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Ampofo AG, Mackenzie LJ, Osei Asibey S, Oldmeadow C, Boyes AW. Prevalence and Correlates of Cervical Cancer Prevention Knowledge Among High School Students in Ghana. Health Educ Behav 2024; 51:185-196. [PMID: 38105234 PMCID: PMC10981191 DOI: 10.1177/10901981231217978] [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] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Cervical cancer is a preventable yet highly prevalent disease in Africa. Despite female adolescents and young women being a target group for cervical cancer prevention strategies, little research has examined their knowledge of how to prevent the disease. The study aimed to describe: (a) knowledge about cervical cancer prevention and (b) sociodemographic, social, and systemic factors associated with and interacting with knowledge among female senior high school students in Ghana. METHODS A cross-sectional survey assessed knowledge about (a) risk factors and (b) primary and secondary prevention of cervical cancer among 2,400 female students from 17 public senior high schools in the Ashanti region, Ghana. Descriptive statistics were used to describe knowledge. Linear mixed-effects regression models were used to examine factors associated with knowledge scores. RESULTS Knowledge gaps were observed for at least two-thirds (>65%) of students. Most students (mean age = 17) did not know that early sexual debut (before 18 years) is a risk factor for cervical cancer (72%) and that a blood test cannot detect cervical cancer (71%). Students in later stages of senior high school education and those who received sexual health education from teachers and parents had significantly greater cervical cancer knowledge scores than their counterparts. Interactive effects showed that school-based sexual health education was associated with higher knowledge scores than home-based education among students. CONCLUSIONS Most female senior high school students had gaps in knowledge about cervical cancer prevention. Finding new ways to strengthen the capacity of schools and parents to deliver accurate cervical cancer prevention information is warranted.
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Affiliation(s)
- Ama Gyamfua Ampofo
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Lisa J Mackenzie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Shadrack Osei Asibey
- Faculty of Applied Sciences and Technology, Kumasi Technical University, Kumasi, Ghana
| | | | - Allison W Boyes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Mancilla V, Jimenez NR, Bishop NS, Flores M, Herbst-Kralovetz MM. The Vaginal Microbiota, Human Papillomavirus Infection, and Cervical Carcinogenesis: A Systematic Review in the Latina Population. J Epidemiol Glob Health 2024:10.1007/s44197-024-00201-z. [PMID: 38407720 DOI: 10.1007/s44197-024-00201-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Latina women experience disproportionately higher rates of HPV infection, persistence, and progression to cervical dysplasia and cancer compared to other racial-ethnic groups. This systematic review explores the relationship between the cervicovaginal microbiome and human papillomavirus infection, cervical dysplasia, and cervical cancer in Latinas. METHODS The review abides by the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, EMBASE, and Scopus databases were searched from January 2000 through November 11, 2022. The review included observational studies reporting on the cervicovaginal microbiota in premenopausal Latina women with human papillomavirus infection, cervical dysplasia, and cervical cancer. RESULTS Twenty-five articles were eligible for final inclusion (N = 131,183). Forty-two unique bacteria were reported in the cervicovaginal microbiome of Latinas. Seven bacteria: Lactobacillus crispatus, Lactobacillus iners, Chlamydia trachomatis, Prevotella spp., Prevotella amnii, Fusobacterium spp. and Sneathia spp. were enriched across multiple stages of cervical carcinogenesis in Latinas. Therefore, the total number of reported bacteria includes four bacteria associated with the healthy state, 16 bacteria enriched in human papillomavirus outcomes, 24 unique bacteria associated with abnormal cytology/dysplasia, and five bacteria associated with cervical cancer. Furthermore, three studies reported significantly higher alpha and beta diversity in Latinas with cervical dysplasia and cancer compared to controls. Lactobacillus depletion and an increased abundance of L. iners in Latinas compared to non-Latinas, regardless of human papillomavirus status or lesions, were observed. CONCLUSIONS The identification of 42 unique bacteria and their enrichment in cervical carcinogenesis can guide future cervicovaginal microbiome research to better inform cervical cancer prevention strategies in Latinas.
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Affiliation(s)
- Vianney Mancilla
- Department of Basic Medical Sciences, University of Arizona College of Medicine-Phoenix, 425 N. 5th Street, Phoenix, AZ, 85004-2157, USA
| | - Nicole R Jimenez
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, 425 N. 5th Street, Phoenix, AZ, 85004-2157, USA
| | - Naomi S Bishop
- Associate Librarian, University of Arizona Health Sciences, University of Arizona College of Medicine-Phoenix, 475 N. 5th Street, Phoenix, AZ, 85004, USA
| | - Melissa Flores
- Department of Psychology, University of Arizona, 1200 E University Boulevard, Tucson, AZ, 85721, USA
| | - Melissa M Herbst-Kralovetz
- Department of Basic Medical Sciences, University of Arizona College of Medicine-Phoenix, 425 N. 5th Street, Phoenix, AZ, 85004-2157, USA.
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, 425 N. 5th Street, Phoenix, AZ, 85004-2157, USA.
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Sethi S, Santiago PHR, Soares GH, Ju X, Antonsson A, Canfell K, Smith M, Garvey G, Hedges J, Jamieson L. Development and validation of an HPV infection knowledge assessment scale among Aboriginal and Torres Strait Islander Peoples. Vaccine X 2023; 14:100317. [PMID: 37288370 PMCID: PMC10241973 DOI: 10.1016/j.jvacx.2023.100317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/15/2023] [Accepted: 05/21/2023] [Indexed: 06/09/2023] Open
Abstract
Background An increased incidence of Human Papillomavirus (HPV) infection and its related cancers has been observed in recent years. Correct knowledge about HPV infection can lead to a significant decrease in transmission and a subsequent increase in vaccine uptake. Awareness and behavioural perception towards HPV infections are critical for improving HPV vaccination rates among Aboriginal and/or Torres Strait Islander Peoples. However, to the best of our knowledge, there has been no instrument designed to measure knowledge about HPV infection that is culturally appropriate and validated among Aboriginal and/or Torres Strait Islander People. Aim To address this research gap, this paper aims to examine the psychometric properties of the HPV Knowledge Tool (HPV-KT) in an Indigenous population sample from South Australia. Methodology Data from 747 Indigenous Australian Adults who participated in the 12-month follow-up of the HPV and Oropharyngeal Carcinoma in Indigenous Australians Study was utilised for this study. The psychometric properties examined included1) dimensionality and item redundancy; (2) network loadings; (3) model fit; (4) criterion validity; and (5) reliability. The network model was estimated using the Graphical Least Absolute Shrinkage and Selector Operator (GLASSO). Evaluation of the HPV-KT (10 items) dimensionality and item redundancy was conducted within the framework of Exploratory Graph Analysis (EGA). Reliability was evaluated with the McDonald's Omega (ω) coefficient. Results After the exclusion of two items, the HPV-KT exhibited good psychometric properties for Aboriginal and/or Torres Strait Islander Peoples. The two dimensions of "General HPV Knowledge" and "Commonness of HPV" were identified. The dimension of "Commonness of HPV" displayed poor reliability, so a sum score for this subscale is not recommended (i.e. the items can still be used individually) The network model of the 7-item HPV-KT was fitted in the validation sample and model fit was adequate (x2 (7) = 17.17, p < 0.016; CFI = 0.980; TLI = 0.94; RMSEA = 0.063, 90% CI = 0.025-0.010). Furthermore, the reliability of the "General HPV Knowledge" subscale (ω = 0.76, 95% CI: 0.72-0.79), while the reliability of the "Commonness of HPV" subscale (ω = 0.58, 95% CI0.58-0.88) was poor. Conclusion The HPV-KT was adapted for an Aboriginal and/or Torres Strait Islander population and is readily available for future use in Australia. The addition of items assessing specifications of HPV infection, natural history and behaviour will improve the reliability and usability to assess the level of accurate knowledge about HPV infection. Future studies should investigate the possibility of developing new items for the dimension 'Commonness of HPV'.
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Affiliation(s)
- Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | | | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW
| | - Megan Smith
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW
| | - Gail Garvey
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
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Lindsay AC, Delgado D, Valdez MJ, Granberry P. Latinx fathers report low awareness and knowledge of the human papillomavirus vaccine, but high willingness to vaccinate their children if recommended by a healthcare provider: A qualitative study. Glob Public Health 2022; 17:2883-2897. [PMID: 34605379 PMCID: PMC8976858 DOI: 10.1080/17441692.2021.1985580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [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: 03/23/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022]
Abstract
This descriptive qualitative study explored Latinx fathers' awareness, knowledge, and acceptability of the human papillomavirus (HPV) vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analysed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Nineteen, majority foreign-born Latinx fathers participated. Four main themes and two subthemes emerged from the analyses. Results found fathers' low awareness and knowledge of HPV and the HPV vaccine. Results also identified fathers' positive attitudes toward vaccines in general. Moreover, results revealed fathers trust in healthcare providers and high willingness to vaccinate their children against HPV if recommended by their child's primary healthcare provider. Findings indicate the need for increased efforts to raise awareness and knowledge among Latinx fathers of HPV and the HPV vaccine. Given the limited research focused on Latinx fathers, the study's findings are valuable in building a knowledge foundation for developing future studies and interventions to promote the HPV vaccine targeting Latinx fathers living in the United States. Future research should quantify Latinx fathers' awareness, knowledge, and acceptability of the HPV vaccine for their sons and daughters and assess fathers' role in the decision-making process to vaccinate their children against HPV.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Denisse Delgado
- Department of Public Policy and Public Affairs, McCormack Graduate School of Policy and Global Studies, University of Massachusetts—Boston, Massachusetts, USA
| | - Madelyne J. Valdez
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Phillip Granberry
- College of Liberal Arts and The Mauricio Gastón Institute for Latino Community Development and Public Policy, University of Massachusetts—Boston, Massachusetts, USA
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Morales-Campos DY, McDaniel MD, Amaro G, Flores BE, Parra-Medina D. Factors Associated with HPV Vaccine Adherence among Latino/a Adolescents in a Rural, Texas-Mexico Border County. Ethn Dis 2022; 32:275-284. [PMID: 36388859 PMCID: PMC9590603 DOI: 10.18865/ed.32.4.275] [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: 12/29/2022] Open
Abstract
Objective Completion of human papillomavirus (HPV) vaccine series among Texas Hispanic adolescents is low compared to national data. We examined the association between HPV vaccine initiation and completion among Hispanic adolescents in a rural, Texas-Mexico border county and specific individual and neighborhood-level characteristics. Design Cross-sectional analysis of data from a broader cancer prevention program. Setting Underserved colonias communities in a Texas-Mexico border county. Participants Hispanic mothers or caregivers (n=712) and adolescents aged 11-17 years (n=1120) linked to publicly available data about their neighborhood. Main Outcome Measures HPV vaccine adherence (ie, initiation and completion) as reported in either the Texas Immunization Registry or adolescents' electronic medical records, measured at the end of the cancer prevention program. Methods Logit and multi-level mixed-effects logistic regression of individual- and neighborhood-level data. Results Factors associated with HPV vaccine initiation and completion were female gender (P<.01), adolescent insurance status (P<.001), and receipt of required vaccines (P<.001). After controlling for neighborhood-level characteristics, only receipt of required vaccines remained significant. Conclusions Findings indicate a relationship between Hispanic adolescents' receiving the required vaccine series for school admission and HPV vaccine initiation and completion. In resource-limited settings like federally qualified health centers, further efforts should focus on implementing best practices at both the provider level (eg, education on bundled vaccine recommendation) and practice-level (eg, outreach and support by trained immunization navigators).
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Affiliation(s)
- Daisy Y. Morales-Campos
- Latino Research Institute, The University of Texas at Austin, TX, Address correspondence to Daisy Y. Morales-Campos, PhD; Latino Research Institute at The University of Texas at Austin, TX;
| | | | - Gabriel Amaro
- Latino Research Institute Affiliate, The University of Texas at Austin, TX
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Cordoba-Sanchez V, Lemos M, Tamayo-Lopera DA, Sheinfeld Gorin S. HPV-Vaccine Hesitancy in Colombia: A Mixed-Methods Study. Vaccines (Basel) 2022; 10:1187. [PMID: 35893836 PMCID: PMC9332743 DOI: 10.3390/vaccines10081187] [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: 06/05/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/24/2022] Open
Abstract
In Colombia, the uptake rate of the HPV vaccine dropped from 96.7% after its introduction in 2013 to 9% in 2020. To identify the behavioural components of HPV-vaccine hesitancy in females aged 15 and under and their families, we conducted a convergent mixed-methods study in which 196 parents/caregivers responded to an online questionnaire and 10 focus groups were held with 13 of these parents/caregivers, and 50 age-eligible girls. The study is novel as it is the first to explore the factors influencing HPV-vaccine hesitancy alongside the COVID vaccine within an integrative model of behaviour change, the capability-opportunity-motivation-behaviour (COM-B) model. We found that COVID-19 has had an impact on the awareness of HPV and HPV vaccination. Lack of information about the vaccination programs, concerns about vaccine safety and the relationship between HPV and sexuality could be related to vaccine hesitancy. Trust in medical recommendations and campaigns focused on the idea that vaccination is a way of protecting daughters from cervical cancer could improve HPV vaccine uptake.
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Affiliation(s)
- Veronica Cordoba-Sanchez
- Department of Psychology, School of Social Sciences, Institucion Universitaria de Envigado, Envigado 055422, Colombia;
| | - Mariantonia Lemos
- Department of Psychology, School of Arts and Social Sciences, Universidad EAFIT, Medellín 050022, Colombia;
| | - Diego Alfredo Tamayo-Lopera
- Department of Psychology, School of Social Sciences, Institucion Universitaria de Envigado, Envigado 055422, Colombia;
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Patrick L, Bakeera-Kitaka S, Rujumba J, Malande OO. Encouraging improvement in HPV vaccination coverage among adolescent girls in Kampala, Uganda. PLoS One 2022; 17:e0269655. [PMID: 35679304 PMCID: PMC9182299 DOI: 10.1371/journal.pone.0269655] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/26/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction WHO recommends vaccination against HPV for girls before sexual debut. Uganda started HPV vaccination in 2008 as pilot programs in 2 districts, followed by national roll out in 2015. Despite the availability of vaccines against human papillomavirus (HPV) in Uganda in the period covered by the study, there was reported low HPV vaccine uptake and completion especially of the second dose in Uganda; with little information available on timely completion of HPV vaccine and the associated factors in Uganda. This study was therefore done to determine the HPV vaccine dose 2 completion and describe the possible factors associated with timely HPV vaccine completion and non-completion among girls of age 9–14 years attending the adolescent clinic at Mulago hospital. Methods A retrospective mixed methods study was conducted in Mulago National Referral hospital adolescent clinic. Data were mainly collected through review of charts and folders for clinic attendance by eligible girls and focus group discussions with eligible girls that completed the 2 doses of HPV vaccine on recommended/scheduled time. Results Out of the 201 girls studied, 87 girls (43.3%) had timely completion of the HPV vaccination. Knowledge about HPV infection and HPV vaccine benefits, positive peer influence and healthcare worker recommendation to get vaccinated at health facility level positively influenced timely completion of HPV vaccine. Among barriers to completion of HPV vaccine identified were: inadequate information about HPV infection and HPV vaccine, concerns about HPV vaccine efficacy and safety, unclear communication with adolescents/caregivers from healthcare workers and -stock out of the HPV vaccine. Conclusion Timely completion of the second dose of HPV vaccine among girls attending the adolescent clinic of Mulago hospital was low (at 43.3%) but higher when compared to earlier published reports. Interventions around improved social mobilization, enhanced outreach and static vaccination approach and education of eligible girls on HPV vaccination can help increase vaccine uptake.
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Affiliation(s)
- Lydia Patrick
- Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda
| | | | - Joseph Rujumba
- Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda
| | - Oliver Ombeva Malande
- Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda
- Administration Department, East Africa Centre for Vaccines and Immunization (ECAVI), Kampala, Uganda
- Department of Public Health Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Paediatrics & Child Health, Egerton University, Nakuru, Kenya
- * E-mail:
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Lindsay AC, Delgado D, Valdez MJ, Restrepo E, Granberry P. "Everyone in our community should be informed about the HPV vaccine": Latinx mothers' suggested strategies to promote the human papillomavirus vaccine. Am J Health Promot 2022; 36:853-863. [PMID: 35081770 DOI: 10.1177/08901171211073960] [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] [Indexed: 11/15/2022]
Abstract
PURPOSE Parents play a critical decision-making role in vaccinating their children against HPV, and mothers, in particular, are key stakeholders as they are often the parent taking their children to healthcare visits. Given the importance of the HPV vaccination as a cancer prevention strategy, this study was designed to explore Latinx mothers' suggested strategies to promote vaccine uptake among Latinx parents. SETTING AND PARTICIPANTS Community-based in Massachusetts, United States, and Latinx mothers. DESIGN AND METHODS Descriptive qualitative research employing individual semi-structured interviews. Data were analyzed using a hybrid method of thematic analysis incorporating deductive and inductive approaches. RESULTS Twenty-two, majority foreign-born (91%) Latinx mothers of adolescent girls (∼60%) and boys (∼40%) aged 11-19 years participated. Mothers suggested several strategies to promote uptake of the HPV vaccine among Latinx families including healthcare providers' increased communication and anticipatory guidance addressing factors influencing parents' HPV vaccination hesitancy, and improved community-wide dissemination of culturally and linguistically relevant information targeting not only parents of age-eligible participants but the broader community. Finally, mothers suggested the use of social media using personal narratives and an enhanced active role of schools in providing accurate information to raise awareness and educate adolescents and parents about the importance of HPV vaccination. CONCLUSION Findings are relevant to the development of tailored interventions to meet the needs of Latinx populations, and ultimately increase Latinx children's HPV vaccination rates.
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Affiliation(s)
| | | | | | - Emily Restrepo
- Exercise and Health Sciences14708University of Massachusetts Boston
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Peterson CE, Silva A, Goben AH, Ongtengco NP, Hu EZ, Khanna D, Nussbaum ER, Jasenof IG, Kim SJ, Dykens JA. Stigma and cervical cancer prevention: A scoping review of the U.S. literature. Prev Med 2021; 153:106849. [PMID: 34662598 DOI: 10.1016/j.ypmed.2021.106849] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 05/17/2021] [Revised: 09/20/2021] [Accepted: 10/11/2021] [Indexed: 01/08/2023]
Abstract
Cervical cancer is preventable through HPV vaccination and screening however, uptake falls below national targets. A scoping review was conducted to describe stigmas related to HPV infection and vaccination and cervical cancer and screening in the US. Results were organized into the domains proposed by Stangl and colleagues' Health Stigma and Discrimination Framework. Common drivers of stigma were fear of social judgement and rejection, self-blame, and shame. Positive facilitators included social norms that provided motivation to receive HPV vaccination and screening. Gender and social norms were notable negative facilitators of stigma. HPV infection and cervical cancer resulted in stigma marking through the belief that both result from incautious behavior-either multiple sexual partners or failing to get screening. Stereotyping and prejudice were stigma practices attributed to HPV infection and cervical cancer through these same behaviors. Stigma experiences related to HPV infection, cervical cancer, and abnormal screening results included altered self-image based on perceived/anticipated stigma, as well as discrimination. This review advances understanding of the multiple dimensions of stigma associated with these outcomes in the US population. Three areas warrant additional consideration. Future studies should 1) assess how stigma dimensions affect uptake of cervical cancer preventions efforts; 2) focus on US women most affected by cervical cancer incidence and mortality to identify potential differences in these dimensions and tailor interventions accordingly; 3) include women from geographic areas of the US with high rates of cervical cancer to adapt interventions that address potential regional variations in resources and need.
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Affiliation(s)
- Caryn E Peterson
- School of Public Health, University of Illinois at Chicago, USA.
| | - Abigail Silva
- Department of Public Health Sciences, Loyola University Chicago, Parkinson School of Health Sciences and Public Health, USA
| | | | | | - Elise Z Hu
- University of Illinois College of Medicine, USA
| | | | | | - Ian G Jasenof
- University of Illinois Health, Mile Square Health Center, USA
| | - Sage J Kim
- School of Public Health, University of Illinois at Chicago, USA
| | - J Andrew Dykens
- University of Illinois College of Medicine, USA; Department of Family Medicine, College of Medicine, Center for Global Health, USA
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Díaz de León-Martínez L, Flores-Ramírez R, López-Mendoza CM, Rodríguez-Aguilar M, Metha G, Zúñiga-Martínez L, Ornelas-Rebolledo O, Alcántara-Quintana LE. Identification of volatile organic compounds in the urine of patients with cervical cancer. Test concept for timely screening. Clin Chim Acta 2021; 522:132-140. [PMID: 34418363 DOI: 10.1016/j.cca.2021.08.014] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/19/2021] [Accepted: 08/13/2021] [Indexed: 01/15/2023]
Abstract
The objective of this research was to identify a global chemical pattern of volatile organic compounds (VOCs) in urine capable of discriminating between women with cervical cancer (CC) and control women using an electronic nose and to elucidate potential biomarkers by gas chromatography-mass spectrometry (GC-MS). A cross-sectional study was performed, with 12 control women, 5 women with CIN (Cervical Intraepithelial Neoplasia) and 12 women with CC. Global VOCs in urine were assessed using an electronic nose and specific by GC-MS. Multivariate analysis was performed: Principal Component Analysis (PCA), Canonical Principal Coordinate Analysis (CAP) and Partial Least Squares Discriminant Analysis (PLS-DA) and the test's diagnostic power was evaluated through ROC (Receiver Operating Characteristic) curves. Results from the PCA between the control group compared to the CC present variability of 98.4% (PC1 = 93.9%, PC2 = 2.3% and PC3 = 2.1%). CAP model shows a separation between the overall VOCs profile of the control and CC group with a correct classification of 94.7%. PLS-DA indicated that 8 sensors have a higher contribution in the CC group. The sensitivity, specificity, value reached 91.6% (61.5%-99.7%) and 100% (73.5%-100%) respectively, according to the ROC curve. GC-MS analysis indicated that 33 compounds occur only in the CC group and some of them have been found in other types of cancer. In all, this study provides the basis for the development of an accessible, non-invasive, sensitive and specific screening platform for cervical cancer through the application of electronic nose and chemometric analysis.
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Affiliation(s)
- Lorena Díaz de León-Martínez
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, México
| | - Rogelio Flores-Ramírez
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, México.
| | - Carlos Miguel López-Mendoza
- Unidad de Innovación en Diagnóstico Celular y Molecular. Coordinación para la Innovación y la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2a sección, 78120 San Luis Potosí, México
| | | | - Garima Metha
- CEO of Altus Lifescience, San José, CA, United States
| | - Lourdes Zúñiga-Martínez
- Unidad de Innovación en Diagnóstico Celular y Molecular. Coordinación para la Innovación y la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2a sección, 78120 San Luis Potosí, México
| | - Omar Ornelas-Rebolledo
- Labinnova Center of Research in Breath for early diseases detection, Guadalajara, Mexico
| | - Luz Eugenia Alcántara-Quintana
- Unidad de Innovación en Diagnóstico Celular y Molecular. Coordinación para la Innovación y la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2a sección, 78120 San Luis Potosí, México.
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Grandahl M, Nevéus T. Barriers towards HPV Vaccinations for Boys and Young Men: A Narrative Review. Viruses 2021; 13:v13081644. [PMID: 34452508 PMCID: PMC8402923 DOI: 10.3390/v13081644] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/07/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background: HPV vaccination of both girls and boys can protect against infection and eliminate the risk for HPV-associated cancer. Due to a common misconception that the virus only poses risks to women, vaccine coverage is suboptimal among men in many countries. It is urgent to identify barriers to vaccination of boys and men. Methods: We conducted a narrative review of publications examining attitudes and beliefs regarding HPV vaccination for boys and young men. The electronic databases searched were PubMed, PsychInfo and Scopus (December 2020; last update July 2021). A total of 103 original articles were included in the final analysis. Results: The central barriers against vaccination of boys and men are: (1) lack of knowledge, (2) vaccine hesitancy in general, (3) lack of recommendation from and/or discussions with healthcare providers, (4) cost and logistics, and (5) the idea that HPV vaccination may promote promiscuity. Men who have sex with men and families belonging to ethnic minorities express a need for information tailored to their situation. Conclusions: Boys should be included in national immunization programs and men should also be offered catch-up vaccinations. Future studies should focus on addressing vaccine hesitancy and developing interventions to promote pan-gender HPV vaccination.
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Abstract
Purpose Human papillomavirus (HPV) vaccination uptake continues to be low in the United States. While a recommendation from a health care provider (HCP) has been shown to be associated with vaccine acceptability among parents, little is known about factors associated with hesitancy despite HCP recommendation. We examined factors associated with HPV vaccine hesitancy, despite a physician recommendation, among Latina immigrant mothers of daughters aged 9-12 years. Methods As part of a group randomized trial to promote HPV vaccination between 2013 and 2016, we conducted a baseline interviewer-administered survey of mothers to assess sociodemographics, knowledge and perceived risk of cervical cancer/HPV infection, self-efficacy, and intention to vaccinate their unvaccinated daughters. Hesitancy was defined as "don't know/not sure" (DK/NS) in response to the question: "If your daughter's doctor recommended that she gets the HPV vaccine, would you let her get it?" Results Of the 317 participants, 35.3% indicated hesitancy to vaccinate their daughters if their physician recommended it. Although a number of variables were associated with HPV vaccine hesitancy in the univariate model, five remained significant in the final multivariable model: daughter's health insurance status; HPV awareness; perceived risk of HPV infection for their daughters; perceived self-risk of cervical cancer; and a self-efficacy score of ability to complete the HPV vaccination series. Conclusions A recommendation by a health care provider may be not enough to motivate Latina immigrant mothers to vaccinate their daughters. Further efforts should focus on increasing awareness regarding HPV and cervical cancer, heightening perceived risk of HPV infection among daughters and boosting self-efficacy to get their children vaccinated against HPV.
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Affiliation(s)
- Alexandra B Khodadadi
- University of Alabama at Birmingham School of Medicine, Birmingham, AL.,University of Alabama at Birmingham School of Public Health, Birmingham, AL
| | - David T Redden
- University of Alabama at Birmingham School of Public Health, Birmingham, AL
| | - Isabel C Scarinci
- University of Alabama at Birmingham Division of Preventive Medicine, Birmingham, AL
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Zhou Q, Xie Y, Wang L, Xu T, Gao Y. LncRNA EWSAT1 upregulates CPEB4 via miR-330-5p to promote cervical cancer development. Mol Cell Biochem 2020; 471:177-188. [PMID: 32556917 DOI: 10.1007/s11010-020-03778-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/02/2020] [Indexed: 12/19/2022]
Abstract
Long non-coding RNA (lncRNA) Ewing sarcoma associated transcript 1 (EWSAT1) is an oncogene in a variety of tumors. Here, we planned to demonstrate EWSAT1 function in cervical cancer and further illustrate its underlying mechanism. EWSAT1 expression in cervical cancer was evaluated through qRT-PCR. Colony forming capacity was measured by colony formation assay and cell proliferation ability was measured by CCK-8 kit. Wound healing experiment was applied to test the cell migration and transwell assay was applied to test the invasion ability. Luciferase assay was employed to demonstrate EWSAT1 and miR-330-5p interaction. In cervical cancer, the expression of EWSAT1 was enhanced and contributed to the poor prognosis. Downregulated EWSAT1 expression inhibited Hela cell migration, proliferation, and invasion. EWSAT1 targeted to miR-330-5p and upregulated cytoplasmic polyadenylation element-binding protein 4 (CPEB4) expression by sponging miR-330-5p. Our study revealed that EWSAT1 enhances CPEB4 expression through sponging miR-330-5p, thereby promoting cervical cancer development, which might provide potential therapeutic targets for clinically cervical cancer patients.
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Affiliation(s)
- Qingyan Zhou
- Department of Gynecology, Dongchangfu District, Liaocheng Dongchangfu People's Hospital, No. 128 Songgui Road, Liaocheng, 252000, Shandong, China.
| | - Yuan Xie
- Department of Gynecology, Dongchangfu District, Liaocheng Dongchangfu People's Hospital, No. 128 Songgui Road, Liaocheng, 252000, Shandong, China
| | - Li Wang
- Department of Gynecology, Dongchangfu District, Liaocheng Dongchangfu People's Hospital, No. 128 Songgui Road, Liaocheng, 252000, Shandong, China
| | - Tao Xu
- Delivery Room, Dongchangfu District, Liaocheng Dongchangfu People's Hospital, No. 128 Songgui Road, Liaocheng, 252000, Shandong, China
| | - Yongbin Gao
- Department of Gynecology, Dongchangfu District, Liaocheng Dongchangfu People's Hospital, No. 128 Songgui Road, Liaocheng, 252000, Shandong, China
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