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Webster EM, Ahsan MD, Kulkarni A, Peñate E, Beaumont S, Ma X, Wilson-Taylor M, Chang J, Ipp L, Safford MM, Cantillo E, Frey M, Holcomb K, Chapman-Davis E. Building knowledge using a novel web-based intervention to promote HPV vaccination in a diverse, low-income population. Gynecol Oncol 2024; 181:102-109. [PMID: 38150834 DOI: 10.1016/j.ygyno.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/24/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES HPV vaccination rates remain suboptimal despite proven efficacy. Data suggest misconceptions or lack of knowledge are leading barriers. Our study aimed to develop and pilot a novel interactive education resource designed to educate parents and patients about HPV vaccines. METHODS This is a prospective pilot study conducted in an urban teaching hospital pediatric clinic. The Patient Activated Learning System (PALS) intervention included 3 web-based videos with HPV vaccine-related educational content. Participants were parents of adolescent patients, aged 11-17 years, and young adult patients, aged 18-26 years. Enrolled participants completed an HPV vaccine knowledge survey before and after watching PALS; paired scores were evaluated. Acceptability and participant-reported impact of PALS modules were measured via Likert-scale surveys. RESULTS 132 individuals were approached; 101 (76%) enrolled and completed the study. Participants self-identified as Hispanic (50%), non-Hispanic Black (23%), non-Hispanic White (7%), Asian (6%), American/Alaskan/Hawaiian Native or Pacific Islander (5%). Half reported earning ≤$40,000 annually; 57% had only a high school education. Post-intervention knowledge scores were increased compared to baseline (9.87/27 points vs 17.53/27 points, p < 0.01). PALS modules were reported as enjoyable to use and understandable (89% and 93%, respectively), and improved participants' understanding of the importance of HPV vaccination (90%). Of the 18 patients unvaccinated at baseline, 39% received 1 shot of the HPV vaccine within one month. CONCLUSION The PALS HPV vaccine educational intervention was feasible, acceptable, and improved knowledge among a diverse, underserved population. Our intervention may positively influence HPV vaccination rates, with potential to overcome HPV vaccine hesitancy.
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Affiliation(s)
- Emily M Webster
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America.
| | - Muhammad Danyal Ahsan
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Amita Kulkarni
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Emilio Peñate
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Shanice Beaumont
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Xiaoyue Ma
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America
| | - Melanie Wilson-Taylor
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States of America
| | - Jane Chang
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States of America
| | - Lisa Ipp
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States of America
| | - Monika M Safford
- Department of Medicine, Weill Cornell Medicine, New York, NY, United States of America
| | - Evelyn Cantillo
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Melissa Frey
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Kevin Holcomb
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
| | - Eloise Chapman-Davis
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America
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Coleman DC, Markham C, Guilamo-Ramos V, Santa Maria D. Relationship between religiosity and HPV vaccine initiation and intention in urban black and hispanic parents. BMC Public Health 2024; 24:265. [PMID: 38263012 PMCID: PMC10804600 DOI: 10.1186/s12889-024-17653-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/03/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE Religion is believed to be an important sociocultural influence in the U.S., but little is known about how religiosity shapes the human papillomavirus (HPV) vaccine decision in racial/ethnic minorities. The purpose of this study was to examine the relationship between religiosity and HPV vaccine initiation and intention among urban, racial/ethnic minority parents of adolescents 11-14 years old. DESIGN This study employed a descriptive, cross-sectional design using baseline data from Black and Hispanic parents (N = 175 and 285, respectively) recruited from medically underserved communities. Chi-square tests for independence and independent-samples t-tests were run to assess sociodemographic differences in vaccine initiation and vaccine intention. Binary logistic regression analyses were conducted to determine whether religious attendance and religious salience were associated with parents' HPV vaccine decisions for their children. RESULTS Approximately 47% of Black parents had vaccinated their youth against HPV. Of those who had not initiated the vaccine for their child, 54% did not intend to do so. 54% of Hispanic parents had initiated the HPV vaccine for their youth. Of those who had not initiated the vaccine for their child, 51% did not intend to do so. Frequency of attendance at religious services and the importance of religion in one's life was not significantly correlated with HPV vaccine decision-making for Black nor Hispanic parents. CONCLUSION This study suggests that religiosity does not influence the HPV vaccine decision for urban, Black and Hispanic parents. Future studies using measures that capture the complexity of religion as a social construct are needed to confirm the findings. In addition, studies with representative sampling will enable us to make generalizations about the influence of religion on HPV vaccine decision-making for urban, racial/ethnic minority parents.
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Affiliation(s)
- Deidra Carroll Coleman
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit. 1440, 77030, Houston, TX, USA.
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, 77030, Houston, TX, USA
| | - Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, 27710, Durham, MC, USA
| | - Diane Santa Maria
- Department of Research, The University of Texas Health Science Center at Houston, Cizik School of Nursing, 77030, Houston, TX, USA
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Coleman DC, Frederick A, Cron S, Markham C, Guilamo-Ramos V, Santa Maria D. Impact of preparing nursing students to deliver a parent-based sexual health intervention on attitudes and intentions for sexual health education and parent communication counseling: a mixed methods study. BMC Nurs 2023; 22:375. [PMID: 37817237 PMCID: PMC10563268 DOI: 10.1186/s12912-023-01531-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Nurses are well positioned to promote sexual health but are not adequately prepared in their nursing programs to engage families on this topic and often lack the knowledge and confidence necessary to counsel families about sexual health communication. The purpose of this study was to determine how facilitating a parent-based sexual health intervention would impact nursing students' attitudes and intentions about sexual health education and parent communication counseling. METHODS Using an embedded mixed-methods design, which integrated a quasi-experimental framework, we examined the impact of participation in a parent-based sexual health intervention among 126 baccalaureate nursing students enrolled in a community/public health nursing clinical course. Independent t-tests, chi-squared tests, and the Mann-Whitney U test were used to compare intervention and control groups at baseline. Multiple linear regression was used to compare the groups for pre-post changes. Qualitative content analysis was used to analyze exit interview transcripts. RESULTS We found statistically significant differences in nursing students' confidence to teach sexual health (p = < 0.001), satisfaction with skills as a sexual health educator (p = < 0.001), beliefs about the efficacy of parent-adolescent communication for reducing negative sexual outcomes among adolescents (p = < 0.001), and intentions to counsel parents on sexual health (p = < 0.001), with greater improvements in the intervention group than in the control group. Furthermore, we found statistically significant differences in nursing students' intentions to counsel parents about the HPV vaccine (p = < 0.01) and to endorse the HPV vaccine (p = < 0.05), with greater improvements in the intervention group than in the control group. Across all survey categories, qualitative findings confirmed improvements seen on the pre-post survey. CONCLUSION Providing evidence-based adolescent sexual health training, including sexual health education content and discussion strategies, can prepare nursing students to strongly endorse sexual health communication and HPV vaccination uptake and to counsel parents on initiating and navigating these conversations with their youth. Our project exemplifies how a nursing program could organize an immersive experience, or elective within a specialty area, that aligns with the competency-based approach endorsed by the American Association of Colleges of Nursing. TRIAL REGISTRATION This study was registered with ClinicalTrials.gov (NCT02600884) on 09/01/2015; the first participant was recruited on 09/29/2015.
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Affiliation(s)
- Deidra Carroll Coleman
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit. 1440, Houston, TX, 77030, USA.
| | - Anitra Frederick
- Department of Undergraduate Studies, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, 77030, USA
| | - Stanley Cron
- Department of Research, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, 77030, USA
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, MC, 27710, USA
| | - Diane Santa Maria
- Department of Research, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, 77030, USA
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Karran EL, Grant AR, Lee H, Kamper SJ, Williams CM, Wiles LK, Shala R, Poddar CV, Astill T, Moseley GL. Do health education initiatives assist socioeconomically disadvantaged populations? A systematic review and meta-analyses. BMC Public Health 2023; 23:453. [PMID: 36890466 PMCID: PMC9996883 DOI: 10.1186/s12889-023-15329-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/27/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Health education interventions are considered critical for the prevention and management of conditions of public health concern. Although the burden of these conditions is often greatest in socio-economically disadvantaged populations, the effectiveness of interventions that target these groups is unknown. We aimed to identify and synthesize evidence of the effectiveness of health-related educational interventions in adult disadvantaged populations. METHODS We pre-registered the study on Open Science Framework https://osf.io/ek5yg/ . We searched Medline, Embase, Emcare, and the Cochrane Register from inception to 5/04/2022 to identify studies evaluating the effectiveness of health-related educational interventions delivered to adults in socio-economically disadvantaged populations. Our primary outcome was health related behaviour and our secondary outcome was a relevant biomarker. Two reviewers screened studies, extracted data and evaluated risk of bias. Our synthesis strategy involved random-effects meta-analyses and vote-counting. RESULTS We identified 8618 unique records, 96 met our criteria for inclusion - involving more than 57,000 participants from 22 countries. All studies had high or unclear risk of bias. For our primary outcome of behaviour, meta-analyses found a standardised mean effect of education on physical activity of 0.05 (95% confidence interval (CI) = -0.09-0.19), (5 studies, n = 1330) and on cancer screening of 0.29 (95% CI = 0.05-0.52), (5 studies, n = 2388). Considerable statistical heterogeneity was present. Sixty-seven of 81 studies with behavioural outcomes had point estimates favouring the intervention (83% (95% CI = 73%-90%), p < 0.001); 21 of 28 studies with biomarker outcomes showed benefit (75% (95%CI = 56%-88%), p = 0.002). When effectiveness was determined based on conclusions in the included studies, 47% of interventions were effective on behavioural outcomes, and 27% on biomarkers. CONCLUSIONS Evidence does not demonstrate consistent, positive impacts of educational interventions on health behaviours or biomarkers in socio-economically disadvantaged populations. Continued investment in targeted approaches, coinciding with development of greater understanding of factors determining successful implementation and evaluation, are important to reduce inequalities in health.
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Affiliation(s)
- E L Karran
- IIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - A R Grant
- IIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - H Lee
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal, Sciences, University of Oxford, Oxford, UK.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - S J Kamper
- School of Health Sciences, University of Sydney, Sydney, NSW, Australia.,Nepean Blue Mountains Local Health District, Penrith, NSW, Australia
| | - C M Williams
- University of Newcastle, Sydney, NSW, Australia.,Population Health, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - L K Wiles
- IIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.,Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.,South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - R Shala
- IIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.,Department of Physiotherapy, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - C V Poddar
- Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, India
| | - T Astill
- Western Sydney University, Sydney, NSW, Australia
| | - G L Moseley
- IIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia
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Choi J, Markham C, Tamí-Maury I, Kim S, Cuccaro P. Maternal perceptions of vaccinating boys against human papillomavirus (HPV) in Seoul, South Korea: A descriptive exploratory qualitative study. PLoS One 2023; 18:e0282811. [PMID: 36897868 PMCID: PMC10004501 DOI: 10.1371/journal.pone.0282811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023] Open
Abstract
Human Papillomavirus (HPV) vaccination is of paramount importance to reduce HPV-associated cancers in both genders. In South Korea, the prophylactic vaccine is recognized as prevention of cervical cancer with little attention given to male HPV vaccination. The purpose of this study was to explore perceptions of male HPV vaccination and underlying factors for vaccine hesitancy among mothers of unvaccinated boys in Seoul, Korea using a qualitative method. We used a purposive sampling strategy to recruit mothers of unvaccinated middle school-aged boys living in one of the 25 districts in Seoul, supplemented by a snowball sampling approach. We conducted one-on-one telephone interviews with ten mothers using a semi-structured interview guide. Questions probed mothers' views on vaccinating boys against HPV and the reasons for not vaccinating their sons. We found that mothers were hesitant to vaccinate their sons against HPV due to high out-of-pocket costs, fear of side effects concerning the young age of their sons, and low awareness of HPV and HPV vaccine, all of which stemmed from the exclusion of male HPV vaccination in the national immunization program. Sociocultural factors, including vaccination norms, lack of HPV education, and values associated with sexually transmitted infections were also likely to negatively impact mothers' vaccination decision-making. Despite the barriers, mothers were willing to accept HPV vaccination when it was framed as cancer prevention for not only the sons but also their future spouses. In conclusion, reasons for Korean mothers' hesitancy for their sons' HPV vaccine uptake were multifaceted. Healthcare providers' role in emphasizing and conveying the importance of gender-neutral HPV vaccination will be essential to alleviate negative sentiments around the vaccine for boys and reduce their risk of compromised sexual health. As an effective public health strategy, tailored cancer prevention messages should be delivered heightening significant benefits of the HPV vaccine beyond the prevention of cervical cancer.
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Affiliation(s)
- Jihye Choi
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Irene Tamí-Maury
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Sooyoun Kim
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
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Mohamed R, Kelly KM, Nili M, Kelley GA. A systematic review with meta-analysis of parental interventions for human papillomavirus vaccine uptake. J Am Pharm Assoc (2003) 2022; 62:1142-1153. [DOI: 10.1016/j.japh.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/26/2022]
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