/52/58) between the 2v-HPV and 4v-HPV vaccines in female HPV infection-naïve populations. However, the 9v-HPV vaccine showed a significantly superior effect compared with 2v-HPV and 4v-HPV vaccines in preventing HPV 31/33/45/52/58 infections. Although 2v-HPV and 4v-HPV vaccines provided some cross-protection against HPV 31/33/45/52/58 infections, the effect was significant only on HPV 31 infection. For HPV 16 and 18, neither statistically significant nor small differences were found in the prevention of HPV infection among the 2v-HPV, 4v-HPV, and 9v-HPV vaccines. CONCLUSION Our study complements previous understanding of how the effect of HPV vaccines differs according to the HPV genotype. This is important because HPV genotype prevalence varies among countries. We advocate for continued efforts in vaccinating against HPV, while public health agencies should consider the difference in the vaccine effect and HPV genotype prevalence when implementing HPV vaccination in public vaccination programs.
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Affiliation(s)
- Jimin Kim
- Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jungeun Park
- Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Jahyun Cho
- Graduate School of Public Health, Seoul National University, Seoul, Korea
| | | | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Mihai Park
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Eunha Shim
- Department of Mathematics, Soongsil University, Seoul, Korea
| | - Su-Yeon Yu
- Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
- Department of Medical Information, School of Nursing and Health, Kongju National University, Gongju, Korea.
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Schelbar N, Ward CN, Phillips E, Herr MJ, Acevedo S, Conner H, Greiner A, Corriveau E. Impact of COVID-19 pandemic and vaccine perceptions on HPV vaccine hesitancy. Am J Otolaryngol 2024; 45:104172. [PMID: 38103489 DOI: 10.1016/j.amjoto.2023.104172] [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: 10/04/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE This study evaluated the impact of the COVID-19 pandemic and vaccine perceptions on Human Papillomavirus (HPV) vaccine hesitancy. Secondary endpoints included comparing COVID-19 and HPV vaccination trends regarding time, community of residence, and unmet social needs. METHODS This was a survey-based, cross-sectional study that included 101 participants who were recruited through the Wyandotte County Public Health Department. Participants were eligible for inclusion in this study if they were a parent/guardian of one or more children aged 13 to 17; English- or Spanish-speaking. This study took place in Wyandotte County, Kansas. Descriptive statistics and chi-square analyses were utilized. RESULTS There was no difference in completion of COVID-19 and HPV vaccines (p = 0.0975). Significantly more individuals started and did not finish the HPV vaccine series compared to the COVID-19 vaccine series (p = 0.0004). Most participants indicated their opinion on the HPV vaccine had not changed due to the pandemic (71.3 %). Participants who felt familiar with HPV had higher rates of HPV vaccine completion. While 77 % of participants felt extremely or moderately familiar with HPV, 61.4 % were unaware of its association with oropharyngeal cancer. CONCLUSION There was minimal change in parents' perception of the HPV vaccine due to the COVID-19 pandemic despite decreased rates of vaccination during this time. HPV vaccine series completion was significantly lower than COVID-19 vaccine series completion, highlighting a need to improve HPV vaccine completion counseling. Additionally, patient education should address the knowledge gap discovered regarding the link between HPV infection and oropharyngeal cancer.
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Affiliation(s)
- Natalie Schelbar
- University of Kansas School of Medicine, Kansas City, KS, United States of America.
| | - Christina N Ward
- University of Tennessee Health Science Center, Department of Otolaryngology-Head & Neck Surgery, Memphis, TN, United States of America
| | - Elaine Phillips
- University of Kansas School of Medicine, Kansas City, KS, United States of America
| | - Michael J Herr
- University of Alabama at Birmingham Heersink School of Medicine, Department of Cell, Developmental, and Integrative Biology, United States of America
| | - Sarah Acevedo
- University of Virginia, Department of Medicine, Charlottesville, VA, United States of America
| | - Hannah Conner
- Wyandotte County Unified Government Public Health Department, Kansas City, KS, United States of America
| | - Allen Greiner
- Wyandotte County Unified Government Public Health Department, Kansas City, KS, United States of America; University of Kansas Medical Center Department of Family Medicine & Community Health, Kansas City, KS, United States of America
| | - Erin Corriveau
- Wyandotte County Unified Government Public Health Department, Kansas City, KS, United States of America; University of Kansas Medical Center Department of Family Medicine & Community Health, Kansas City, KS, United States of America
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Zhang Y, Wang Y, Guo S, Cui H. METTL3-mediated HPV vaccine enhances the effect of anti PD-1 immunotherapy to alleviate the development of cutaneous squamous cell carcinoma. An Bras Dermatol 2024; 99:210-222. [PMID: 38030537 PMCID: PMC10943324 DOI: 10.1016/j.abd.2023.05.006] [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: 03/16/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) develops from epithelial keratinocytes by dysregulation of self-renewal and differentiation. Recent studies have found that the size and number of cSCC tumors gradually decrease or even disappear after HPV vaccination. However, the role of the HPV vaccine in the cSCC mechanism is poorly understood. OBJECTIVE The aim of this study is to investigate the effect and mechanism of the HPV vaccine in cSCC. METHODS Immunofluorescence was used to study the immune infiltrating cells in the tumor tissues of patients with cSCC. The effects of the HPV vaccine on cSCC cells and tissues were studied by Cell Culture, Real-time PCR, Western Blot, Cytotoxicity Assay, Enzyme-linked Immunosorbent Assay, m6A Blotting, CCK-8 Assay, m6A Ribonucleic acid Methylation Quantification and tumor transplantation. RESULTS The HPV vaccine enhanced the toxic effect of CD8+T cells on cSCC cells and promoted the secretion of multiple cytokines by CD8+T cells. In addition, HPV vaccines can increase tumor sensitivity to anti-PD-1 therapy by downregulating METTL3 in tumor tissue, with the combination of HPV vaccine and PD-1 monoclonal antibodies producing enhanced immune cell infiltration compared to PD-1 blockade alone. STUDY LIMITATIONS It is important to note the limitations of this study, including the small sample size, the construction of the mouse model, and the choice of HPV vaccine and PD-1 monoclonal antibody, which may limit the generalization of our findings to a wider population. CONCLUSIONS It is hoped that this research will contribute to a deeper understanding of the role of the HPV vaccine in the treatment of cSCC. HPV vaccine is expected to become an important approach to alleviate the development of cSCC.
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Affiliation(s)
- Yingjie Zhang
- Department of Dermatology, First Hospital of Shanxi Medical University, Taiyuan, China; The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Yiru Wang
- Department of Dermatology, Taiyuan Maternity and Child Health Care Hospital, Taiyuan, China
| | - Shuping Guo
- Department of Dermatology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hongzhou Cui
- Department of Dermatology, First Hospital of Shanxi Medical University, Taiyuan, China; The First Clinical Medical College, Shanxi Medical University, Taiyuan, China.
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Zhang F, Ren J, Garon C, Huang Z, Kubale J, Wagner AL. Complex interplay of science reasoning and vaccine hesitancy among parents in Shanghai, China. BMC Public Health 2024; 24:596. [PMID: 38395774 PMCID: PMC10893659 DOI: 10.1186/s12889-024-17990-4] [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: 06/02/2023] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
The psychosocial underpinnings of vaccine hesitancy are complex. Research is needed to pinpoint the exact reasons why people hesitate to vaccinate themselves or their children against vaccine-preventable diseases. One possible reason are concerns that arise from a misunderstanding of vaccine science. We examined the impact of scientific reasoning on vaccine hesitancy and human papillomavirus (HPV) vaccination intent through a cross-sectional study of parents of vaccine-eligible children (N = 399) at immunization clinics in Shanghai, China. We assessed the relationship between science reasoning and both vaccine hesitancy and HPV vaccine acceptance using general additive models. We found a significant association between scientific reasoning and education level, with those with less than a high school education having a significantly lower scientific reasoning that those with a college education (ß = -1.31, p-value = 0.002). However, there was little evidence of a relationship between scientific reasoning and vaccine hesitancy. Scientific reasoning therefore appears not to exert primary influence on the formation of vaccine attitudes among the respondents surveyed. We suggest that research on vaccine hesitancy continues working to identify the styles of reasoning parents engage in when determining whether or not to vaccinate their children. This research could inform the development and implementation of tailored vaccination campaigns.
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Affiliation(s)
- Felicia Zhang
- Department of Epidemiology, University of Michigan, 48109, Ann Arbor, MI, USA
| | - Jia Ren
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, 200336, Shanghai, China
| | - Colin Garon
- Department of Anthropology, University of Michigan, 48109, Ann Arbor, MI, USA
| | - Zhuoying Huang
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, 200336, Shanghai, China
| | - John Kubale
- Institute for Social Research, University of Michigan, 48109, Ann Arbor, MI, USA
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, 48109, Ann Arbor, MI, USA.
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Kong WY, Queen TL, Gottfredson O'Shea N, Heisler-MacKinnon J, Liu A, Ozawa S, Brewer NT, Gilkey MB. Impact of visit characteristics on intention to recommend HPV vaccine: An experiment with US health care professionals. Prev Med 2024; 179:107841. [PMID: 38160884 PMCID: PMC10872220 DOI: 10.1016/j.ypmed.2023.107841] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/23/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Presumptive recommendations that assume parents want to vaccinate can increase human papillomavirus (HPV) vaccine uptake. We sought to examine how visit characteristics affect health care professionals' (HCPs) intention to use this evidence-based recommendation style. METHODS In 2022, we conducted an online experiment with 2527 HCPs who had a role in adolescent vaccination in the United States. Participants read 1 of 8 randomly assigned vignettes about a well-child visit. Using a 2 × 2 × 2 between-subjects factorial design, the vignettes varied the following visit characteristics: patient age (9 vs. 12-year-old), prior parental vaccine refusal (yes vs. no), and time pressure on the HCP (low vs. high). HCPs reported on their intention to use a presumptive HPV vaccine recommendation, as well as on related attitudes, subjective norms, and self-efficacy. Analyses used 3-way analysis of variance and parallel mediation. RESULTS Participants were pediatricians (26%), family/general medicine physicians (22%), advanced practitioners (24%), and nursing staff (28%). Overall, about two-thirds of HCPs (64%) intended to use a presumptive recommendation. Intentions were higher for older children (b = 0.23) and parents without prior vaccine refusal (b = 0.39, both p < 0.001). Time pressure had no main effect or interactions. HCPs' attitudes and self-efficacy partially mediated effects of patient age and prior vaccine refusal (range of b = 0.04-0.28, all p < 0.05). CONCLUSION To better support visits with younger children and parents who have refused vaccines, HCPs may need more training for making presumptive recommendations for HPV vaccine. Reinforcing positive attitudes and self-efficacy can help HCPs adopt this evidence-based recommendation style.
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Affiliation(s)
- Wei Yi Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America.
| | - Tara L Queen
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Nisha Gottfredson O'Shea
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America; RTI International, Research Triangle Park, North Carolina, United States of America
| | - Jennifer Heisler-MacKinnon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Amy Liu
- School of Medicine, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Sachiko Ozawa
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina, United States of America; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, North Carolina, United States of America
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Wahab MT, Tan RKJ, Cook AR, Prem K. Impact of including boys in the national school-based human papillomavirus vaccination programme in Singapore: A modelling-based cost-effectiveness analysis. Vaccine 2023; 41:1934-42. [PMID: 36797100 DOI: 10.1016/j.vaccine.2023.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
Globally, gender-neutral Human Papillomavirus (HPV) vaccination programmes are gaining traction. Although cervical cancer remains the most prevalent, other HPV-related cancers are increasingly recognised as important, especially among men who have sex with men. We assessed if including adolescent boys in Singapore's school-based HPV vaccination programme is cost-effective from the healthcare perspective. We adapted a World Health Organization-supported model, Papillomavirus Rapid Interface for Modelling and Economics, and modelled the cost and quality-adjusted life years (QALY) associated with vaccinating 13-year-olds with the HPV vaccine. Cancer incidence and mortality rates were obtained from local sources and adjusted based on the expected direct and indirect vaccine protection for various population subgroups at an 80 % vaccine coverage. Moving to a gender-neutral vaccination programme with a bivalent or nonavalent vaccine could avert 30 (95 % uncertainty interval [UI]: 20-44) and 34 (95 % UI: 24-49) HPV-related cancers per birth cohort, respectively. At a 3 % discount rate, a gender-neutral vaccination programme is not cost-effective. However, with a 1.5 % discount rate, which puts more value on long-term health gains from vaccination, moving to a gender-neutral vaccination programme with the bivalent vaccine is likely cost-effective, with an incremental cost-effectiveness ratio of SGD$19 007 (95 % UI: 10 164-30 633) per QALY gained. The findings suggest the need to engage experts to examine, in detail, the cost-effectiveness of gender-neutral vaccination programmes in Singapore. Issues of drug licensing, feasibility, gender equity, global vaccine supplies, and the global trend towards disease elimination/eradication should also be considered. This model provides a simplified method for resource-strapped countries to gain a preliminary estimate of the cost-effectiveness of a gender-neutral HPV vaccination programme before investing resources for further research.
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Habermacher C, Lalloué B, Lamouille V, Thilly N, Agrinier N. Family physicians' practices and attitudes towards HPV vaccination since extension of HPV vaccination to males. Infect Dis Now 2023; 53:104669. [PMID: 36736826 DOI: 10.1016/j.idnow.2023.104669] [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: 09/01/2022] [Revised: 01/06/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To describe family physicians' (FP) practices and attitudes towards HPV vaccination guidelines since its extension to males in 2021, and to identify levers to promote HPV vaccination in all adolescents. PATIENTS AND METHODS Cross-sectional study among FPs established in France in 2021. We collected sociodemographic data, practices, opinions, and attitudes towards vaccination, and FPs' demands regarding training and information about HPV. We used logistic regression models to identify the variables associated with HPV vaccination proposal. RESULTS Of 530 FPs included, 469 (88.5%) reported that they systematically proposed HPV vaccines to girls vs 335 (63.2%) to boys. A total of 366 (69.0%) FPs reported an increase in HPV vaccines proposal to all adolescents since the extension of HPV vaccination to males recommended by French guidelines. However, factors associated with HPV vaccination proposal differed by target females and target males. Setting and mode of practice, opinion about the number of recommended vaccines and HPV vaccines, and demands of training on HPV vaccines were associated with HPV vaccination proposal to target females. Whereas academic status, opinion about HPV vaccination guidelines extension to males, using continuing medical education as the main source of information on HPV vaccines, and demands for training on HPV vaccines were associated with HPV vaccination proposal to target males. CONCLUSIONS Extension of HPV vaccination to males in French guidelines might have had a favorable impact on HPV vaccination proposal by FPs to adolescents. However, levers to promote HPV vaccination might differ according to the target population sex.
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Affiliation(s)
- C Habermacher
- Université de Lorraine, Faculté de médecine, F-54000 Nancy, France
| | - B Lalloué
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie clinique, F-54000 Nancy, France
| | - V Lamouille
- Université de Lorraine, Faculté de médecine, F-54000 Nancy, France
| | - N Thilly
- Université de Lorraine, APEMAC, F-54000 Nancy, France; Université de Lorraine, CHRU-Nancy, Département Méthodologie, Promotion, Investigation, F-54000 Nancy, France
| | - N Agrinier
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie clinique, F-54000 Nancy, France; Université de Lorraine, APEMAC, F-54000 Nancy, France.
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11
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Osegueda ER, Chi X, Hall JM, Vadaparampil ST, Christy SM, Staras SAS. County-Level Factors Associated With HPV Vaccine Coverage Among 11-Year-Olds to 12-Year-Olds Living in Florida in 2019. J Adolesc Health 2023; 72:130-137. [PMID: 36244897 DOI: 10.1016/j.jadohealth.2022.09.005] [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: 02/07/2022] [Revised: 07/27/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND In the United States, human papillomavirus (HPV) vaccine initiation and up-to-date (UTD) status are associated with multiple factors at the individual level such as racial/cultural (e.g., race, immigration status), socioeconomic status (e.g., living below poverty level, education), and healthcare access (e.g., insurance status/type). HPV vaccination rates differ dramatically by US geographic areas and within states. To tailor interventions to local areas, it is important to understand county-level characteristics associated with HPV vaccination rates. METHODS Using linear regression, we assessed the association between county-level HPV vaccination initiation and UTD rates for 11-year-olds to 12-year-olds in Florida (collected from the Florida SHOTS immunization registry) and county-level variables. Factors found significant in bivariate analysis and with a variance influence factors <4 were included in multivariable models. RESULTS In 2019, county-level HPV vaccine coverage among Florida 11-year-olds to 12-year-olds ranged from 31% to 92% initiation and 3%-36% UTD. Counties with the lowest HPV vaccine coverage were concentrated in Florida's North-Central and Panhandle regions. In multivariable models, counties with primarily rural populations had lower vaccination initiation and UTD coverage. Above and beyond the association with rurality, UTD coverage was associated with family physicians per 100,000 residents and uninsured or Medicaid-enrolled populations. DISCUSSION While Florida county-level HPV vaccine initiation rates among 11-year-olds to 12-year-olds varied by county in 2019, UTD rates remained universally low despite recommendations. Tailoring interventions toward healthcare access in rural communities may increase HPV vaccine coverage.
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Affiliation(s)
- Eduardo R Osegueda
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida; Health Services Research, Management & Policy, College of Public Health & Health Professions, University of Florida, Gainesville, Florida
| | - Xiaofei Chi
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Jaclyn M Hall
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida; Institute of Child Health Policy, College of Medicine, University of Florida, Gainesville, Florida
| | | | | | - Stephanie A S Staras
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida; Institute of Child Health Policy, College of Medicine, University of Florida, Gainesville, Florida.
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Lee GY, Inthasorn P, Laowahutanont P, Lawpoolsri S, Kamolratanakul S, Lungchukiet P, Oh J, Termrungruanglert W, Taechakraichana N, Pitisuttithum P. Long-term effectiveness of human papillomavirus vaccines among adult women: A real-world scenario. Vaccine 2022; 40:1968-1976. [PMID: 35190207 DOI: 10.1016/j.vaccine.2022.02.042] [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: 06/23/2021] [Revised: 01/26/2022] [Accepted: 02/09/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to determine the real-world effectiveness of bi- or quadrivalent human papillomavirus (HPV) vaccines in Thai adult women ≥5 years post-vaccination in reducing HPV 16/18-associated low-grade squamous intraepithelial lesions or worse (LSIL+), atypical squamous cells of undetermined significance or worse (ASC-US+), and HPV 16/18 positivity. METHODS A retrospective cohort study was conducted among Thai women aged 20-45 years in Bangkok. The vaccinated and unvaccinated groups were matched according to baseline years. HPV/Pap test results were collected from the medical records and/or obtained by cervical sample collection at the study sites. Adjusted hazard ratios were measured using multivariable Cox regression analyses. RESULTS A total of 993 participants (493 vaccinated and 500 unvaccinated) were enrolled from 2018 to 2019. The median ages at baseline of the vaccinated and unvaccinated groups were 33 years (interquartile range [IQR] 27-38) and 34 years (IQR 30-38), respectively. The median follow-up periods were 7.3 years (IQR 6.1-8.6) and 7.2 years (IQR 5.8-8.9) for the vaccinated group and the unvaccinated group, respectively. More women in the vaccinated group were single (29.2% vs. 13.2%, P < 0.001) and university graduates (83.2% vs. 75.4%, P = 0.009). The vaccinated and unvaccinated groups had similar personal monthly incomes (>20,000 THB/month, 63.9% vs. 62.4%, respectively, P = 0.685). There were no cases of HPV 16/18-associated LSIL+ in the vaccinated group, whereas there were four cases in the unvaccinated group. HPV vaccine effectiveness was 88.0% (95% CI 2.0-98.5) in the reduction of HPV 16/18-associated ASC-US+, and 84.6% (95% CI 43.5-95.8) in the reduction of HPV 16/18 positivity. CONCLUSIONS HPV vaccine effectiveness was high in adult women in a real-world scenario in a developing country. Free HPV vaccination in adult women in this age group should be further explored when vaccine supplies are not limited. (HPV: human papillomavirus. LSIL+: low-grade squamous intraepithelial lesion or worse. ASC-US+: atypical squamous cells of undetermined significance or worse).
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Affiliation(s)
- Ga Young Lee
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Perapong Inthasorn
- Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand
| | - Piyawat Laowahutanont
- National Cancer Institute of Thailand, 268/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Supitcha Kamolratanakul
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Palita Lungchukiet
- Bumrungrad International Hospital, 33 Sukhumvit 3, Wattana, Bangkok 10110, Thailand
| | - Juhwan Oh
- Department of Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Wichai Termrungruanglert
- Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama VI Road, Pathumwan, Bangkok 10330, Thailand
| | | | - Punnee Pitisuttithum
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand.
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13
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Huang Z, Ji M, Ren J, Sun X, Boulton ML, Zikmund-Fisher BJ, Wagner AL. Effect of the framing of HPV vaccination on parents' willingness to accept an HPV vaccine. Vaccine 2022; 40:897-903. [PMID: 34996644 PMCID: PMC8816874 DOI: 10.1016/j.vaccine.2021.12.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/29/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022]
Abstract
In China, HPV vaccines are not mandatory and have low uptake. In light of the U.S.'s experience in rolling out the vaccine with an initial focus primarily on HPV as a sexually transmitted infection but transitioning later to cancer messaging, we used a multifactorial experiment to create several different messages about the HPV vaccine across age, communicability, and cancer domains. In this study, we assess the effect of the different messages on willingness to accept an HPV vaccine, and characterize how parental sociodemographics and the age/gender of a child also impact willingness to obtain an HPV vaccine. In total, 1,021 parents of children aged<18 years old in Shanghai, China were randomized to receive a message about cancer (HPV causes cervical cancers vs cancers in general), infectiousness (HPV is sexually transmitted, or is an infectious disease in general, or not mentioned), and recommended age of vaccination (before middle school, before college/work, or not mentioned). Parents were asked if they would vaccinate a hypothetical son or daughter of different ages 6, 12, or 18 years old). In a multivariable logistic regression model adjusting for parental sociodemographic characteristics, parents were more likely to want to vaccinate a daughter vs a son, and an older vs younger child. Messaging had some effect in certain circumstances: parents were more likely to accept a vaccine for a 6-year-old son if given information that it protected against cancers in general. Providing information about a sexually transmitted infection led to higher willingness to vaccinate a son 6 years old and a daughter 6 or 12 years old. This study showed messaging had some limited impact on willingness to vaccinate against HPV, but more research is needed on how to increase uptake of the HPV vaccine when it is not publicly funded.
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Affiliation(s)
- Zhuoying Huang
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, NO. 1380, West Zhongshan Road, 200336, Shanghai, China
| | - Mengdi Ji
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Jia Ren
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, NO. 1380, West Zhongshan Road, 200336, Shanghai, China
| | - Xiaodong Sun
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, NO. 1380, West Zhongshan Road, 200336, Shanghai, China
| | - Matthew L. Boulton
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA,Department of Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Brian J. Zikmund-Fisher
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA,Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Abram L. Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
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Kurani S, MacLaughlin KL, Jacobson RM, St Sauver JL, Jenkins GD, Fan C, Jacobson DJ, Inselman J, Zhu X, Griffin JM, Finney Rutten LJ. Socioeconomic disadvantage and human papillomavirus (HPV) vaccination uptake. Vaccine 2022; 40:471-476. [PMID: 34916103 PMCID: PMC8778948 DOI: 10.1016/j.vaccine.2021.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 06/22/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 01/26/2023]
Abstract
IMPORTANCE Despite availability of safe and effective human papillomavirus (HPV) vaccines, vaccination uptake remains low in the U.S. Research examining the impact of neighborhood socioeconomic status on HPV vaccination may help target interventions. OBJECTIVE To examine the association between area deprivation and HPV vaccine initiation and completion. DESIGN, SETTING, PARTICIPANTS Retrospective cohort study of individuals aged 11-18 years residing in the upper Midwest region. Receipt of HPV vaccination was examined over a three-year follow-up period (01/01/2016-12/31/2018). MAIN OUTCOMES AND MEASURES Outcomes of interest were initiation and completion of HPV vaccination. Demographic data were collected from the Rochester Epidemiology Project (REP). Area-level socioeconomic disadvantage was measured by calculating an Area Deprivation Index (ADI) score for each person, a measure of socioeconomic disadvantage derived from American Community Survey data. Multivariable mixed effect Cox proportional hazards models were used to examine the association of ADI quartiles (Q1-Q4) with HPV vaccine series initiation and completion, given initiation. RESULTS Individuals residing in census block groups with higher deprivation had significantly lower likelihood of HPV vaccine initiation (Q2: HR = 0.91, 0.84-0.99 Q3: HR = 0.83, 0.76-0.90; Q4: HR = 0.84, 0.74-0.96) relative to those in the least-deprived block groups (Q1). Similarly, those living in block groups with higher deprivation had significantly lower likelihood of completion (Q2: HR = 0.91, 0.86-0.97; Q3: HR = 0.87, 0.81-0.94; Q4: HR = 0.82, 0.74-0.92) compared to individuals in the least-deprived block groups (Q1). CONCLUSIONS AND RELEVANCE Lower probability of both HPV vaccine-series initiation and completion were observed in areas with greater deprivation. Our results can inform allocation of resources to increase HPV vaccination rates in our primary care practice and provide an example of leveraging public data to inform similar efforts across diverse health systems.
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Affiliation(s)
- Shaheen Kurani
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Kathy L MacLaughlin
- Department of Family Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA; Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Jennifer L St Sauver
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Gregory D Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Chun Fan
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Debra J Jacobson
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Jonathan Inselman
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Xuan Zhu
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Joan M Griffin
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Lila J Finney Rutten
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
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Medina-Laabes DT, Colón-López V, Rivera-Figueroa V, Vázquez-Otero C, Arroyo-Morales GO, Arce-Cintrón L, Fernández-Rivera P, Vega I, Soto-Abreu R, Díaz-Miranda OL, Rivera Á, Cardona I, Ortiz AP, Capó LR, Hull PC. [Efforts towards the consolidation of public policies for the prevention of HPV-associated cancers in Puerto RicoEsforços realizados em Porto Rico para a consolidação de políticas públicas de prevenção de cânceres associados ao HPV]. Rev Panam Salud Publica 2022; 46:e3. [PMID: 35350461 PMCID: PMC8956971 DOI: 10.26633/rpsp.2022.3] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022] Open
Abstract
The purpose of this special report is to describe chronologically the events that contributed to the development and approval of legislation and subsequent implementation of a school vaccination mandate in order to prevent HPV and HPV-associated cancers in Puerto Rico (PR). Starting in 2010, PR initiated public-policy approvals aimed at improving cancer registries and HPV vaccine coverage through health insurance for adolescents aged 11 to 18 years. In 2014, scientific and community efforts succeeded in documenting the magnitude of morbidity caused by HPV and jointly developing HPV vaccine prevention and promotion strategies. In August 2018, PR became one of the first four territories of the United States of America to implement the HPV vaccine school entry requirement to decrease the incidence of HPV-associated cancers on the island. In 2019, it was enshrined in law that every immunization provider must submit immunization data to the Puerto Rico Immunization Registry. The case of PR demonstrates that public policy-making alongside collaboration between academic, scientific, and community coalitions can achieve population change and measurable outcomes aimed at HPV prevention. Countries with a similar public health problem could adopt efforts similar to those presented herein and align them with the World Health Organization goal of eradicating cervical cancer by 2030.
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Affiliation(s)
- Diana T Medina-Laabes
- División de Ciencias de la Población y Control del Cáncer de Puerto RicoCentro Comprensivo de Cáncer de la Universidad de Puerto RicoSan JuanPuerto RicoDivisión de Ciencias de la Población y Control del Cáncer de Puerto Rico, Centro Comprensivo de Cáncer de la Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Vivian Colón-López
- División de Ciencias de la Población y Control del Cáncer de Puerto RicoCentro Comprensivo de Cáncer de la Universidad de Puerto RicoSan JuanPuerto RicoDivisión de Ciencias de la Población y Control del Cáncer de Puerto Rico, Centro Comprensivo de Cáncer de la Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Vilnery Rivera-Figueroa
- División de Ciencias de la Población y Control del Cáncer de Puerto RicoCentro Comprensivo de Cáncer de la Universidad de Puerto RicoSan JuanPuerto RicoDivisión de Ciencias de la Población y Control del Cáncer de Puerto Rico, Centro Comprensivo de Cáncer de la Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Coralia Vázquez-Otero
- Department of Public Health. College for Health, Community and PolicyUniversity of Texas at San AntonioSan AntonioTexasEstados Unidos de AméricaDepartment of Public Health. College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, Texas, Estados Unidos de América.
| | - Glizette O Arroyo-Morales
- División de Ciencias de la Población y Control del Cáncer de Puerto RicoCentro Comprensivo de Cáncer de la Universidad de Puerto RicoSan JuanPuerto RicoDivisión de Ciencias de la Población y Control del Cáncer de Puerto Rico, Centro Comprensivo de Cáncer de la Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Lara Arce-Cintrón
- Baylor University, Robins College of Arts and SciencesWacoEstados Unidos de AméricaBaylor University, Robins College of Arts and Sciences, Waco, Estados Unidos de América.
| | - Paola Fernández-Rivera
- Facultad de Ciencias Naturales, Recinto de Río PiedrasUniversidad de Puerto RicoSan JuanPuerto RicoFacultad de Ciencias Naturales, Recinto de Río Piedras, Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Idamaris Vega
- Departamento de Bioestadística y Epidemiología, Escuela Graduada de Salud Pública, Recinto de Ciencias Médicas, Universidad de Puerto RicoSan JuanPuerto RicoDepartamento de Bioestadística y Epidemiología, Escuela Graduada de Salud Pública, Recinto de Ciencias Médicas, Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Roxana Soto-Abreu
- División de Ciencias de la Población y Control del Cáncer de Puerto RicoCentro Comprensivo de Cáncer de la Universidad de Puerto RicoSan JuanPuerto RicoDivisión de Ciencias de la Población y Control del Cáncer de Puerto Rico, Centro Comprensivo de Cáncer de la Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Olga L Díaz-Miranda
- División de Ciencias de la Población y Control del Cáncer de Puerto RicoCentro Comprensivo de Cáncer de la Universidad de Puerto RicoSan JuanPuerto RicoDivisión de Ciencias de la Población y Control del Cáncer de Puerto Rico, Centro Comprensivo de Cáncer de la Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Ángel Rivera
- Programa de InmunizaciónDepartamento de Salud de Puerto RicoSan JuanPuerto RicoPrograma de Inmunización, Departamento de Salud de Puerto Rico, San Juan, Puerto Rico.
| | - Iris Cardona
- Programa de InmunizaciónDepartamento de Salud de Puerto RicoSan JuanPuerto RicoPrograma de Inmunización, Departamento de Salud de Puerto Rico, San Juan, Puerto Rico.
| | - Ana P. Ortiz
- División de Ciencias de la Población y Control del Cáncer de Puerto RicoCentro Comprensivo de Cáncer de la Universidad de Puerto RicoSan JuanPuerto RicoDivisión de Ciencias de la Población y Control del Cáncer de Puerto Rico, Centro Comprensivo de Cáncer de la Universidad de Puerto Rico, San Juan, Puerto Rico.
| | - Lilliam Rodríguez Capó
- VOCES PR.org; Coalición de Inmunización y Promoción de la Salud de Puerto RicoGuaynaboPuerto RicoVOCES PR.org; Coalición de Inmunización y Promoción de la Salud de Puerto Rico, Guaynabo, Puerto Rico.
| | - Pamela C. Hull
- Department of Behavioral ScienceUniversity of Kentucky, College of Medicine, Markey Cancer Center, 1100 Veteran Drive, Medical Behavioral Science BuildingLexingtonEstados Unidos de AméricaDepartment of Behavioral Science, University of Kentucky, College of Medicine, Markey Cancer Center, 1100 Veteran Drive, Medical Behavioral Science Building, Lexington, Estados Unidos de América.
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Wheldon CW, Garg A, Galvin AM, Moore JD, Thompson EL. Decision support needs for shared clinical decision-making regarding HPV vaccination among adults 27-45 years of age. Patient Educ Couns 2021; 104:3079-3085. [PMID: 33980398 DOI: 10.1016/j.pec.2021.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/27/2020] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Identify HPV information needs and shared clinical decision-making preferences among adults 27-45 and describe differences in needs and preferences among underserved and vulnerable populations. METHODS Participants 27-45 years old with no history of HPV vaccination completed a cross-sectional web-based survey between April-May 2020 (N = 702). Preferred role in shared clinical decision making was described across demographic groups and sociodemographic correlates of HPV vaccine information needs. RESULTS Most (77.6%) reported a preference to make a medical decision on their own or after consulting with a healthcare provider, while the remaining respondents preferred to make a joint decision (17.0%) or for their doctor to make the decision (5.4%). Over 80% needed more information about safety, effectiveness, personal benefit, provider recommendation, side effects, and risks. Education was the strongest demographic factors associated with higher information needs (p<0.05). CONCLUSION The majority of individuals across demographic groups were individually focused with regard to their healthcare decisions and wanted more information about HPV vaccine safety, side effects, and risks, in addition to personalized information about benefits from HPV vaccination. PRACTICAL IMPLICATIONS Patient-centered interventions are needed to engage adults in shared decision-making regarding HPV vaccination.
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Affiliation(s)
- Christopher W Wheldon
- Department of Social and Behavioral Sciences, Temple University, 1301 Cecil B. Moore Ave. Ritter Hall Annex 9th Floor, Room 955, Philadelphia, PA 19122 USA.
| | - Ashvita Garg
- Department of Biostatistics and Epidemiology, 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, 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 76107 USA.
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Blvd Fort Worth, TX 76107 USA.
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Bruel S, Dutzer D, Pierre M, Botelho-Nevers E, Pozzetto B, Gagneux-Brunon A, Chauvin F, Frappé P. Vaccination for Human Papillomavirus: an historic and bibliometric study. Hum Vaccin Immunother 2021; 17:934-942. [PMID: 32955407 DOI: 10.1080/21645515.2020.1805991] [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] [Indexed: 12/09/2022] Open
Abstract
A systematic literature review was conducted to describe in a historical perspective the evolution of studies concerning HPV vaccination. The search identified 794 articles of which 568 were included. The first article was published in 2001, and the maximum annual number of publications was reached in 2014. The average number of authors per paper was 8.8. Papers originated from 49 different countries, with the USA accounted for the maximum number of publications (n = 217). Efficacy (46.5%) and safety (31.0%) were the most prevalent objectives. Clinical trials constituted the largest group of methods (37.9%). Chronological trends did not reveal any lasting curve-crossings, indicating that the priority topics have remained the same. The geographical origin of these studies raises questions about the transposability of the results to populations where HPV vaccination has been studied only a little. This study could help guide future research to less-studied research objectives, particularly for vaccines.
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Affiliation(s)
- Sébastien Bruel
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France.,HESPER EA7425, Saint-Etienne-Lyon University, Saint-Etienne, France.,PRESAGE Academic Institute, Saint-Etienne-Lyon University, Saint-Etienne, France.,CIC-INSERM 1408, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Dominique Dutzer
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France
| | - Marion Pierre
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- PRESAGE Academic Institute, Saint-Etienne-Lyon University, Saint-Etienne, France.,CIC-INSERM 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,EA 3064 Groupe Immunité Des Muqueuses Et Agents Pathogènes, Saint-Etienne-Lyon University, Saint-Etienne, France
| | - Bruno Pozzetto
- Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- PRESAGE Academic Institute, Saint-Etienne-Lyon University, Saint-Etienne, France.,CIC-INSERM 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,EA 3064 Groupe Immunité Des Muqueuses Et Agents Pathogènes, Saint-Etienne-Lyon University, Saint-Etienne, France
| | - Franck Chauvin
- HESPER EA7425, Saint-Etienne-Lyon University, Saint-Etienne, France.,PRESAGE Academic Institute, Saint-Etienne-Lyon University, Saint-Etienne, France
| | - Paul Frappé
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France.,PRESAGE Academic Institute, Saint-Etienne-Lyon University, Saint-Etienne, France.,CIC-INSERM 1408, University Hospital of Saint-Etienne, Saint-Etienne, France
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18
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Brandt HM, Vanderpool RC, Pilar M, Zubizarreta M, Stradtman LR. A narrative review of HPV vaccination interventions in rural U.S. communities. Prev Med 2021; 145:106407. [PMID: 33388323 PMCID: PMC10064483 DOI: 10.1016/j.ypmed.2020.106407] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 06/17/2020] [Revised: 10/20/2020] [Accepted: 12/28/2020] [Indexed: 11/25/2022]
Abstract
Uptake of human papillomavirus (HPV) vaccine in the United States (U.S.) is far below the Healthy People 2020 goal of 80% coverage among adolescents. In rural communities, HPV vaccination coverage is low, yet incidence and mortality rates of HPV-associated cancer are high. Much of the research focused on HPV vaccination in rural U.S. communities has involved qualitative investigations, observations, survey research, and secondary data analysis with limited implementation of interventional study designs. The purpose of this narrative review was to examine intervention studies to increase HPV vaccination in rural settings and to summarize study characteristics and associated outcomes. PubMed, PsycINFO, CINAHL, and Web of Science were searched utilizing systematic narrative review methodology for studies describing implementation of HPV vaccination interventions in rural U.S. settings from January 2006-December 2019. Using specific search criteria, 991 studies were identified. After abstract review, 30 full-text articles were assessed for eligibility, and 15 met the inclusion criteria. The 15 articles - published from 2011 to 2019 - described HPV vaccination interventions in rural settings of six states, including communities, health clinics, and schools. A range of primary and secondary outcomes were reported, including HPV vaccine receipt (series initiation, continuation, and/or completion); HPV vaccine knowledge; and/or cervical cancer knowledge. Across the studies, there was an absence of the description of rural context. As compared to the broader HPV vaccination intervention literature, interventions in rural settings were limited. More interventional research is needed in rural communities given the elevated rates of HPV-related cancer and low rates of HPV vaccine uptake.
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Affiliation(s)
- Heather M Brandt
- University of South Carolina Arnold School of Public Health, Department of Health Promotion, Education, Behavior, Rural and Minority Health Research Center, 915 Greene Street, Columbia, SC 29208, United States.
| | - Robin C Vanderpool
- National Cancer Institute, Division of Cancer Control and Population Sciences, Health Communication and Informatics Research Branch, 9609 Medical Center Drive, 3E610, Rockville, MD 20850, United States.
| | - Meagan Pilar
- Washington University in St. Louis, Brown School of Social Work, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, United States.
| | - Maria Zubizarreta
- University of South Carolina Arnold School of Public Health, Core for Applied Research and Evaluation, 915 Greene Street, Columbia, SC 29208, United States.
| | - Lindsay R Stradtman
- University of Kentucky College of Public Health, Department of Health, Behavior & Society, 113 Washington Avenue, Lexington, KY 40506, United States
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19
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Rosen BL, Gorbach P, Ding L, Covert C, Ermel AC, Chandler E, Malagón T, Kahn JA. Sexual Network Patterns and Their Association With Genital and Anal Human Papillomavirus Infection in Adolescent and Young Men. J Adolesc Health 2021; 68:696-704. [PMID: 32873501 DOI: 10.1016/j.jadohealth.2020.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine individual- and partner-level factors associated with human papillomavirus (HPV) infection in vaccinated and unvaccinated men. METHODS A total of 747 men, aged 13-26 years, completed a survey of sexual behaviors and were tested for genital and perianal/anal HPV (36 types). Sexual network variables included recent and lifetime concurrency (being in more than one sexual relationship at the same time) and recent sex partner discordance (by race, ethnicity, age, and number of sexual partners). We determined individual-level and sexual network variables associated with ≥1 HPV type and HPV16/18, stratified by vaccination status, using separate multivariable logistic regression models. RESULTS Participants' mean age was 21.2 years; 64% were positive for ≥1 HPV type and 21% for HPV16/18. Factors associated with ≥1 HPV type in unvaccinated men included recruitment site and lifetime concurrency. Factors associated with ≥1 HPV type among vaccinated men included recruitment site, Chlamydia history, main male partner, number of lifetime female partners, and no condom use with female partner. Factors associated with HPV16/18 in unvaccinated men included race and partner concurrency. Factors associated with HPV16/18 in vaccinated men included ethnicity, main male partner, and recent concurrency. CONCLUSIONS Sexual network variables associated with HPV infection were different based on vaccination status and HPV type, suggesting risk factors for HPV infection may change as the proportion of vaccinated men increases. In addition, participant report of concurrency and not knowing whether one had practiced concurrency were consistent risk factors; clinicians should consider including concurrency in the sexual history to determine the risk of HPV.
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20
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Jhon M, Kim JW, Kang HJ, Kim SY, Lee JY, Kim SW, Shin IS, Kim JM. Delayed Onset of Manic Symptoms in a Patient with Influenza A (H1N1) after administration of Oseltamivir (Tamiflu): A Case Report. Clin Psychopharmacol Neurosci 2021; 19:166-169. [PMID: 33508801 PMCID: PMC7851458 DOI: 10.9758/cpn.2021.19.1.166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/30/2019] [Accepted: 11/04/2019] [Indexed: 11/18/2022]
Abstract
Psychiatric side effects of oseltamivir can result in accident-proneness and suicide. Reportedly, such adverse psychiatric events are more common in children than in adults, but other risk factors are not known. We present a 13-year-old girl with influenza infection who developed manic symptoms after taking oseltamivir and receiving the human papillomavirus vaccination. While other research has found that psychiatric side effects associated with oseltamivir generally occur within 48 hours after beginning administration, in this case the manic symptoms developed on the fourth day after cessation of 5-day course of oseltamivir administration. Based on our review of this case, we recommend that clinicians should carry out vigilant monitoring of each patient’s mental state when the patient is young, has a family history of psychiatric disorder, has drug sensitivity and has received medical treatments such as vaccination before or after taking oseltamivir. In addition, as side effects of oseltamivir may occur more than 48 hours after administration, it will be necessary to observe patients for several days after the prescription of oseltamivir.
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Affiliation(s)
- Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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21
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Gerend MA, Stephens YP, Kazmer MM, Slate EH, Reyes E. Acculturation and Health Beliefs: Interactions Between Host and Heritage Culture Underlie Latina/o Caregivers' Beliefs About HPV Vaccination. J Immigr Minor Health 2021; 23:113-120. [PMID: 32410014 PMCID: PMC7665994 DOI: 10.1007/s10903-020-01020-7] [Citation(s) in RCA: 3] [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: 10/24/2022]
Abstract
This study examined the interactive effects of acculturation (host culture acquisition) and enculturation (heritage culture retention) on Latina/o caregivers' beliefs about their child completing the human papillomavirus vaccine series. Participants were 161 caregiver-child dyads from Florida. Using multiple regression, caregiver knowledge and health beliefs (perceived threat, benefits, barriers, subjective norms, and self-efficacy) about series completion were predicted from caregivers' scores on acculturation, enculturation, and their interaction, controlling for sociodemographics. Acculturation and enculturation interacted to predict knowledge, benefits, barriers, and self-efficacy. Caregivers with high acculturation scores generally supported series completion, regardless of their enculturation score. However, when acculturation was low, caregivers who retained more (vs. less) of their heritage culture were more knowledgeable and held more favorable beliefs about series completion. Findings highlight the importance of independently assessing acculturation and enculturation in Latina/o immigrant populations. Overlooking enculturation may lead to incomplete conclusions about acculturation and health.
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Affiliation(s)
- Mary A Gerend
- Northwestern University, Chicago, IL, USA.
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University (FSU), 1115 West Call Street, Tallahassee, FL, 32306-4300, USA.
| | | | - Michelle M Kazmer
- School of Information, College of Communication and Information, FSU, Tallahassee, FL, USA
| | - Elizabeth H Slate
- Department of Statistics, College of Arts & Sciences, FSU, Tallahassee, FL, USA
| | - Elena Reyes
- Department of Behavioral Sciences and Social Medicine, College of Medicine, FSU, Tallahassee, FL, USA
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22
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McClung N, Burnett J, Wejnert C, Markowitz LE, Meites E. Human papillomavirus vaccination coverage among men who have sex with men-National HIV Behavioral Surveillance, United States, 2017. Vaccine 2020; 38:7417-7421. [PMID: 33046266 DOI: 10.1016/j.vaccine.2020.08.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 03/11/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 12/28/2022]
Abstract
Men who have sex with men (MSM) are at high risk for infections and diseases caused by human papillomavirus (HPV), many of which are vaccine-preventable. In the United States, routine HPV vaccination has been recommended for adolescent males since 2011. This analysis evaluated self-reported receipt of ≥ 1 HPV vaccine dose by age group and HIV status among adult MSM using 2017 data from National HIV Behavioral Surveillance (NHBS) and compared the proportion vaccinated to prior years. Among 10,381 MSM aged ≥ 18 years, 17.9% of MSM overall and 28.4% of MSM living with HIV reported any HPV vaccination. Among 2,482 MSM aged 18-26 years, 32.8% overall and 51.3% living with HIV reported HPV vaccination. Since 2011, the proportion of MSM aged 18-26 years reporting HPV vaccination has increased over six-fold. As vaccinated adolescents age into young adults, coverage will continue to increase overall, including among MSM.
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Affiliation(s)
- Nancy McClung
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Janet Burnett
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cyprian Wejnert
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lauri E Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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23
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Chen J, Tao R, Guo Q. Analysis of the interactive meaning of journalistic images of the human papillomavirus vaccine and the perceptions of female undergraduate students. Int J Nurs Sci 2020; 7:S61-S66. [PMID: 32995381 PMCID: PMC7501498 DOI: 10.1016/j.ijnss.2020.07.004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 07/06/2020] [Indexed: 11/25/2022] Open
Abstract
Objectives This paper focuses on the underlying mechanisms of women’s perceptions of persuasive visual health information. Methods In the image viewing process, a separation between the image producer and the image viewer occurs, and the connection between the two is fractured. This mixed method research included modal discourse analysis (coding based on visual grammar theory), an eye tracking experiment, a questionnaire survey, and in-depth semi-structured interviews. The interactive meanings of journalistic images related to the human papillomavirus (HPV) vaccine were identified through four sets of codes. In addition, the perceptions of female viewers were analyzed. Results In the first set of stimuli, i.e., the infographic, the female participants focused most of their attention on information about the nine-valent HPV vaccine. An analysis of the interactive meaning of two sets of journalistic pictures, i.e., fictional pictures and nonfictional pictures, indicated that the image producers did not implement useful viewer involvement strategies to persuade viewers. Furthermore, female viewers focused their attention on the “similar other” during the viewing process, gazing at the patient the longest as the primary area of interest (AOI). Conclusions The study indicates that the current persuasive visual information about the HPV vaccine needs further improvement due to the high demand for information about HPV from the Chinese female audience.
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Affiliation(s)
- Jingxi Chen
- School of Languages and Communication studies, Beijing Jiaotong University, Beijing, China
| | - Ran Tao
- School of Journalism and Communication, Peking University, Beijing, China
| | - Qiaomin Guo
- School of New Media, Peking University, Beijing, China
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24
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MacLaughlin KL, Jacobson RM, Sauver JLS, Jacobson DJ, Fan C, Wi CI, Finney Rutten LJ. An innovative housing-related measure for individual socioeconomic status and human papillomavirus vaccination coverage: A population-based cross-sectional study. Vaccine 2020; 38:6112-6119. [PMID: 32713679 DOI: 10.1016/j.vaccine.2020.07.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 03/25/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is a known cause of anogenital (eg, cervical) and oropharyngeal cancers. Despite availability of effective HPV vaccines, US vaccination-completion rates remain low. Evidence is conflicting regarding the association of socioeconomic status (SES) and HPV vaccination rates. We assessed the association between SES, defined by an individual validated Housing-based Index of Socioeconomic Status (HOUSES), and HPV vaccination status. METHODS We conducted a cross-sectional study of children/adolescents 9-17 years as of December 31, 2016, living in southeastern Minnesota by using a health-record linkage system to identify study-eligible children/adolescents, vaccination dates, and home addresses matched to HOUSES data. We analyzed the relationship between HPV vaccination status and HOUSES using multivariable Poisson regression models stratifying by age, sex, race, ethnicity, and county. RESULTS Of 20,087 study-eligible children/adolescents, 19,363 (96.4%) were geocoded and HOUSES measures determined. In this cohort, 57.9% did not receive HPV vaccination, 15.8% initiated (only), and 26.3% completed the series. HPV vaccination-initiation and completion rates increased over higher SES HOUSES quartiles (P < .001). Rates of HPV vaccination initiation versus unvaccinated increased across HOUSES quartiles in multivariable analysis adjusted for age, sex, race, ethnicity, and county (1st quartile, referent; 2nd quartile, 0.97 [0.87-1.09]; 3rd quartile, 1.05 [0.94-1.17]; 4th quartile, 1.15 [1.03-1.28]; test for trend, P = .002). HOUSES was a stronger predictor of HPV vaccination completion versus unvaccinated (1st quartile referent; 2nd quartile, 1.06 [0.96-1.16]; 3rd quartile, 1.12 [1.03-1.23]; 4th quartile, 1.32 [1.21-1.44]; test for trend, P < .001). Significant interactions were shown for HPV vaccination initiation by HOUSES for sex (P = .009) and age (P = .006). CONCLUSION The study showed disparities in HPV vaccination by SES, with the highest HOUSES quartiles associated with increased rates of initiating and even greater likelihood of completing the series. HOUSES data may be used to target and tailor HPV vaccination interventions to undervaccinated populations.
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Affiliation(s)
- Kathy L MacLaughlin
- Department of Family Medicine, Mayo Clinic, Rochester, MN, United States; The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States; The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | - Jennifer L St Sauver
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States; The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | - Debra J Jacobson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Chun Fan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Chung-Il Wi
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Lila J Finney Rutten
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States; The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
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25
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Karapetiantz P, Audeh B, Lillo-Le Louët A, Bousquet C. Discrepancy Between Personal Experience and Negative Opinion with Human Papillomavirus Vaccine in Web Forums. Stud Health Technol Inform 2020; 272:417-420. [PMID: 32604691 DOI: 10.3233/shti200584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While vaccines are intended to protect people from infectious diseases, public confidence in vaccination has evolved as patients have reservation about vaccination, with a major concern about its safety. Social media may help regulatory authorities to better understand opposition to vaccination and make informed decisions for better promotion of vaccines' benefits towards the public. Our objective was to explore French web forums for potential pharmacovigilance signals associated with human papillomavirus infections (HPV) vaccines. Among 138 posts associated with a signal randomly chosen for manual review, 29% were actually adverse drug reactions to the vaccine described in clinical studies, and only 2 were personal experiences. Only 14% of the reviewed posts described positive opinion about the vaccine whereas 46% were neutral and 40% were negative. While few personal experiences of adverse reactions were actually reported by users, our case study showed a large proportion of negative opinions.
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Affiliation(s)
- Pierre Karapetiantz
- Inserm, Sorbonne Université, université Paris 13, Laboratoire d'informatique médicale et d'ingénierie des connaissances en e-santé, LIMICS, F-75006 Paris, France
| | - Bissan Audeh
- Inserm, Sorbonne Université, université Paris 13, Laboratoire d'informatique médicale et d'ingénierie des connaissances en e-santé, LIMICS, F-75006 Paris, France
| | | | - Cédric Bousquet
- Inserm, Sorbonne Université, université Paris 13, Laboratoire d'informatique médicale et d'ingénierie des connaissances en e-santé, LIMICS, F-75006 Paris, France.,Unit of Public Health and Medical Informatics, University of Saint Etienne, France
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26
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Kussaibi H, Al Dossary R, Ahmed A, Muammar A, Aljohani R. Correlation of High-Risk HPV Genotypes with Pap Test Findings: A Retrospective Study in Eastern Province, Saudi Arabia. Acta Cytol 2020; 65:48-55. [PMID: 32784299 DOI: 10.1159/000509669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/09/2020] [Accepted: 06/24/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION High-risk human papillomavirus (HR HPV) is found to be responsible for 4.5% of cancer in general, primarily cervical cancer. We aim here to highlight the prevalence and genotypes of HR HPV and correlate its association with Pap tests' results, which are still not well known in the Eastern Province of Saudi Arabia. METHODS Over 7 years (2013-2019), the results of 164 Saudi women coinvestigated for HR HPV along with Pap tests were collected from the archive of King Fahd University Hospital. Only women who had atypical squamous cells of undetermined significance (ASCUS) on the Pap test and those at elevated risk of infection were cotested for HR HPV; otherwise, the Pap test was the only screening modality for cervical cancer. Data were organized and statistically analyzed using IBM SPSS v26. RESULTS Out of 164 Saudi women, 14.5% (n = 24/164) showed positive results for HR HPV (8 patients had HPV16 and 2 had both HPV16 and HPV18/45, while the remaining 14 had other HR HPV); among them, 41.5% (n = 10/24) had an abnormal Pap test (5 ASCUS and 5 LSIL), while 58.5% (n = 14/24) had a negative Pap test. On the other hand, 21% (n = 35/164) of patients, in the study, had an abnormal Pap test (24 ASCUS, 8 low-grade squamous intraepithelial lesion [LSIL], and 3 atypical glandular cell [AGC]). In 80% (n = 19/24) of ASCUS cases, HR HPV was not detected; however, 20% (n = 5/24) were positive for other HR HPV. Concerning LSIL cases, 62.5% (n = 5/8) were positive for HR HPV (1 case showed HPV16 and HPV18/45, 2 cases showed HPV16, and 2 cases showed other HR HPV), while in the remaining 37.5% (n = 3/8) LSIL cases, HR HPV was negative; similarly, all AGC cases were negative for HR HPV. Statistical analysis showed a significant correlation between HPV status and Pap test findings (p value <0.001). DISCUSSION/CONCLUSION HR HPV frequency and genotype distribution, in this study, might reflect a different regional infection pattern. The high association of HR HPV with negative cytology emphasizes the need to add the HR HPV test to screening modalities of cervix cancer.
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Affiliation(s)
- Haitham Kussaibi
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia,
| | - Reem Al Dossary
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Ayesha Ahmed
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Aroub Muammar
- College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Raghad Aljohani
- College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia
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27
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Askelson NM, Ryan G, Seegmiller L, Pieper F, Kintigh B, Callaghan D. Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State. J Community Health 2020; 44:790-795. [PMID: 31102115 DOI: 10.1007/s10900-019-00676-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 11/28/2022]
Abstract
Efforts to understand low human papillomavirus vaccine coverage led us to explore quality improvement (QI) decision-making programs and processes to increase vaccine uptake. These QI programs often include interventions recommended by the AFIX (Assessment Feedback Incentives eXchange) Program that supports Vaccines for Children (VFC) clinics. However, little is known about decision-making around intervention selection or extent of implementation. In collaboration with the state public health department in the rural Midwestern, investigators developed a survey to explore vaccine-related QI in VFC clinics. The survey was distributed via email to all VFC clinics (n = 605); results presented are from the primary care clinics (n = 115). Respondents (VFC liaisons) reported decisions about vaccine QI were made by multiple actors within their own clinics (45.1%), by a clinic manager in charge of multiple clinics (33.0%) and/or at a centralized administrative office (35.2%). Additionally, the majority of respondents considered external actors, like insurance companies (52.7%) or Medicaid/Medicare (50.5%), important to the decision-making process. Most commonly implemented interventions focused on provider knowledge and patient education. Least commonly implemented interventions required systematic changes, such as reminder/recall and follow-up after missed appointments. This preliminary research indicates there are multiple points of decision-making within clinics and health care systems, and therefore change agents at all points need to be involved. The most commonly implemented interventions focus on providers and patients, with an emphasis on education. Interventions requiring system-level changes and use of electronic health records are less common and more attention should be directed towards such interventions.
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Affiliation(s)
- Natoshia M Askelson
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA, 52242, USA
- Public Policy Center, University of Iowa, 310 S Grand Ave, Iowa City, Iowa, USA
| | - Grace Ryan
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA, 52242, USA.
- Public Policy Center, University of Iowa, 310 S Grand Ave, Iowa City, Iowa, USA.
| | - Laura Seegmiller
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA, 52242, USA
| | - Felicia Pieper
- Public Policy Center, University of Iowa, 310 S Grand Ave, Iowa City, Iowa, USA
| | - Bethany Kintigh
- Bureau of Immunization and Tuberculosis, Iowa Department of Public Health, Des Moines, Iowa, USA
| | - Donald Callaghan
- Bureau of Immunization and Tuberculosis, Iowa Department of Public Health, Des Moines, Iowa, USA
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Meites E, Markowitz LE, Kempe A, O'Leary ST, Crane LA, Hurley LP, Brtnikova M, Beaty BL, Stokley S, Lindley MC. Primary care physician support for harmonizing HPV vaccination recommendations across genders - United States, 2018. Vaccine 2020; 38:3699-701. [PMID: 32276802 DOI: 10.1016/j.vaccine.2020.03.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 11/24/2022]
Abstract
In the United States, human papillomavirus (HPV) catch-up vaccination has been nationally recommended for women and men of different ages. We surveyed national networks of primary care physicians specializing in family medicine, pediatrics, and internal medicine to assess attitudes about HPV vaccination. Of 785 physicians, 730 (93.0%), were in favor of a change to harmonize the recommended catch-up vaccination age across genders; the most commonly cited reason was to simplify the immunization schedule (97.9%). After considering these and other data, the Advisory Committee on Immunization Practices updated national policy to recommend catch-up vaccination for all persons through age 26 years.
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Gerend MA, Murdock C, Grove K. An intervention for increasing HPV vaccination on a university campus. Vaccine 2019; 38:725-729. [PMID: 31767468 DOI: 10.1016/j.vaccine.2019.11.028] [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] [Received: 10/07/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the effects of a human papillomavirus (HPV) vaccination intervention implemented on a large university campus in the United States. METHODS The intervention consisted of student-directed campaign materials promoting HPV vaccination (e.g., posters, yard signs, social media posts) and provider recommendation for HPV vaccine to students attending university health services (UHS) from January through March of 2019. RESULTS We observed a 75% increase in HPV vaccine doses administered at UHS in the spring semester of 2019 vs. 2018. In both semesters a higher percentage of doses was given to females than males. Further, the increase from 2018 to 2019 was larger for females than males. Age at vaccine receipt did not differ by year. CONCLUSIONS Partnering with college and university health centers to implement HPV vaccine interventions could be a promising strategy for increasing HPV vaccination coverage among young adult college students across the country.
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Affiliation(s)
- Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University (FSU), Tallahassee, FL, USA.
| | | | - Kelly Grove
- University Health Services (UHS), Center for Health Advocacy and Wellness, FSU, Tallahassee, FL, USA.
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30
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Harris KL, Tay D, Kaiser D, Praag A, Rutkoski H, Dixon BL, Pinzon LM, Winkler JR, Kepka D. The perspectives, barriers, and willingness of Utah dentists to engage in human papillomavirus (HPV) vaccine practices. Hum Vaccin Immunother 2019; 16:436-444. [PMID: 31361179 DOI: 10.1080/21645515.2019.1649550] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/19/2022] Open
Abstract
Including dental health providers in human papillomavirus (HPV) vaccination could reduce rising rates in HPV-associated oropharyngeal cancer (HPV-OPC). This study assessed Utah dentists' perspectives on providing HPV vaccination education and services in the dental setting. A cross-sectional, 70-item self-administered survey was conducted among a convenience sample of N = 203 practicing Utah dentists. Statistical analyses included Chi Square tests of independence, scaled scores and Cronbach's alpha coefficients. Majority of Utah dentists surveyed perceived that discussing the link between HPV and OPC and recommending the HPV vaccine is within their scope of practice, but not administration of the HPV vaccine. Dentists with >10 minutes of patient education per week were less likely to be concerned about the cultural, social norms or religious ideology of discussing HPV with their patients (p = .024). Rural dentists were more concerned about the safety and liability of the HPV vaccine (p = .011). Good internal consistency was observed survey items regarding barriers and willing to engage in HPV vaccination practices. Dental providers were interested in HPV training and patient education brochures as strategies, but less interested in administering the HPV vaccine. Dental associations support dentists' engagement in HPV education and HPV-OPC prevention. This is the first study in Utah to examine dentists' perspectives on HPV vaccination. Findings have implications for program planning, intervention development, and future research.
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Affiliation(s)
- Katherine L Harris
- Gyneocologic Oncology, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - D Tay
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - D Kaiser
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - A Praag
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - H Rutkoski
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - B L Dixon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - L M Pinzon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - J R Winkler
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - D Kepka
- College of Nursing, University of Utah, Salt Lake City, UT, USA.,Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
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Kepka D, Rutkoski H, Pappas L, Tay DL, Winkler JR, Dixon B, Velazquez A, Pinzon LM. US oral health students' willingness to train and administer the HPV vaccine in dental practices. Prev Med Rep 2019. [PMID: 31372330 DOI: 10.1016/j.pmedr.2019.100957)] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
HPV oropharyngeal cancers have now surpassed cervical cancer rates in the US. Dental providers' engagement in HPV education and vaccination efforts may help reduce the burden of HPV oropharyngeal cancers. We examined factors associated with oral health students' willingness to train and administer the human papillomavirus (HPV) vaccine in dental settings. US students in 15 oral health programs participated in an online survey in 2016. Unadjusted and adjusted multivariable logistic regression were conducted and odds ratios (OR) and 95% confidence intervals (CI) were reported. Analyses were conducted in SAS Version 9.4. Data from a total of N = 306 students were analyzed to examine sociodemographic, educational, practice, and attitudinal factors associated with willingness to train and administer the HPV vaccine. Majority of the participants were female (70.3%), non-Hispanic/Latino (90.8%), and White (62.1%). Perceiving that HPV vaccination recommendation (OR = 1.95, 95% CI = 1.14-3.35) and administration (OR = 3.79, 95% CI = 1.63-8.81) was in the dental professional's scope was positively associated with outcome measures when other factors were held constant. Students with greater patient contact time (OR = 4.47, 95% CI = 1.14-17.58) and lower role conflict (agreed that HPV vaccine administration was in the dental professional's scope) had higher odds of willingness to administer the HPV vaccine when other factors were held constant (OR = 5.9, 95% CI = 2.27-15.3). The major barrier to engaging oral health students in HPV vaccination efforts was role conflict. Professional organizations and oral health programs should strongly support the role of oral health professionals in HPV oropharyngeal prevention.
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Affiliation(s)
- Deanna Kepka
- Huntsman Cancer Institute, USA
- College of Nursing, University of Utah, USA
| | | | | | - Djin L Tay
- Huntsman Cancer Institute, USA
- College of Nursing, University of Utah, USA
| | | | | | - Alan Velazquez
- Facultad de Odontología, Universidad Autónoma de Baja , Baja California, Mexico
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Solazzo AL, Tabaac AR, Agénor M, Austin SB, Charlton BM. Sexual orientation inequalities during provider-patient interactions in provider encouragement of sexual and reproductive health care. Prev Med 2019; 126:105787. [PMID: 31374238 PMCID: PMC7008518 DOI: 10.1016/j.ypmed.2019.105787] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/03/2019] [Accepted: 07/26/2019] [Indexed: 11/22/2022]
Abstract
The human papillomavirus (HPV) vaccination, sexually transmitted infection (STI) tests, and Papanicolaou (Pap) testing rates vary by sexual orientation, which may be due in part to healthcare providers (HCP) recommending this care unevenly. Data (N = 17,675) came from the Growing Up Today Study (GUTS) (N = 8039) and Nurses' Health Study 3 (NHS3) (N = 9636). Among participants who met clinical guidelines to receive the care in question, we estimated the probability of an HCP encouraging participants to have the HPV vaccination, STI tests, or Pap test. Regardless of sexual orientation, participants whose HCP knew their sexual orientation were more likely to have been encouraged to get care compared to those whose HCP did not know the participant's sexual orientation. Sexual minority men and women were more likely to be encouraged to obtain HPV vaccination, STI tests, and Pap test than same-gender, completely heterosexuals with no same-sex partners, with some variation by gender and the care in question. Lesbian women were the sole sexual orientation subgroup that was less likely to be encouraged to receive care (HPV vaccination and Pap test) than their same gender, completely heterosexual counterparts with no same-sex partners (odds ratio [95% confidence interval]: 0.90 [0.80-1.00] and 0.94 [0.91-0.98], respectively). The differences across sexual orientation in HCPs' encouragement of care indicate a possible explanation for differences in utilization across sexual orientation. Across the US, HCPs under-encourage HPV vaccination, STI tests, and Pap test for all sexual orientation groups. Lesbian patients appear to be at high risk of under-encouragement for the Pap test.
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Affiliation(s)
- Alexa L Solazzo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States of America; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave, Boston, MA 02115, United States of America.
| | - Ari R Tabaac
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave, Boston, MA 02115, United States of America; Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States of America.
| | - Madina Agénor
- Department of Community Health, Tufts University, 574 Boston Ave, Medford, MA 02155, United States of America; Tufts Clinical and Translational Science Institute, Tufts Medical Center, 35 Kneeland St, Boston, MA 02111, United States of America; The Fenway Institute, Fenway Health, Boston, MA, 1340 Boylston St, 02215, United States of America.
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave, Boston, MA 02115, United States of America; Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States of America; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States of America; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Ave, Boston, MA 02115, United States of America.
| | - Brittany M Charlton
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States of America; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave, Boston, MA 02115, United States of America; Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States of America; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Ave, Boston, MA 02115, United States of America.
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Cordoba-Sanchez V, Tovar-Aguirre OL, Franco S, Arias Ortiz NE, Louie K, Sanchez GI, Garces-Palacio IC. Perception about barriers and facilitators of the school-based HPV vaccine program of Manizales, Colombia: A qualitative study in school-enrolled girls and their parents. Prev Med Rep 2019; 16:100977. [PMID: 31508297 PMCID: PMC6722392 DOI: 10.1016/j.pmedr.2019.100977] [Citation(s) in RCA: 10] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 08/13/2019] [Accepted: 08/16/2019] [Indexed: 11/24/2022] Open
Abstract
In 2012, Colombia implemented a school-based HPV vaccination program of a 3-dose series for nine year old girls. Following a mass psychogenic response after vaccination in a Colombian town, vaccination rates dropped from 80% in 2012-2013 to 5% in 2016. The study aimed to identify barriers and facilitators of HPV vaccine uptake among girls eligible for vaccination in the initial years of vaccine implementation from 2012 to 2014, and their parents. We conducted 19 individual qualitative interviews and 18 focus groups with an average of 5 girls, in Manizales, Colombia between 2016 and 2017. In total, 49 girls from six schools and 58 of their parents participated in the study. Participants had some degree of awareness about cervical cancer, especially among those of middle and upper socioeconomic level. However, the vaccine was known as a prevention measure only after pap-smears and condoms. The main facilitator for vaccine uptake for parents was the desire to prevent diseases in general and for girls, it was facilitated by receiving positive information about the vaccine. The main barriers for vaccine uptake or for three doses completion were the event in Carmen de Bolivar, fear of adverse effects and fear of needles. Girls and parents stated that they received little or no information from schools or health care services about the HPV vaccine prior to vaccination. Our results suggest that improving HPV vaccination rates in Colombia will require a comprehensive education program including mass media information about HPV vaccine.
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Affiliation(s)
- Verónica Cordoba-Sanchez
- Grupo Infección y Cáncer, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Olga Lucía Tovar-Aguirre
- Grupo GINEI, Programa de Bacteriología, Universidad Católica de Manizales UCM, Carrera 23 No. 60-63, Manizales, Colombia
| | - Sandra Franco
- Grupo Promoción de la salud y Prevención de la Enfermedad, Facultad de Ciencias para la Salud, Universidad de Caldas, Calle 65 No. 26-10, Manizales, Colombia
| | - Nelson Enrique Arias Ortiz
- Grupo Promoción de la salud y Prevención de la Enfermedad, Facultad de Ciencias para la Salud, Universidad de Caldas, Calle 65 No. 26-10, Manizales, Colombia
| | - Karly Louie
- School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, London SE1 9RT, UK
| | - Gloria Ines Sanchez
- Grupo Infección y Cáncer, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Isabel C Garces-Palacio
- Grupo de Epidemiologia, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
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34
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Kepka D, Rutkoski H, Pappas L, Tay DL, Winkler JR, Dixon B, Velazquez A, Pinzon LM. US oral health students' willingness to train and administer the HPV vaccine in dental practices. Prev Med Rep 2019; 15:100957. [PMID: 31372330 PMCID: PMC6661379 DOI: 10.1016/j.pmedr.2019.100957] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 06/14/2019] [Accepted: 07/16/2019] [Indexed: 12/25/2022] Open
Abstract
HPV oropharyngeal cancers have now surpassed cervical cancer rates in the US. Dental providers' engagement in HPV education and vaccination efforts may help reduce the burden of HPV oropharyngeal cancers. We examined factors associated with oral health students' willingness to train and administer the human papillomavirus (HPV) vaccine in dental settings. US students in 15 oral health programs participated in an online survey in 2016. Unadjusted and adjusted multivariable logistic regression were conducted and odds ratios (OR) and 95% confidence intervals (CI) were reported. Analyses were conducted in SAS Version 9.4. Data from a total of N = 306 students were analyzed to examine sociodemographic, educational, practice, and attitudinal factors associated with willingness to train and administer the HPV vaccine. Majority of the participants were female (70.3%), non-Hispanic/Latino (90.8%), and White (62.1%). Perceiving that HPV vaccination recommendation (OR = 1.95, 95% CI = 1.14-3.35) and administration (OR = 3.79, 95% CI = 1.63-8.81) was in the dental professional's scope was positively associated with outcome measures when other factors were held constant. Students with greater patient contact time (OR = 4.47, 95% CI = 1.14-17.58) and lower role conflict (agreed that HPV vaccine administration was in the dental professional's scope) had higher odds of willingness to administer the HPV vaccine when other factors were held constant (OR = 5.9, 95% CI = 2.27-15.3). The major barrier to engaging oral health students in HPV vaccination efforts was role conflict. Professional organizations and oral health programs should strongly support the role of oral health professionals in HPV oropharyngeal prevention.
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Affiliation(s)
- Deanna Kepka
- Huntsman Cancer Institute, USA.,College of Nursing, University of Utah, USA
| | | | | | - Djin L Tay
- Huntsman Cancer Institute, USA.,College of Nursing, University of Utah, USA
| | | | | | - Alan Velazquez
- Facultad de Odontología, Universidad Autónoma de Baja , Baja California, Mexico
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35
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Gerend MA, Stephens YP, Kazmer MM, Slate EH, Reyes E. Predictors of Human Papillomavirus Vaccine Completion Among Low-Income Latina/o Adolescents. J Adolesc Health 2019; 64:753-762. [PMID: 30777636 PMCID: PMC6534422 DOI: 10.1016/j.jadohealth.2018.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/11/2018] [Accepted: 12/04/2018] [Indexed: 01/26/2023]
Abstract
PURPOSE The purpose of this longitudinal study was to identify individual and interpersonal factors associated with human papillomavirus (HPV) vaccine series completion in a sample of low-income Latina/o adolescent girls and boys. METHODS Caregiver-adolescent dyads (N = 161) were recruited from a rural Federally Qualified Health Center in southwest Florida when the adolescent (aged 11-17 years) received the first dose of HPV vaccine. Dyads completed a baseline assessment that measured demographic and cultural characteristics, past medical history, provider-patient communication, HPV knowledge, health beliefs about completing the series, and the adolescent's experience receiving the first dose. Using multivariable logistic regression, we identified caregiver- and adolescent-related factors associated with series completion (receipt of three doses of HPV vaccine within 1 year of initiation) as indicated in the adolescent's medical record and state immunization registry. RESULTS Within 1 year of initiation, 57% (n = 92) completed the three-dose series. Missed opportunities for completion were observed for 20% of the sample who returned to the clinic. Caregiver-related predictors of completion included education, self-efficacy to complete the series, and knowledge of the required number of doses. Adolescent-related predictors included age, influenza vaccination within the past 2 years, having a chronic medical condition, reason for the baseline visit, and receipt of written information about HPV vaccination from a health care provider. CONCLUSIONS Findings highlight important opportunities for improving completion of the HPV vaccine series among Latina/o adolescents. Intervention efforts should involve health care providers and parent-adolescent dyads and prioritize evidence-based strategies for reducing missed opportunities for series completion.
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Affiliation(s)
- Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University (FSU), Tallahassee, Florida.
| | | | - Michelle M Kazmer
- School of Information, College of Communication and Information, Florida State University, Tallahassee, Florida
| | - Elizabeth H Slate
- Department of Statistics, College of Arts & Sciences, Florida State University, Tallahassee, Florida
| | - Elena Reyes
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University (FSU), Tallahassee, Florida
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Rosen BL, Bishop JM, Anderson R, Real FJ, Klein MD, Kreps GL. A content analysis of HPV vaccine online continuing medical education purpose statements and learning objectives. Hum Vaccin Immunother 2019; 15:1508-1518. [PMID: 30932718 DOI: 10.1080/21645515.2019.1587273] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Numerous online HPV vaccine education interventions for clinicians have been created to improve HPV vaccinations rates. The aims for this study were to (1) assess the content of the purpose statements and learning objectives of online HPV vaccine continuing medical education (CME) activities developed for clinicians and (2) identify themes and gaps in the purpose statements and learning objectives. A content analysis was conducted of the purpose statements and learning objectives for each HPV vaccine online CME activity. Open coding identified the following purpose statements topics: 1) delivering recommendations, 2) HPV epidemiology, 3) HPV vaccine, 4) guidelines, and 5) medical news. The following topics for learning objectives were identified: 1) delivering recommendations, 2) strategies, 3) HPV epidemiology, 4) HPV vaccine, 5) guidelines, 6) prevention services, 7) HPV vaccination advocacy, and 8) disparities. Phrases about guidelines for vaccine administration and vaccine recommendation guidelines were the most common for purpose statements and learning objectives, respectively. One learning objective focused on behavior/skill change, which is concerning considering clinicians do not feel well prepared to provide strong vaccine recommendations. Clear and intentional purpose statements and learning objectives must be used to guide the development of effective CME activities.
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Affiliation(s)
| | | | - Ryan Anderson
- b Public Health Student College of Medicine, University of Cincinnati
| | - Francis J Real
- c Pediatrics Cincinnati Children's Hospital Medical Center, University of Cincinnati
| | - Melissa D Klein
- c Pediatrics Cincinnati Children's Hospital Medical Center, University of Cincinnati.,d Department of Communication, Center for Health and Risk Communication, George Mason University
| | - Gary L Kreps
- e Department of Communication, Center for Health and Risk Communication,George Mason University , Fairfax , Virginia
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Forster AS, Gilson R. Challenges to optimising uptake and delivery of a HPV vaccination programme for men who have sex with men. Hum Vaccin Immunother 2019; 15:1541-1543. [PMID: 30570380 PMCID: PMC6746470 DOI: 10.1080/21645515.2018.1560783] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/13/2018] [Indexed: 11/05/2022] Open
Abstract
Human papillomavirus (HPV) vaccine programmes targeted at men who have sex with men (MSM) may reduce HPV-related disease burden among this at-risk group in countries where uptake of the vaccine among adolescent girls is sub-optimal and where adolescent boys are not routinely vaccinated. There are challenges to optimising the impact of a MSM programme: ensuring good uptake, understanding the effectiveness of the vaccine in this population and considering the longevity of the programme. Furthermore, monitoring of uptake and ensuring that delivery of the programme does not deprive other aspects of sexual health service resources may present challenges to programme evaluation and delivery. We draw on experience from the UK HPV vaccination programme for MSM, delivered in sexual health and HIV clinics, to better understand these challenges with the aim of supporting the implementation of similar programmes elsewhere in the world.
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Affiliation(s)
- Alice S. Forster
- Research Department of Behavioural Science and Health, UCL, London, UK
| | - Richard Gilson
- UCL Centre for Clinical Research in Infection and Sexual Health, The Mortimer Market Centre, UCL, London, UK
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Rutkoski H, Fowler B, Mooney R, Pappas L, Dixon BL, Pinzon LM, Winkler J, Kepka D. Pilot Test of Survey to Assess Dental and Dental Hygiene Student Human Papillomavirus-Related Oropharyngeal Cancer Knowledge, Perceptions, and Clinical Practices. J Cancer Educ 2018; 33:907-914. [PMID: 28091963 DOI: 10.1007/s13187-017-1165-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This was the first study to develop and pilot test an assessment tool for the examination of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) knowledge, perceptions, and clinical practices of oral health students. An interdisciplinary team developed the tool using surveys that examined this topic in other populations. The tool was then pilot tested at two different dental programs. Results from the pilot informed revisions to the final version of the tool. Of the 46 student participants, 18 were first-year dental hygiene and 28 were first-year dental students. The majority of participants were female (N = 29, 63%) and ages 18 to 29 years old (N = 41, 89%). Four scales used in the questionnaire were analyzed for reliability. Of these, the HPV and HPV-OPC knowledge and the HPV vaccination knowledge scales had Cronbach alphas of 0.71 and 0.79, respectively. Questions assessing HPV and the role of dental professionals had a correlation coefficient of 0.71. Questions assessing willingness to administer vaccines in the dental office had a correlation coefficient of 0.85. Assessing oral health students' HPV-OPC knowledge, perceptions, and clinical practices are important for future assessment of possible HPV-OPC cases. Dental professionals may be optimally positioned to provide HPV patient education. The tool developed and pilot tested in this study can help schools assess their students' knowledge and guide their dental curriculum to address deficiencies. Since this topic has not been effectively examined with dental health students, the results could help improve dental education and dental care.
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Affiliation(s)
- Holdunn Rutkoski
- School of Dental Medicine, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Brynn Fowler
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Ryan Mooney
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Lisa Pappas
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Barbara L Dixon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Lilliam M Pinzon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - James Winkler
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
- College of Nursing, Cancer Control and Population Science, University of Utah, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4144, Salt Lake City, UT, 84112, USA.
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Rockliffe L, Chorley AJ, McBride E, Waller J, Forster AS. Assessing the acceptability of incentivising HPV vaccination consent form return as a means of increasing uptake. BMC Public Health 2018; 18:382. [PMID: 29558923 PMCID: PMC5859432 DOI: 10.1186/s12889-018-5278-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 03/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Uptake of human papillomavirus (HPV) vaccination is high overall but there are disparities in uptake, particularly by ethnicity. Incentivising vaccination consent form return is a promising approach to increase vaccination uptake. As part of a randomised feasibility trial we qualitatively assessed the acceptability of increasing uptake of HPV vaccination by incentivising consent form return. METHODS In the context of a two-arm, cluster randomised feasibility trial, qualitative free-text questionnaire responses were collected from adolescent girls (n = 181) and their parents (n = 61), assessing the acceptability of an incentive intervention to increase HPV vaccination consent form return. In the incentive intervention arm, girls who returned a signed consent form (regardless of whether consent was given or refused), had a 1-in-10 chance of winning a £50 shopping voucher. Telephone interviews were also conducted with members of staff from participating schools (n = 6), assessing the acceptability of the incentive. Data were analysed thematically. RESULTS Girls and parents provided a mix of positive, negative and ambivalent responses about the use of the incentive to encourage HPV vaccination consent form return. Both girls and parents held misconceptions about the nature of the incentive, wrongly believing that the incentive was dependent on vaccination receipt rather than consent form return. School staff members also expressed a mix of opinions on the acceptability of the incentive, including perceptions of effectiveness and ethics. CONCLUSIONS The use of an incentive intervention to encourage the return of HPV vaccination consent forms was found to be moderately acceptable to those receiving and delivering the intervention, although a number of changes are required to improve this. In particular, improving communication about the nature of the incentive to reduce misconceptions is vital. These findings suggest that incentivising consent form return may be an acceptable means of improving HPV vaccination rates, should improvements be made. TRIAL REGISTRATION ISRCTN Registry; ISRCTN72136061 , 26 September 2016, retrospectively registered.
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Affiliation(s)
- Lauren Rockliffe
- Research Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT UK
| | - Amanda J. Chorley
- Research Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT UK
| | - Emily McBride
- Research Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT UK
| | - Jo Waller
- Research Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT UK
| | - Alice S. Forster
- Research Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT UK
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He ZH, Kou ZQ, Xu AQ. [Human papillomavirus infection and vaccination]. Zhonghua Yu Fang Yi Xue Za Zhi 2018; 52:106-112. [PMID: 29334719 DOI: 10.3760/cma.j.issn.0253-9624.2018.01.021] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Human papillomavirus (HPV) is an infection that can be sexually transmitted and result in health consequences. Persistent high-risk HPV infection can lead to various cancers and is the essential cause of cervical cancer. HPV vaccine can prevent the HPV infection and thus the incidence of cervical cancer. In this review we introduced the prevalence of HPV infection and vaccination, and the prevention and early detection of cervical cancer. We also introduced the present knowledge and awareness of HPV infection and HPV vaccine in Chinese. Propaganda all over China should be performed on HPV vaccination to improve the vaccination rate, thus preventing the incidence of cervical cancer.
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Affiliation(s)
- Z H He
- Department of Obstetrics & Gynaecology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
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41
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Han YF, Zhuang YN, Li Y, Fang Y. [Analysis of mothers' acceptance of HPV vaccination of adolescent girls in Xiamen]. Zhonghua Yu Fang Yi Xue Za Zhi 2018; 52:38-42. [PMID: 29334706 DOI: 10.3760/cma.j.issn.0253-9624.2018.01.008] [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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To survey the mothers' acceptance of the HPV vaccination for their adolescent girls in Xiamen and to explore the influencing factors. Methods: Mothers of adolescent girls were selected by multistage cluster random sampling. Data of demography of the mothers and girls, the knowledge and attitude of cervical cancer and HPV vaccine of the mothers were collected. The influencing factors of mothers' attitudes were analyzed with univariate and multivariate logistic regression. Results: A total of 2 307 mothers were selected. The average age of mothers was (38.0±4.7) years. 13.1% (300) of the mothers had a family history of malignant tumor. The mothers' acceptance for vaccinating girls was 61.9% (1 428). The awareness rates of HPV and HPV vaccine were 42.5% (980) and 21.4% (493), respectively. Mothers who had family history of cancer (OR=1.36, 95%CI:1.02-1.82) showed a greater willingness to vaccinate their girls than the mothers who had not. Mothers who had knowledge of HPV (OR=1.32, 95%CI:1.08-1.62) and HPV (OR=2.03, 95%CI:1.56-2.66) vaccines showed a greater willingness to vaccinate their girls than the mothers who had not. Conclusion: The mothers' acceptance to vaccinate adolescent girls against cervical cancer needs to be raised, especially for the mothers who had not family history of cancer, no-knowledge of HPV and HPV vaccines.
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Affiliation(s)
- Y F Han
- School of Public Health, Xiamen University, Xiamen 361102, China
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42
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Lai D, Bodson J, Davis FA, Lee D, Tavake-Pasi F, Napia E, Villalta J, Mukundente V, Mooney R, Coulter H, Stark LA, Sanchez-Birkhead AC, Kepka D. Diverse Families' Experiences with HPV Vaccine Information Sources: A Community-Based Participatory Approach. J Community Health 2018; 42:400-412. [PMID: 27734247 DOI: 10.1007/s10900-016-0269-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 02/05/2023]
Abstract
Current sources of publicly available human papillomavirus (HPV) information may not adequately meet the needs of diverse families. This study sought to describe associations between sociodemographic and acculturation factors, and sources of HPV information among diverse parents and caregivers. Community organizations purposively recruited participants from African American, African refugee, Hispanic/Latino, American Indian, and Native Hawaiian and Pacific Islander communities for a 21-item survey (N = 228). Ninenty-three of these participants also participated in ten focus groups conducted in three languages. Descriptive statistics and Fishers' Exact Test for Count Data were produced and triangulated with focus group data to provide additional context. Overall, HPV vaccine awareness and knowledge in the five communities was low. This study found that a greater proportion of lower-acculturated participants had heard of HPV through personal networks (foreign-born = 50 % vs US-born = 30 %, p < 0.05; medium acculturation = 60 % vs high acculturation = 26 %, p = 0.01), while greater proportions of US-born participants reported media sources (49 % vs foreign-born = 29 %, p < 0.05). Across communities, healthcare system sources were described as important and preferred sources of HPV information. Hearing about the HPV vaccine from healthcare settings was significantly associated with increased accuracy in HPV vaccine knowledge (p < 0.05). Communities described a need for more in-depth information about the HPV vaccine, and culturally and linguistically appropriate educational materials. Culturally-competent delivery of HPV information through the healthcare system sources may be important in improving knowledge and acceptability of the HPV vaccine among diverse families.
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Affiliation(s)
- Djin Lai
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, UT, 84112, USA. .,College of Nursing, University of Utah, Salt Lake City, UT, USA.
| | - Julia Bodson
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, UT, 84112, USA
| | - France A Davis
- Community Faces of Utah, Salt Lake City, UT, USA.,Calvary Baptist Church, Salt Lake City, UT, USA
| | - Doriena Lee
- Community Faces of Utah, Salt Lake City, UT, USA.,Calvary Baptist Church, Salt Lake City, UT, USA
| | - Fahina Tavake-Pasi
- Community Faces of Utah, Salt Lake City, UT, USA.,National Tongan American Society, Salt Lake City, UT, USA
| | - Edwin Napia
- Community Faces of Utah, Salt Lake City, UT, USA.,Urban Indian Center, Salt Lake City, UT, USA
| | - Jeannette Villalta
- Community Faces of Utah, Salt Lake City, UT, USA.,Hispanic Healthcare Task Force, Salt Lake City, UT, USA
| | - Valentine Mukundente
- Community Faces of Utah, Salt Lake City, UT, USA.,Best of Africa, West Valley, UT, USA
| | - Ryan Mooney
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, UT, 84112, USA
| | - Heather Coulter
- Community Outreach and Collaboration Core, Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Louisa A Stark
- Community Outreach and Collaboration Core, Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Department of Human Genetics, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Ana C Sanchez-Birkhead
- College of Nursing, University of Utah, Salt Lake City, UT, USA.,Community Faces of Utah, Salt Lake City, UT, USA.,Hispanic Healthcare Task Force, Salt Lake City, UT, USA
| | - Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, UT, 84112, USA.,College of Nursing, University of Utah, Salt Lake City, UT, USA
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la Hoz Restrepo FD, Guzman NA, la Hoz Gomez AD, Ruiz C. Policies and processes for human papillomavirus vaccination in Latin America and the Caribbean. Rev Panam Salud Publica 2017; 41:e124. [PMID: 31391830 PMCID: PMC6660837 DOI: 10.26633/rpsp.2017.124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/10/2017] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Three highly effective vaccines are available to prevent human papillomavirus (HPV) infection, and they have been introduced in many countries around the world. This article describes advances and challenges in introducing HPV vaccines in the Expanded Program of Immunization (EPI) of countries in Latin America and the Caribbean (LAC). METHODS We reviewed national and regional sources of information to identify LAC countries with and without universal HPV vaccination, along with the year of introduction, type of HPV vaccine, vaccination scheme, age groups targeted, and coverage level reached. Incidence rates of cervical cancer were compared across countries with and without an HPV vaccination program, in order to identify inequities in access to HPV vaccines. RESULTS So far, 10 LAC countries have supplied data on their vaccination policies and vaccination coverage rates to the Pan America Health Organization. The majority of those 10 started their vaccination programs using quadrivalent vaccine. Only Chile, Ecuador, and Mexico started their programs using a two-dose scheme. However, by the end of 2016, most of the other countries had switched from a three-dose to a two-dose scheme. Different age groups are targeted in the various programs. Some countries vaccinate one-year birth cohorts, while others vaccinate multiple-year birth cohorts. By the end of 2014, coverage with at least two doses ranged from a low of 2% to a high of 86%. With the exception of Venezuela, the LAC countries with the largest populations introduced universal HPV vaccination between 2010 and 2014. Despite the progress that has occurred in some LAC countries, there are still 10 LAC nations with cervical cancer rates above the LAC average (21.2 cases per 100 000) that have not introduced an HPV vaccine in their EPI. CONCLUSIONS With several key adjustments, HPV vaccination programs across Latin America and the Caribbean could be substantially strengthened. Ongoing monitoring of HPV infection outcomes is needed in order to assess the impact of different vaccination policies.
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Affiliation(s)
- Fernando De la Hoz Restrepo
- Universidad Nacional de ColombiaFacultad de MedicinaBogotáColombiaUniversidad Nacional de Colombia, Facultad de Medicina, Bogotá, Colombia.
| | - Nelson Alvis Guzman
- Universidad de CartagenaFacultad de EconomíaBolívarColombiaUniversidad de Cartagena, Facultad de Economía, Bolívar, Colombia.
| | - Alejandro De la Hoz Gomez
- Pontificia Universidad JaverianaFacultad de MedicinaBogotáColombiaPontificia Universidad Javeriana, Facultad de Medicina, Bogotá, Colombia.
| | - Cuauhtémoc Ruiz
- Organización Panamericana de la SaludUnidad de Inmunización Integral de la FamiliaWashington, D.C.United States of AmericaOrganización Panamericana de la Salud, Unidad de Inmunización Integral de la Familia, Washington, D.C., United States of America.
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VanWormer JJ, Bendixsen CG, Vickers ER, Stokley S, McNeil MM, Gee J, Belongia EA, McLean HQ. Association between parent attitudes and receipt of human papillomavirus vaccine in adolescents. BMC Public Health 2017; 17:766. [PMID: 28969653 PMCID: PMC5625818 DOI: 10.1186/s12889-017-4787-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 09/21/2017] [Indexed: 11/16/2022] Open
Abstract
Background Human papillomavirus (HPV) vaccine coverage rates remain low. This is believed to reflect parental hesitancy, but few studies have examined how changes in parents’ attitudes impact HPV vaccine uptake. This study examined the association between changes in parents’ vaccine attitudes and HPV vaccine receipt in their adolescent children. Methods A baseline and 1-year follow-up survey of HPV vaccine attitudes was administered to parents of 11–17 year olds who had not completed the HPV vaccine series. Changes in attitudinal scores (barriers, harms, ineffectiveness, and uncertainties) from the Carolina HPV Immunization Attitudes and Beliefs Scale were assessed. Two outcomes were measured (in parents’ adolescent children) over an 18-month period and analyzed using multivariable regression; receipt of next scheduled HPV vaccine dose and 3-dose series completion. Results There were 221 parents who completed the baseline survey (11% response rate) and 164 with available follow-up data; 60% of their adolescent children received a next HPV vaccine dose and 38% completed the vaccine series at follow-up. Decrease in parents’ uncertainties was a significant predictor of vaccine receipt, with each 1-point reduction in uncertainties score associated with 4.9 higher odds of receipt of the next vaccine dose. Higher baseline harms score was the only significant predictor of lower series completion. Conclusions Reductions in parents’ uncertainties appeared to result in greater likelihood of their children receiving the HPV vaccine. Only baseline concerns about vaccine harms were associated with lower series completion rate. Education for parents should emphasize the HPV vaccine’s safety profile.
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Affiliation(s)
- Jeffrey J VanWormer
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI, 54449, USA.
| | - Casper G Bendixsen
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI, 54449, USA
| | - Elizabeth R Vickers
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI, 54449, USA
| | | | | | - Julianne Gee
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Edward A Belongia
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI, 54449, USA
| | - Huong Q McLean
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI, 54449, USA
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Serrano B, Brotons M, Bosch FX, Bruni L. Epidemiology and burden of HPV-related disease. Best Pract Res Clin Obstet Gynaecol 2017; 47:14-26. [PMID: 29037457 DOI: 10.1016/j.bpobgyn.2017.08.006] [Citation(s) in RCA: 255] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 08/24/2017] [Accepted: 08/24/2017] [Indexed: 12/29/2022]
Abstract
Human papillomavirus (HPV) infection is recognized as one of the major causes of infection-related cancer in both men and women. High-risk HPV types are not only responsible for virtually all cervical cancer cases but also for a fraction of cancers of the vulva, vagina, penis, anus, and head and neck cancers. Furthermore, HPV is also the cause of anogenital warts and recurrent respiratory papillomatosis. Despite the availability of multiple preventative strategies, HPV-related cancer remains a leading cause of morbi-mortality in many parts of the world, particularly in less developed countries. Thus, in this review, we summarize the latest estimates of the global burden of HPV-related diseases, trends, the attributable fraction by HPV types, and the potential preventative fraction.
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Affiliation(s)
- Beatriz Serrano
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme (CERP), Institut Català d'Oncologia (ICO) - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.
| | - María Brotons
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme (CERP), Institut Català d'Oncologia (ICO) - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.
| | - Francesc Xavier Bosch
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme (CERP), Institut Català d'Oncologia (ICO) - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.
| | - Laia Bruni
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme (CERP), Institut Català d'Oncologia (ICO) - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.
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Fernández-Feito A, Antón-Fernández R, Paz-Zulueta M. [Sexual risk behaviours and PAP testing in university women vaccinated against human papillomavirus]. Aten Primaria 2017; 50:291-298. [PMID: 28867156 PMCID: PMC6836978 DOI: 10.1016/j.aprim.2017.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 02/16/2017] [Revised: 05/05/2017] [Accepted: 05/14/2017] [Indexed: 11/24/2022] Open
Abstract
Objetivo Estimar la asociación entre la vacunación frente al virus papiloma humano (VPH) y las conductas sexuales de riesgo, así como la participación en el Programa de Detección Precoz de Cáncer de Cuello Uterino (PDPCCU). Diseño Estudio descriptivo transversal. Emplazamiento Facultad de Medicina y Ciencias de la Salud, Facultad de Derecho y Facultad de Economía y Empresa (Universidad de Oviedo). Participantes Estudiantes universitarias. Mediciones principales Se recogió información sobre métodos anticonceptivos, conducta sexual, conocimientos sobre VPH y participación en el PDPCCU. Se estimaron proporciones y odds ratio (OR) con sus correspondientes intervalos de confianza al 95% (IC 95%). Resultados El 67,7% de la muestra estaban vacunadas frente al VPH. Un total de 216 mujeres (65,3%) eran sexualmente activas. El 67,6% utilizaba un método de barrera en la relación actual, siendo menos frecuente entre las mujeres no vacunadas (54,9% frente al 75,4% en estudiantes vacunadas) (p = 0,002). El riesgo de mantener al menos una conducta sexual de riesgo era mayor entre las mujeres no vacunadas: OR 2,29 (IC 95%: 1,29-4,07). La probabilidad de realizar una citología dentro del PDPCCU fue mayor entre las mujeres no vacunadas: OR 2,18 (IC 95%: 1,07-4,47). Conclusiones La prevalencia de conductas sexuales de riesgo en mujeres no vacunadas es elevada y se relaciona con la no utilización de métodos de barrera. La vacunación frente al VPH puede influir en la conducta sexual y en la participación en PDPCCU. Se debería reforzar la información que reciben los jóvenes sobre anticoncepción, enfermedades de transmisión sexual y prevención del cáncer.
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Affiliation(s)
- Ana Fernández-Feito
- Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España.
| | | | - María Paz-Zulueta
- Departamento de Enfermería, Escuela Universitaria de Enfermería, Universidad de Cantabria, Santander, España
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Dixon BE, Kasting ML, Wilson S, Kulkarni A, Zimet GD, Downs SM. Health care providers' perceptions of use and influence of clinical decision support reminders: qualitative study following a randomized trial to improve HPV vaccination rates. BMC Med Inform Decis Mak 2017; 17:119. [PMID: 28797293 PMCID: PMC5553598 DOI: 10.1186/s12911-017-0521-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Received: 12/21/2016] [Accepted: 08/07/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) leads to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. Furthermore, providers recommend the HPV vaccine less than half the time for eligible patients. Prior informatics research has demonstrated the effectiveness of computer-based clinical decision support (CDS) in changing provider behavior, especially in the area of preventative services. METHODS Following a randomized clinical trial to test the effect of a CDS intervention on HPV vaccination rates, we conducted semi-structured interviews with health care providers to understand whether they noticed the CDS reminders and why providers did or did not respond to the prompts. Eighteen providers, a mix of medical doctors and nurse practitioners, were interviewed from five publicly-funded, urban health clinics. Interview data were qualitatively analyzed by two independent researchers using inductive content analysis. RESULTS While most providers recalled seeing the CDS reminders, few of them perceived the intervention as effective in changing their behavior. Providers stated many reasons for why they did not perceive a change in their behavior, yet the results of the trial showed HPV vaccination rates increased as a result of the intervention. CONCLUSIONS CDS reminders may be effective at changing provider behavior even if providers perceive them to be of little use. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02551887 Registered on September 15, 2015.
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Affiliation(s)
- Brian E. Dixon
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St, Indianapolis, IN 46202 USA
- Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, 1481 W. 10th St, 11H, Indianapolis, IN 46202 USA
| | - Monica L. Kasting
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202 USA
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, 4115 East Fowler Ave, Tampa, FL 33617 USA
| | - Shannon Wilson
- Department of Pediatrics, Indiana University School of Medicine, 410 W 10th Street Suite 1001, Indianapolis, IN 46202 USA
| | - Amit Kulkarni
- Merck & Co., 2000 Galloping Hill Road, Kenilworth, NJ 07033 USA
| | - Gregory D. Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 W 10th Street Suite 1001, Indianapolis, IN 46202 USA
| | - Stephen M. Downs
- Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St, Indianapolis, IN 46202 USA
- Department of Pediatrics, Indiana University School of Medicine, 410 W 10th Street Suite 1001, Indianapolis, IN 46202 USA
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Forster AS, McBride KA, Davies C, Stoney T, Marshall H, McGeechan K, Cooper SC, Skinner SR. Development and validation of measures to evaluate adolescents' knowledge about human papillomavirus (HPV), involvement in HPV vaccine decision-making, self-efficacy to receive the vaccine and fear and anxiety. Public Health 2017; 147:77-83. [PMID: 28404501 PMCID: PMC5476903 DOI: 10.1016/j.puhe.2017.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 02/03/2017] [Accepted: 02/06/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We describe the development and validation of measures of human papillomavirus (HPV)/HPV vaccination knowledge, fear/anxiety about vaccination, involvement in HPV vaccine decision-making, and self-efficacy with regard to getting the vaccine, designed to evaluate the efficacy of an intervention to affect these domains (collectively termed the HAVIQ: HPV Adolescent Vaccine Intervention Questionnaire). STUDY DESIGN Literature search, cognitive interviews and cross-sectional survey. METHODS A literature search identified existing items that were modified for the present measures. Experts reviewed draft measures for face and content validity. Cognitive interviews with adolescents were also used to assess content validity. Adolescents completed the measures and an internal reliability analysis of each measure was performed. RESULTS The four experts concurred that the measures had face validity. Cognitive interviews identified items requiring refinement. Content validity was examined with ten experts and was deemed acceptable. There were 1800 adolescents who completed the measures; Cronbach's alpha was >0.6 for three of the four measures. The four final measures are brief, comprising 25 items in total. CONCLUSIONS The measures are robustly developed and validity-tested. The HAVIQ may be used in research settings to evaluate adolescents' knowledge and experiences of the process of HPV vaccination in a school-based vaccination programme.
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Affiliation(s)
- A S Forster
- Department of Behavioural Science and Health, UCL, London, WC1E 6BT, UK
| | - K A McBride
- Centre for Health Research, Western Sydney University, NSW, Australia
| | - C Davies
- Discipline of Child and Adolescent Health, Children's Hospital Westmead, University of Sydney, NSW, Australia
| | - T Stoney
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - H Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network and Robinson Research Institute and School of Medicine, University of Adelaide, Adelaide, Australia
| | - K McGeechan
- School of Public Health, University of Sydney, Sydney, Australia
| | - S C Cooper
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Policy, New York, USA
| | - S R Skinner
- Discipline of Child and Adolescent Health, Children's Hospital Westmead, University of Sydney, NSW, Australia.
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Skufca J, Ollgren J, Ruokokoski E, Lyytikäinen O, Nohynek H. Incidence rates of Guillain Barré (GBS), chronic fatigue/systemic exertion intolerance disease (CFS/SEID) and postural orthostatic tachycardia syndrome (POTS) prior to introduction of human papilloma virus (HPV) vaccination among adolescent girls in Finland, 2002-2012. Papillomavirus Res 2017; 3:91-96. [PMID: 28720463 PMCID: PMC5883192 DOI: 10.1016/j.pvr.2017.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/09/2017] [Accepted: 03/09/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Finland a vaccination programme against human papillomavirus (HPV) was introduced in November 2013 for girls aged 11-12 years with a catchup for girls 13-15 years. Allegations that HPV vaccine is causing Guillain Barré syndrome (GBS) and non-specific diagnostic entities, such as chronic fatigue syndrome/systemic exertion intolerance disease (CFS/SEID) and postural orthostatic tachycardia syndrome (POTS), continue to surface. We examined population register-based incidence rates of CFS/SEID, GBS and POTS to provide baseline data for future HPV vaccine safety evaluations. METHODS First diagnosis of CFS/SEID, GBS and POTS in girls aged 11-15 years were obtained from the National Hospital Discharge Register during 2002-2012. We considered the following ICD-10 codes: G93.3 for CFS; G61.0 for GBS and G90.9, G90.8, G93.3, I49.8 for POTS. We calculated incidence rates per 100,000 person-years with 95% confidence intervals (CI). RESULTS In total, 9 CFS/SEID, 19 GBS and 72 POTS cases were identified. The overall incidence rate was 0.53/100,000 (95% CI; 0.27-1.01) for CFS/SEID, 1.11 (95% CI; 0.71-1.74) for GBS and 4.21 (95%CI; 3.34-5.30) for POTS. Significant relative increase in annual incidence rate with a peak in 2012 was observed in CFS/SEID (33% (95% CI; 3.0-70.3: p=0.029) and POTS (16.5% (95% CI; 7.8-25.9: p<0.05), but not in GBS (5.4% (95% CI; -8.4-21.3: p=0.460). CONCLUSIONS Our findings provide baseline estimates of CFS/SEID, GBS and POTS incidences in Finland. However, rates based on register data should be interpreted with caution, especially for non-specific diagnostic entities for which internationally and even nationally agreed criteria are still being discussed. To assess the associations with HPV vaccine, methods using register linkage for cohort and self-controlled case series should be explored in addition to factors contributing to patients seeking care, treating physicians setting the diagnoses, and their preference of using of codes for these clinical entities.
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Affiliation(s)
- J Skufca
- Department of Infectious Diseases, National Institute for Health and Welfare (THL), Helsinki, Finland; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - J Ollgren
- Department of Infectious Diseases, National Institute for Health and Welfare (THL), Helsinki, Finland.
| | - E Ruokokoski
- Department of Health Protection, National Institute for Health and Welfare (THL), Helsinki, Finland.
| | - O Lyytikäinen
- Department of Infectious Diseases, National Institute for Health and Welfare (THL), Helsinki, Finland.
| | - H Nohynek
- Department of Health Protection, National Institute for Health and Welfare (THL), Helsinki, Finland.
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Kasting ML, Wilson S, Zollinger TW, Dixon BE, Stupiansky NW, Zimet GD. Differences in cervical cancer screening knowledge, practices, and beliefs: An examination of survey responses. Prev Med Rep 2017; 5:169-74. [PMID: 28050339 DOI: 10.1016/j.pmedr.2016.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/12/2016] [Accepted: 12/17/2016] [Indexed: 11/30/2022] Open
Abstract
Among the identified barriers to HPV vaccination is the concern that women may compensate for their reduced susceptibility to cervical cancers by reducing cervical cancer screening. This exploratory study examined the relationship between cervical cancer screening rates and HPV vaccination. We conducted a cross-sectional survey using a convenience sample of women aged 21–35 attending a local minority health fair in July 2015. Data were analyzed in 2015–2016. Outcomes assessed were: receiving a Pap test within the last three years, awareness and comfort with current Pap test recommendations, and knowledge regarding the purpose of a Pap test. A total of 291 women were included in the analyses. Mean age was 28.5 years and 62% were non-Hispanic black. 84% had received a Pap test in the last three years and 33% had received at least one HPV vaccine. Logistic regression results showed that women who had been vaccinated did not have lower odds of having a Pap test in the past three years (OR = 1.32; 95% CI = 0.66–2.65). In an adjusted regression model controlling for age and race, vaccinated women were significantly more likely to have had a Pap test (AOR = 3.06; 95% CI = 1.37–6.83). Yet only 26% of women knew the purpose of a Pap test and the proportion who answered correctly was higher among non-Hispanic white women. Women who have been vaccinated for HPV are more likely to have been screened for cervical cancer. These results suggest areas for more robust studies examining pro-health attitudes, behaviors, and communication regarding vaccination and preventive screening. A comparison of cervical cancer screening practices among mostly minority women HPV vaccinated participants didn't have lower rates of cervical cancer screening. Knowledge about the purpose of a Pap test was low especially among minority women. Current recommendations and screening purpose are areas for future interventions.
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