Sociocultural-psychological predictors influencing parents' decision-making regarding HPV vaccination for their adolescent daughters in mainland China: An extended TPB model

Joint consensus on reducing the burden of invasive meningococcal disease in the Asia-Pacific region

Invasive meningococcal disease (IMD) imposes a heavy burden of mortality and life-long sequelae on infected individuals and has devastating impacts on their family members. International data show that meningococcal vaccination programs have reduced IMD incidence and changed the serogroup distribution of the disease. Furthermore, newer data show that although the public health measures in response to the coronavirus disease 2019 (COVID-19) pandemic temporarily reduced the incidence of IMD, there has been a resurgence in the years since. In the Asia-Pacific (APAC) region, many countries do not include meningococcal vaccines in their routine vaccination programs, and approaches to IMD surveillance are inconsistent. This review summarizes recent data and consensus statements from a group of experts from selected APAC countries on the burden of IMD in the region, evidence for vaccination, and how barriers to IMD vaccination may be addressed.

Therapeutic Impact of Gardasil® in Recurrent Respiratory Papillomatosis: A Retrospective Study on RRP Patients

Background: Recurrent respiratory papillomatosis (RRP) is a rare, non-malignant disease caused by human papillomavirus (HPV) types 6 and 11. The condition primarily affects the larynx, potentially leading to life-threatening airway obstruction. It is more aggressive in younger patients, necessitating frequent surgical interventions. This study investigates the therapeutic potential of the prophylactic HPV vaccine Gardasil® in RRP patients, focusing on its impact on lesion size and the frequency of surgical interventions. Furthermore, a literature review was conducted to analyze the factors influencing the decision to vaccinate. Methods: A retrospective analysis was conducted on 63 RRP patients treated from 2008 to 2021. Disease burden was assessed using the Derkay score and the annual frequency of laser-surgical ablations. Comparisons were made between pre- and post-vaccination periods in vaccinated patients (n = 18), and between first and second halves of the disease's course in unvaccinated patients (n = 14). Results: A reduction in the frequency of surgical interventions post-vaccination (p < 0.05) could be seen. The cumulated Derkay score per year decreased after second and third vaccination (p < 0.05). The decision to be vaccinated is influenced by multiple factors (e.g., potential side-effects, sociocultural factors, impact of social media, pre-existing conditions and the wider context of the recent pandemic). Conclusions: Gardasil® appears to reduce the frequency of surgery and lessen disease severity in RRP patients, supporting the potential role of HPV vaccination as a therapeutic option for RRP. Moreover, it is crucial to overcome skepticism towards vaccinations to prevent the development of HPV-associated diseases in the first place.

Comparison of Self-Efficacy and Knowledge of Human Papillomavirus Vaccination among Various Types of Decision Makers in Indonesia: A Cross-Sectional Study

Background

Self-efficacy and knowledge of various types of decision-makers concerning the Human Papillomavirus (HPV) vaccine can play an essential role in the acceptance of the vaccine in women. This study sought to investigate the self-efficacy and knowledge regarding the HPV vaccine among different decision-makers, encompassing self-decision makers (SDM), assisted-decision makers (ADM), and helping-decision makers (HDM).

Methods

This cross-sectional survey was conducted in Jakarta, Indonesia, from May 13th to June 15th, 2023, involving 441 females distributed among three decision-making groups, each comprising 147 participants. Inclusion criteria were not receiving an HPV vaccination and being proficient in Bahasa Indonesia. Specific criteria were women aged 18-26 for SDM, sexually inexperienced female adolescents aged 9-17 for ADM, and mothers of eligible female adolescents for HDM. Participants completed questionnaires on self-efficacy and knowledge of HPV and cervical cancer. The Kruskal-Wallis test and Dunn's post hoc test (P<0.05) were used to analyze the data performed in SPSS 26 software.

Results

Most respondents were employed (224, 50.8%), were of low socioeconomic status (271, 61.5%), and had medium knowledge (278, 63%) and medium self-efficacy (190, 43.1%). The HDM and SDM groups demonstrated the lowest and highest knowledge scores, respectively, across all domains compared to the other groups, encompassing knowledge about HPV infection, cervical cancer, and HPV vaccination. The median score for self-efficacy in the SDM and HDM groups was the highest and lowest among the different types, respectively. The median of self-efficacy and knowledge showed statistically significant differences among decision-making groups (P<0.001).

Conclusion

This study revealed a significant difference between diverse decision-making groups and knowledge and self-efficacy. Educational interventions focusing on various types of decision-maker groups are recommended.

Predicting COVID-19 vaccine uptake: Comparing the health belief model and theory of planned behavior

The COVID-19 outbreak has had a significant impact on the global health landscape, underscoring the crucial role that vaccinations play in achieving herd immunity and reducing the effects of pandemics. Given the importance of this issue, it is imperative to gain a deeper understanding of the various factors that influence individuals' decisions to seek vaccination. This study aimed to compare the prediction level of the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and a combined model in explaining the intention of adults to receive COVID-19 immunization. A cross-sectional online survey was conducted among adults (n = 505) in Saudi Arabia. The survey contained variables related to the HBM and TPB. The prediction level of the two models as well as a combined model were evaluated utilizing Structural Equation Modeling (SEM). Among the recruited 505 participants, 88% fell within the 18 to 30 age range, and 54.5% were male. The proposed HBM model accounted for 68% of the variation in intention, whereas the TPB model explained 78.2% of the variation in COVID-19 vaccination intention. The combined model showed greater explanatory power (82%). The variables of susceptibility (β = 0.20, p < .001), severity (β = 0.49, p < .001), advantages (β = 0.63, p < .001), and obstacles (β = - 0.24, p < .001), perceptions of behavioral control (β = 1.58, p < .001) and attitudes (β = 0.44, p < .001) were found to significantly predict increased vaccination intentions in the combined model. However, the subjective norm construct did not significantly predict vaccination intentions (β = 0.06, p = .34). The TPB has greater explanatory power than the HBM in predicting the intention to obtain COVID-19 vaccination. However, the combined model showed a greater prediction level. Understanding and identifying people's perceived health beliefs and practices is critical for developing successful COVID-19 intervention methods.

A Six-Week Smartphone-Based Program for HPV Prevention Among Mothers of School-Aged Boys: A Quasi-Experimental Study in South Korea

BACKGROUND

Human papilloma virus (HPV) affects both males and females, but in South Korea, vaccination rates for boys are significantly lower due to cultural stigma and limited awareness. Effective strategies are needed to close this gap.

METHODS

This study evaluated a 6-week smartphone-based HPV prevention program for mothers of school-aged boys, designed using the extended theory of planned behavior (E-TPB). The program aimed to enhance knowledge, attitudes, subjective norms, and self-efficacy, with the goal of increasing vaccination intention and uptake. The E-TPB incorporated knowledge as a key element to improve behavioral intention and vaccination uptake. A nonequivalent control group pre-test-post-test design included 54 mothers (28 in the experimental group and 26 in the control group).

RESULTS

The experimental group showed significant improvements in HPV knowledge (p < 0.001; d = 1.41), HPV vaccine knowledge (p < 0.001; d = 1.13), attitudes (p < 0.001; r = 0.48), subjective norms (p = 0.014; d = 0.61), self-efficacy (p < 0.001; r = 0.53), and vaccination intention (p < 0.001; r = 0.58). The experimental group achieved a vaccination uptake rate of 25.0%, compared to 4.0% in the control group, representing a six-fold increase (RR = 6.25; p = 0.033; h = 0.64).

CONCLUSIONS

The program effectively addressed key factors influencing vaccination behavior, leading to significant increases in HPV vaccination rates among boys. Smartphone-based education shows promise in reducing gender disparities in vaccination uptake, though further studies with larger samples are needed to validate these findings.

Clinical significance of peri-appendiceal abscess and phlegmon in acute complicated appendicitis patients undergoing emergency appendectomy

BACKGROUND

Although antibiotic therapy has become the primary treatment for acute uncomplicated appendicitis, the management of acute complicated appendicitis necessitates careful consideration of various treatment options.

AIM

To analyze the clinical data of patients who underwent emergency appendectomy for acute complicated appendicitis with peri-appendiceal abscess or phlegmon, identify factors influencing the postoperative length of hospital stay (LOS), and improve treatment strategies.

METHODS

The clinical data of acute complicated appendicitis patients with peri-appendiceal abscess or phlegmon who underwent emergency appendectomy at The Department of Emergency Surgery, Zhongshan Hospital, Fudan University from January 2016 to March 2023 were retrospectively analyzed.

RESULTS

A total of 234 patients were included in our study. The duration of symptoms and the presence of an appendicolith were significantly correlated with the occurrence of peri-appendiceal abscess in patients with acute complicated appendicitis (P < 0.001 and P = 0.015, respectively). Patients with symptoms lasting longer than 72 h had a significantly longer postoperative LOS compared to those with symptoms lasting 72 h or less [hazard ratio (HR), 1.208; 95%CI: 1.107-1.319; P < 0.001]. Additionally, patients with peri-appendiceal abscesses had a significantly longer postoperative LOS compared to those with phlegmon (HR, 1.217; 95%CI: 1.095-1.352; P < 0.001). The patients with peri-appendiceal abscesses were divided into two groups based on the median size of the abscess: Those with abscesses smaller than 5.0 cm (n = 69) and those with abscesses 5.0 cm or larger (n = 82). Patients with peri-appendiceal abscesses measuring 5.0 cm or larger had a significantly longer postoperative LOS than those with abscesses smaller than 5.0 cm (P = 0.038).

CONCLUSION

The duration of symptoms and the presence of an appendicolith are significant risk factors for the formation of peri-appendiceal abscesses in patients with acute complicated appendicitis. Patients with peri-appendiceal abscesses experience a significantly longer postoperative LOS compared to those with peri-appendiceal phlegmon.

Human papillomavirus vaccination and contributing factors of vaccination intention among adolescents and young adults in China from a socio-ecological perspective: A cross-sectional study

OBJECTIVES

Adolescents and young adults are the main target population for human papillomavirus (HPV). The study aimed to investigate school students' HPV vaccination intentions and explore the contributing factors from a socio-ecological perspective.

DESIGN

A questionnaire survey was conducted in three secondary schools and three colleges in China.

SAMPLE

A total of 1756 students aged 14-22 years participated in this study. Among the 1756 participants, 182 students have received the HPV vaccine. For the remaining 1574 students, we analyzed their HPV vaccination intentions and the influencing factors.

MEASUREMENTS

Survey items for sociodemographics, knowledge and awareness of HPV, sexual intercourse and sexual knowledge, subjective socioeconomic status, self-efficacy, eHealth literacy, perceived social support from family, and the availability of HPV vaccine information were measured.

RESULTS

Only 182 (10.4%) had received the HPV vaccine among the 1756 participants. Among the remaining 1574 students, the majority of the students (1403, 89.1%) were willing to receive the HPV vaccine. Binary logistic regression analysis showed that students who were female, had lower self-efficacy, scored higher on sexual knowledge, believed vaccination preventing related diseases, worried about side effects after vaccination, thought oneself at risk of contracting HPV, had higher family support, knew the availability of the HPV vaccine in Mainland China from healthcare institutions, and with family residence in rural areas were more willing to receive the HPV vaccine.

CONCLUSIONS

Students had high HPV vaccination intentions while had low vaccination rate. Intrapersonal, interpersonal and institutional or community factors predicted HPV vaccination intention. Public health nurses in communities and schools could target the modifiable factors to promote students' HPV vaccine uptake.