Knowledge about Cervical Cancer, Health Beliefs and Human Papillomavirus Vaccination Rate in Female University Students

HPV Vaccination Stages and Associated Factors Among Children of Immigrant Women

OBJECTIVE

This study aimed to identify key determinants by stage of implementation of human papillomavirus (HPV) vaccination among children of immigrant women in South Korea.

DESIGN

Cross-sectional descriptive study.

SAMPLE

The sample comprised 262 Chinese, Vietnamese, and Korean-Chinese women with children living in South Korea.

METHODS

The survey was conducted using self-report questionnaires. The HPV vaccination levels in children were classified into four transition stages. Sequential logistic regression analysis was conducted to identify the factors affecting the transition of HPV vaccination status.

RESULTS

Social norms had the greatest influence on the intention to vaccinate. Perceived barriers were a significant factor associated with intention or initiation of vaccination, whereas perceived severity and susceptibility were associated with the intention and initiation stages, respectively. Upon the initiation of HPV vaccination, low perception of discrimination in healthcare was associated with continued vaccination.

CONCLUSION

Given the importance of completing multiple doses of the HPV vaccine within a given timeframe, it is important to provide culturally appropriate interventions in stages to prevent dropouts.

A Study of Pandemic Prevention Health Behavior in Adults

Following the outbreak of COVID-19, the World Health Organization recommended prevention measures to minimize the spread of the pandemic. However, strict compliance with prevention measures requires positive health behavior practices, especially among adults. Therefore, this study investigated adults’ health behaviors in relation to pandemic prevention based on the health belief model (HBM) and the theory of planned behavior (TPB). This study used a structural model, applying the HBM and the TPB to explain and predict pandemic prevention behaviors in adults. The data obtained were statistically analyzed using SPSS 25.0 and AMOS 25.0. The results revealed that, in total, 341 adults (age: 20–64 years; males: 167, females: 174; single: 167; married: 164; divorced: 8) participated in this study. Of the 341 participants, 339 had use of the internet and a smartphone. Furthermore, the results revealed that attitudes, subjective norms, and perceived behavioral control in relation to pandemic prevention behaviors directly affected people’s intentions to adopt pandemic prevention behaviors. Perceived severity and perceived disability had significant indirect effects on the intention to prevent pandemics; pandemic prevention behavior and perceived behavioral control had a significant effect on pandemic prevention intention. The pandemic prevention education programs suggested in this study have the potential to improve adults’ health behavior in relation to pandemic prevention.

Barriers and strategies for cervical cancer screening: What do female university students know and want?

OBJECTIVE

This study aimed to identify the distinct barriers and knowledge level of cervical cancer screening among female university students and establish intervention strategies to overcome these barriers.

METHODS

This study used a mixed-methods design with 26 female university students aged 20-29 years. We first conducted a quantitative online survey for the same study participants, divided them into three groups, and conducted focus group interviews (FGIs). Group A: participants who had sexual experience and had undergone cervical cancer screening; Group B: participants who had sexual experience and had not undergone cervical cancer screening; Group C: participants who did not have sexual experience and had not undergone cervical cancer screening.

RESULTS

The participants' ages were 21.92 ± 1.26 years. The knowledge levels for cervical cancer and screening were low to moderate. The four main themes that emerged as barriers to cervical cancer screening through the FGIs were: 1) socio-cultural barrier: conservative social perception of unmarried women's sexual life, 2) knowledge barrier: lack of knowledge and information, 3) psychological barrier: discomfort, and 4) practical barrier: time-consuming. The three themes identified for strategies were: 1) socio-cultural intervention: changing social perceptions and ensuring confidentiality, 2) educational intervention: improvement of knowledge and accessibility, and 3) alternative screening intervention: comfortable screening methods.

CONCLUSIONS

While university students' sexual experience rapidly increased, the socio-cultural perceptions of sexual health remained closed, and they had a reasonably low level of knowledge about cervical cancer screening. Therefore, various strategies sensitive to female university students' culture should be implemented to increase the knowledge level, and social efforts should be made to change the socio-cultural perception of unmarried young women's sexual health.

Factors influencing preventive behaviors for Zika virus infection in female nursing students: A cross-sectional study

Backgrounds: Zika virus infection may cause severe complications in women of childbearing age. Female nursing college students, in the role of future nurses and women of childbearing age, can be effective educators and health supporters by stimulating preventive behaviors.Objectives: The purpose of this study was to identify the level of knowledge, attitudes, and preventive behaviors for Zika virus infection and determine the factors that influence this behavior in female nursing students.Methods: This cross-sectional study sample consisted of 335 nursing studentsfrom three nursing colleges in Korea.Results: Preventive behaviors for Zika virus infection were significantly affected by information seeking (β = 0.252, p < .01), perceived severity (β = 0.167, p < .05), intention to receive Zika virus vaccination (β = 0.135, p < .05), intent to travel to countries endemic for Zika virus (β = -0.122, p < .05), and intention to travel overseas (β = 0.122, p < .05). These five variables explained 20.6% of the variance in preventive behaviors for Zika virus infection.Conclusions: The provision of accurate and reliable information on Zika virus infection is essential, and education and publicity are needed to raise awareness about the disease severity. Moreover, preventive behaviors should focus on vaccination and precautions while traveling overseas.Impact Statement: The findings of this study highlight the importance of enhancing nursing students' preventive behaviors to prevent Zika virus infection.

Perceptions of nurses on human papillomavirus vaccinations in the Republic of Korea

BACKGROUND

In June 2016, the Republic of Korea included free human papillomavirus (HPV) vaccinations for all 12-year-old girls in its national immunization program.

PURPOSE

This study investigated perceptions of nurses on HPV vaccination and their intent to vaccinate preteens at the best ages.

METHODS

Recruited for the survey were 514 health teachers (181, 35.2%), public health nurses (168, 32.7%), and clinical nurses (165, 32.1%). Factor-analysis was conducted to validate the Vaccine-Hesitancy Scale for Korean nurses. Related variables associated with vaccine-acceptance were examined using the Kruskal-Wallis test and Spearman's rho coefficients, due to lack of normalization.

RESULTS

Factor-analysis results showed that two factors of positive acceptance (7 items) and negative acceptance (3 items) accounted for 67.46% of the total variance, and explained 47.4% and 20.1%, respectively. Nurses who positively accepted HPV vaccine differed significantly in agreement to vaccinate girls or boys. For the proper vaccination age, a significant difference emerged between answers for girls and vaccine-acceptance scores, whereas no difference emerged between answers for boys and the scores. The vaccinated status of respondents significantly related to higher HPV vaccine acceptance, although age, religion, marital status, education, and working duration did not.

CONCLUSIONS

This study showed that vaccine-acceptance levels reflect nurses' attitudes and opinions about HPV vaccination for girls and boys.

Current Status of Human Papillomavirus Infection and Introduction of Vaccination to the National Immunization Program in Korea: an Overview

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection and is associated with the development of cervical cancer. The purpose of this report is to provide the literature evidences on selecting the HPV vaccine for national immunization program (NIP) in Korea. To complete these tasks, we reviewed domestic and foreign literature on the current status of HPV infection, efficacy and effectiveness of HPV vaccine, safety of vaccine and cost effectiveness analysis of vaccination business. Given that the median age of first sexual intercourse is continuing to fall, this may have serious implications for HPV infection and cervical cancer incidence at the age of 20s. The World Health Organization recommends that the HPV vaccination should be included in the NIP being implemented in each country. Both the bivalent and quadrivalent vaccines have a 90% or greater preventive efficacy on cervical intraepithelial lesion 2-3 and cervical cancer by the HPV 16 or HPV 18. In the future, if HPV vaccination rate as part of NIP increases, it is expected that the incidence of HPV infection, genital warts, and cervical precancerous lesions will be decreased in the vaccination age group. Therefore, in order to increase the HPV vaccination rate at this point in Korea, social consensus and efforts such as the introduction and promotion of HPV vaccine to the NIP according to appropriate cost-effectiveness analysis are required.

Human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis co-infections among patients with anogenital warts in Tabriz, Iran

Introduction: Genital infection with papilloma virus is the most common sexually-transmitted disease (STD). It is recommended that individuals who have a sexual risk factor, should be screened for syphilis, human immunodeficiency virus (HIV), and hepatitis B and C. However, this strategy is often not carried out in Iran. In the present study, patients with genital warts were screened for syphilis, HIV, and hepatitis B and C. Methods: We evaluated 311 patients with anogenital warts visiting dermatology clinics from June 2016 to June 2017. In addition, demographic data were collected using a pre-designed questionnaire. Patients who presented to Sina Hospital, Tabriz, Iran, were examined for HIV, syphilis, hepatitis B and C, urethral and vaginal discharge, and history of painful genital lesions, while patients presenting to Bahar Behavioral Disease Counseling Center of Tabriz were examined only for HIV. Data were analyzed using chi-square and Fisher’s exact tests via SPSS software. Results: Out of 263 cases with genital warts presenting to Sina Hospital, 1, 1, and 2 cases were positive for HIV, syphilis, and hepatitis B, respectively. At the same time, one of the patients presenting to Bahar Center showed HIV infection. Conclusion: We found two HIV-positive, two hepatitis B virus (HBV)-positive, and one syphilis cases in 311 patients with genital warts, so it is recommended to assess these tests routinely in high-risk individuals with genital warts, including multi-partner and addicted patients.

Awareness of and Attitudes toward Human Papillomavirus Vaccination among Adults in Korea: 9-Year Changes in Nationwide Surveys

PURPOSE

Human papillomavirus (HPV) vaccination has been included in the National Immunization Program in Korea since 2016. We aimed to evaluate changes in the awareness of and attitudes toward HPV vaccination, among adults in Korea since the first introduction of the vaccines in 2007.

MATERIALS AND METHODS

A nationwide population-based survey was conducted in 2016 for 1,200 nationally representative Korean men and women; the data obtained were compared with the data from the nationwide survey conducted in 2007.

RESULTS

A significant increase in the awareness of HPV infection (35.8%) and vaccination (36.9%) was observed in 2016 from 13.3% and 8.6% in 2007, respectively. Willingness to be vaccinated against HPV decreased from 55.0% in 2007 to 25.8% in 2016, and the proportion of respondents expressing uncertainty increased from 28.3% in 2007 to 43.3% in 2016. Only 12.1% of men and 22.0% of women knew about the free national HPV vaccination program for girls, launched in June 2016. Younger women, with higher income level, awareness of the HPV vaccine, and perception of the seriousness of infections had a higher willingness to be vaccinated. A high education level, awareness of HPV infection and vaccination, and perception of the seriousness of infection were positively associated with the willingness of respondents to vaccinate their daughters.

CONCLUSION

Raising the awareness of HPV infection and vaccination with appropriate knowledge is necessary for the successful implementation of the national HPV vaccination program.

Factors influencing Human Papillomavirus Vaccination intention in Female High School Students: Application of Planned Behavior Theory

PURPOSE

The purpose of this study was to identify effects of attitude, subjective norm, and perceived behavior control toward Human Papillomavirus (HPV) on HPV vaccination intention in female high school students.

METHODS

Subjects of this study were female students aged 16 to 17 years, the optimal age group of HPV vaccination, arbitrarily selected from three high schools in B city. A total of 140 students agreed to participate in this study. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation, and stepwise multiple regression.

RESULTS

Attitude, subjective norm, and perceived behavior control toward HPV were factors influencing HPV vaccination intention of subjects. Perceived behavior control toward HPV vaccination was the most influential factor. These factors accounted for 49% of HPV vaccination intention.

CONCLUSION

These results suggest a need to increase perceived behavior control to increase HPV vaccination intention. The government needs to establish a national policy system such as financial support for HPV vaccines and free vaccinations so that students are aware that HPV vaccines can be easily inoculated.

Factors involved in human papillomavirus (HPV) vaccine hesitancy among women in the South-East Asian Region (SEAR) and Western Pacific Region (WPR): A scoping review

A scoping review was performed to identify factors that may lead to human papillomavirus (HPV) vaccine hesitancy among women in low- and middle-income countries in South East Asian Region (SEAR) and Western Pacific Region (WPR). A systematic search of English and non-English articles using Pubmed, EMBASE, PsycINFO, Cochrane, MEDLINE, and CINAHL plus was conducted. Only 63 studies conducted in SEAR and WPR were included from inception until December 2016. Results of these studies have shown that poor awareness and knowledge of practices on cervical cancer prevention was evident in both SEAR and WPR. Concerns on safety and efficacy of the vaccine, and costs in getting vaccinated were significant barriers. Most women stated that they needed more information, and strongly welcomed a physician's recommendation in both geographical regions. Women also felt they have a low risk of acquiring HPV infection and cervical cancer. Most women in SEAR and WPR were unable to decide on whether to accept HPV vaccination.

Mothers' intentions to vaccinate their teenaged children against human papillomavirus, as predicted by sex in South Korea: An application of the theory of planned behavior

AIM

This study was conducted in order to examine the intention of mothers to vaccinate their teenaged children against human papillomavirus (HPV) infection, according to the children's sex. Based on the theory of planned behavior, the study identified the sex-specific predictors of mothers' intention to vaccinate their teenaged children against HPV.

METHODS

This was a descriptive survey study that included, as participants, 200 mothers whose teenaged children were not vaccinated against HPV.

RESULTS

The mothers' experience with HPV vaccination was a significant predictor of their childrens' HPV vaccination status. For the mothers of sons, subjective norms, attitudes, and perceived behavioral control were found to be significant predictors of intention of HPV vaccination, with an explanatory power of 69.5%. For those with daughters, only attitudes and subjective norms were significant predictors, with an explanatory power of 79.6%.

CONCLUSION

The application of the theory of planned behavior is an effective method to determine the predictors of children's HPV vaccination status. In order to improve the HPV vaccination rate of teenaged children, strategies for education and effective promotion that involve mothers should be developed.

A study on the predictors of Korean male students' intention to receive human papillomavirus vaccination

AIMS AND OBJECTIVES

The objective was to survey the current state of human papillomavirus (HPV) vaccination and the predictors of vaccination intention among Korean male students of high school (ages 15-19) and university (ages 17-27).

BACKGROUND

Human papillomavirus is a sexually transmitted infectious agent causing uterine cervical, anal, and/or penile cancer and genital warts in males and females. Infection rate of human papillomavirus increases from the age when sexual intercourse first occurs. Therefore, motivation to receive human papillomavirus vaccination is needed to protect infection.

DESIGN

Cross-sectional descriptive survey was performed only in male students. They are less aware of human papillomavirus than females, because human papillomavirus vaccination has been targeted on females for preventing cervical cancer in Korea.

METHODS

Data were collected using a self-reporting questionnaire for male high school and university students sampled from a city in Korea. Human papillomavirus vaccine-related knowledge, health beliefs, demographic, and sexual history information variables relating to intentions to vaccinate were assessed.

RESULTS

The human papillomavirus vaccination rate was very low and the levels of knowledge and health beliefs were low. The significant predictors that raised the intention of human papillomavirus vaccination were a university student, experience of sexual intercourse and perceiving the benefits of human papillomavirus vaccination.

CONCLUSIONS

To promote human papillomavirus vaccination, educational programming targeting males should include health beliefs and knowledge, emphasising that vaccination is important to prevent uterine cervical cancer and to role as a preventative measure against common male diseases.

RELEVANCE TO CLINICAL PRACTICE

Male high school students should be included as a major target population for school human papillomavirus education programmes, as they are at the age of commencing sexual intercourse. In addition, public health policies including human papillomavirus vaccination in the national immunisation programme are warranted.

Barriers to Cervical Cancer Screening and Prevention in Young Korean Immigrant Women: Implications for Intervention Development

This study aimed to identify major barriers to Papanicolaou (Pap) test uptake and human papillomavirus (HPV) vaccine acceptability. Three focus groups with 16 young Korean immigrant women residing in a community in the Midwest were conducted. Braun and Clarke’s six phases of thematic analysis were used to develop themes. Three major themes emerged as barriers: (a) limited knowledge about cervical cancer and preventive behaviors, (b) culture-specific barriers, and (c) low accessibility to health care services. These themes were multifactorial and interrelated barriers to Pap test uptake and HPV vaccine acceptability among young Korean immigrant women. These findings indicate that culturally tailored cervical cancer education is needed to promote Pap test uptake and HPV vaccination in this underserved population.

Sexually Transmitted Infections and First Sexual Intercourse Age in Adolescents: The Nationwide Retrospective Cross-Sectional Study

INTRODUCTION

Sexually transmitted infections (STIs) are major causes of medical and psychological problems globally, while adolescents in South Korea have recently shown rapid changes in sexual behaviors.

AIMS

We aimed to examine the association between the age of first sexual intercourse and the experience of STIs among adolescents. Additionally, in which specific time period would more likely to get infected from sexual intercourse.

METHODS

We used data from the 2007-2013 Korea Youth Risk Behavior Web-based Survey. Only adolescents with sexual intercourse experience (N = 22,381) were included, and multiple logistic regression analysis was performed.

MAIN OUTCOME MEASURES

One dichotomized measure and one continuous measure were assessed: (i) STIs experience (defined as having had STIs); and (ii) association between STIs experience and absolute age gap (defined as temporal differences between secondary sexual character emergence age and first sexual intercourse age).

RESULTS

Approximately 7.4% of boys and 7.5% of girls reported had STI. For both boys and girls, the chance of experiencing STIs increased as the age of first sexual intercourse decreased (boys: before elementary school [age 7 or under]: odds ratio [OR] = 10.81, first grade [age 7 or 8]: OR = 4.44, second grade [age 8 or 9]: OR = 8.90, fourth grade [age 10 or 11]: OR = 7.20, ninth grade [age 15 or 16]: OR = 2.31; girls: before elementary school: OR = 18.09, first grade: OR = 7.26, second grade: OR = 7.12, fourth grade: OR = 8.93, ninth grade: OR = 2.74). The association between the absolute age gap and STI experience was examined additionally (boys: OR = 0.93, girls: OR = 0.87).

CONCLUSIONS

This study shows that earlier initiation of sexual intercourse increases the odds of experiencing STIs. Also as the age gap gets shorter, the odds of experiencing STIs increase. Our study suggests that it is important to consider the time period of first sexual intercourse and to reinforce a monitoring system along with the development of other preventive strategies.

Awareness of cervical cancer prevention among mothers of adolescent daughters in Korea: qualitative research

OBJECTIVES

Korean adolescent girls are unprepared for cervical cancer prevention due to the lack of a mandatory policy regarding human papilloma virus (HPV) vaccination and school health education regarding cervical cancer. The aim of this study was to determine how aware mothers are about cervical cancer prevention in their adolescent daughters, with a view to developing strategies for expanding primary cervical cancer prevention for adolescent girls through the mothers' involvement.

DESIGN

A qualitative design was employed. Nine mothers with adolescent daughters participated in this study and were interviewed using open-ended questions. The themes were extracted by content analysis.

SETTING

A general living area in Seoul, South Korea.

PARTICIPANTS

The snowball method was used to select mothers.

RESULTS

Five themes emerged. In general, the mothers' awareness of cervical cancer was not clear, and they exhibited a lack of awareness of the importance of having a regular Papanicolaou screening test. The mothers recognised that they were role models for their daughters, and realised and accepted the necessity of educating their daughters regarding cervical cancer; however, they perceived barriers related to the prevention of cervical cancer in their daughters. The mothers recommended enforcing sex education in schools and the provision of financial support for HPV vaccination.

CONCLUSIONS

The mothers' awareness and preparedness with respect to the prevention of cervical cancer in their adolescent daughters were low and inadequate. Mothers should be informed and motivated to play a role in the education of their daughters regarding cervical cancer prevention. Strategies for disseminating information regarding early cervical cancer prevention for adolescent girls are recommended by communicating with both the girls and their mothers and providing them with education regarding cervical cancer prevention.

[Development of reproductive health program and identification of effect for married women immigrants]

PURPOSE

This study was done to develop a reproductive health program to improve reproductive health of women immigrants.

METHODS

The participants in the study were 58 immigrant women who lived in Vietnam, China, Philippines, or Cambodia before marriage. They were assigned to the experiment group (n=29) or the control group (n=29). The reproductive health program for this study consisted of reproductive health education, health counseling, phone monitoring, and emotional support based on Cox (1982)'s Interaction Model of Client Health Behavior and was implemented for four weeks.

RESULTS

There were significant differences in reproductive health knowledge (t=9.78, p<.001), reproductive health attitude (t=6.59, p<.001), and reproductive health behavior (t=5.11, p<.001) within and between groups after the reproductive health program. But there were no significant differences in clinical indicators between the two groups.

CONCLUSION

The results of this study indicate the that reproductive health program for the women immigrants is effective in terms of reproductive health knowledge, reproductive health attitude and reproductive health behaviors. Therefore, nurses in public and private facilities, such as multicultural centers and public health centers in each community, should develop strategies to expand and provide reproductive health programs for women immigrants.

Awareness of human papillomavirus and factors associated with intention to obtain HPV vaccination among Korean youth: quasi experimental study

BACKGROUND

This study aimed to determine the awareness among fifth-grade girls and boys of sexually transmitted diseases (STDs), cancer, and human papillomavirus (HPV), and to determine the factors associated with intention to obtain the HPV vaccination.

METHODS

A quasi experimental design was employed with Korean fifth-grade students as the subjects for this study (n=117). Prior to providing HPV education, the awareness and health beliefs regarding STDs and cancer prevention were assessed according to gender. After 2 hours of HPV education, gender comparisons were made with respect to the awareness and health beliefs, HPV knowledge, and intention to obtain the HPV vaccination, and the factors associated with that intention.

RESULTS

Prior to the 2hours education session, only two boys knew that HPV is a virus. There were significant gender differences with respect to responses to the statements "STD is preventable" (χ(2)=8.76, p=0.013) and "cancer is preventable" (χ(2)=6.37, p=0.041), and concerns about the pain associated with vaccine injection (z=-2.44, p=0.015). After HPV education, there were no significant gender differences in HPV knowledge and intention to obtain the HPV vaccination. Awareness that "HPV vaccine can prevent cervical cancer" was significantly related to intention to obtain the HPV vaccine among both boys and girls.

CONCLUSIONS

Increased HPV knowledge could positively influence the intention to obtain the HPV vaccination among youth. Thus, HPV education at elementary school would be helpful to make students aware of HPV and the importance of HPV prevention.

Awareness of Pap testing and factors associated with intent to undergo Pap testing by level of sexual experience in unmarried university students in Korea: results from an online survey

BACKGROUND

Young and unmarried women have not been a target group for cervical cancer prevention in Korea. No previous studies have investigated the awareness of Pap testing, the intention to undergo Pap testing, or the factors associated with that intention, in this group of women. This information would be useful for an expansion in the focus of primary cervical cancer prevention. This study aimed to compare the awareness of Pap testing between groups of unmarried university students in Korea, and to investigate the factors associated with the intention to undergo Pap testing, by level of sexual experience.

METHODS

A total of 475 unmarried university students who had never undergone a Pap test completed a web-based survey. Differences in awareness of the importance of the Pap test, confidence in Pap testing, intention to undergo the test, attitudes, subjective norms, perceived control, stigma, and shame by level of sexual experience were analysed using independent t-tests. Associations between measurement variables and intention to undergo Pap testing were analysed using correlation analysis. Variables yielding significant associations (p < 0.05) were included in a stepwise multiple regression model of intention to undergo Pap testing.

RESULTS

Most participants perceived that the need for regular Pap testing was less important (score, 77.76) than other methods of cervical cancer prevention. They were not confident that is was an effective method of cervical cancer prevention for themselves (score, 59.56). There were differences in confidence in Pap testing and in the factors associated with intention to undergo Pap testing between sexually experienced and sexually inexperienced students. Regardless of level of sexual experience, the subjective norm was the most important predictor of intention to undergo Pap testing.

CONCLUSIONS

There was a low level of Pap screening awareness among the students. The factors associated with intention to undergo Pap testing differed by level of sexual experience. Social influence was an important factor that could be used to increase the intention to receive a Pap test in the university student population. Strategies to increase the intention to undergo Pap screening should be introduced and should be adapted to the level of sexual experience.

Development of an educational program to prevent cervical cancer among immigrants in Korea

BACKGROUND

This study developed and measured the effects of a cervical cancer prevention program for married women immigrants.

MATERIALS AND METHODS

A nonequivalent control group pre-test/post-test design was used with a group of married women immigrants registered at the multi-cultural center in the city of "J. " Data on for 30 participants in the intervention group and 27 participants in the control group (N=57) were used for analysis. The intervention group attended a 4-session cervical cancer prevention program.

RESULTS

The knowledge of the intervention and control groups about cervical cancer post-intervention was significantly different (F=12.55, p<0.001). The perceived susceptibility score before and after the experiment, for the intervention group, and 29.4 and 28 for the control group, was significantly different (t=2.063, p=0.043). After the program, cancer prevention behavior was significantly different in the intervention group (t=2.646, p=0.010).

CONCLUSIONS

The results obtained in this study indicate that the cervical cancer preventive program was effective in increasing cervical cancer knowledge, perceived susceptibility, and cancer prevention behavior.

Knowledge Level of Human Papillomavirus, Cervical Cancer and Vaccination Status among Mothers with Daughters in High School

PURPOSE

The goal of this study was to examine knowledge level of human papillomavirus (HPV), cervical cancer, and vaccination status among Korean mothers' with a daughter in high school.

METHODS

A cross-sectional descriptive study was conducted with a convenience sample of 234 Korean mothers.

RESULTS

The mean score of HPV knowledge level was 4.21 out of 20, and cervical cancer knowledge was 3.88 out of 7. There were low levels of daughters' who received HPV vaccination (3.8%) and high levels of mothers' intention to get their daughters' vaccinated with HPV (85.0%). The major barrier to HPV vaccination was the concern for side effect from the vaccination. The most effective recommendation for HPV vaccination came from health care providers.

CONCLUSION

HPV educational programs targeting mothers of daughters in high school is needed. Future studies need to determine actual HPV vaccination rates and factors related to high uptake using a larger sample from various socioeconomic background.

Evaluation of Korean Version of the Beliefs about Papanicolau Test and Cervical Cancer in Unmarried University Students

PURPOSE

This study was conducted to evaluate Korean version of the beliefs about Papanicolau (Pap) test and cervical cancer [CPC-28] in unmarried university students.

METHODS

The Korean version of CPC-28 (K-CPC-28) was developed through forward-backward translation techniques. A reliability, confirmatory factor analysis and correlations coefficients were evaluated. Data were collected from 303 unmarried female students attending university using a questionnaire that included28 items of CPC, 5 items of susceptibility of cervicalcancer and 8 items of HPV knowledge.

RESULTS

K-CPC-28 had reliable internal consistency with Cronbach's alpha=.74 of six subscales ranged from .66 to .80. Factor loadings of the 28 items of subscales ranged from .31 to .86. Six factors in this study explained 55% of the total variance. In convergent validity of the K-CPC-28, the subscales of K-CPC-28 were significantly correlated with susceptibility scale of cervical cancer and HPV knowledge scale.

CONCLUSION

K-CPC-28has satisfactory construct validity and reliability. It seems to be an acceptable tool to assess the attitudes toward cervical cancer prevention and Pap smear in unmarried women. This tool would be also applicable to screen the risk group in cervical cancer prevention and to identify its association with actual Pap test or cervical cancer prevention behaviors.

Knowledge about human papillomavirus (HPV), and health beliefs and intention to recommend HPV vaccination for girls and boys among Korean health teachers

The human papillomavirus (HPV) vaccination rate in Korea is very low because a school-based HPV vaccination program has not yet been introduced. This study was designed to assess HPV knowledge, compare the health beliefs toward HPV vaccination and intention to recommend HPV vaccination for girls and boys, and identify the factors influencing the intention to recommend HPV vaccination for girls and boys among Korean health teachers. A descriptive cross-sectional study design was employed, in which 757 health teachers who worked at elementary, middle, high, and special schools in Korea participated via an online survey. A self-administered, structured questionnaire was applied, which included items on sociodemographics, HPV awareness, HPV knowledge, perceived benefits, susceptibility, severity, and barriers toward HPV vaccination for girls and boys, and intention to recommend HPV vaccination for girls and boys. The rate of correct HPV knowledge items ranged from 5.2% to 89.2%; 23.4% of the health teachers answered that they had ever taught about HPV, 97% answered that both boys and girls should receive HPV vaccination, and 47.6% answered that the best time for HPV vaccination is when students are at middle school. There were differences regarding the perceived benefits (Z=-7.69, p<0.001), perceived susceptibility (Z=-3.37, p=0.001), perceived severity (Z=-4.13, p<0.001), and perceived barriers (Z=-4.90, p<0.001) toward HPV vaccination, and regarding intention to recommend HPV vaccination (Z=-15.21, p<0.001) for girls and boys. Factors associated with the intention to recommend HPV vaccination for girls were the HPV vaccination status of the health teachers' children [odds ratio (OR)=4.24, 95% confidence interval (95% CI)=1.14-15.72], and the teachers' Pap-test experience (OR=2.50, 95% CI=1.05-5.91), perceived benefits (OR=3.30, 95% CI=1.26-7.40), perceived susceptibility (OR=3.25, 95% CI=1.58-6.68), and perceived barriers (OR=0.51, 95% CI=0.30-0.99); these factors for boys were the health teachers' career duration (OR=1.61, 95% CI=1.12-2.32), HPV knowledge (OR=1.45, 95% CI=1.01-2.09), perceived benefits (OR=3.46, 95% CI=2.27-5.26), perceived susceptibility (OR=1.55, 95% CI=1.04-2.29), and perceived severity (OR=1.71, 95% CI=1.15-2.56). General awareness of HPV should be increased and more specific information about HPV-including that related to vaccination of boys and men-should be provided for health teachers. Although a school-based HPV vaccine program has yet to be introduced in Korea, health teachers should possess general knowledge about HPV and HPV vaccination, and differences in attitudes and intentions related to HPV vaccination between girls and boys should be reduced.

Predictors of Human Papillomavirus Vaccination in Female University Students

PURPOSE

The purpose of this study was to identify predictors of HPV (Human papillomavirus) vaccination among female university students.

METHODS

The participants in this study were 1,486 female university students. Data were collected using self-administered questionnaire from september 1, 2010 to June 30, 2011. Data were analysed using descriptive statistics, t-test, chi2-test and logistic regression.

RESULTS

The rate of HPV vaccination was 7.2%. Factors that influence HPV vaccination included residential region, smoking experience, family history of cervical cancer, experience having heard about the HPV vaccination, awareness that HPV is a sexual disease, HPV knowledge, perceived seriousness, perceived benefit and perceived barrier in health beliefs.

CONCLUSION

The results suggest a need to increase HPV vaccination campaigns to increase awareness of HPV vaccination. University and health care facilities should provide health education emphasizing perceived seriousness and perceived benefits. Also, the national health insurance corporation should consider addressing cost issues as a barrier to HPV vaccination.

Comparison of Factors Associated with Intention to Receive Human Papillomavirus Vaccine Between Male and Female Undergraduate Students

PURPOSE

This study was done to identify and compare factors associated with intention to receive Human Papillomavirus (HPV) vaccine between male and female undergraduate students.

METHODS

In the fall of 2010, 479 students responded to self-administered questionnaires about their intention to receive HPV vaccine, HPV knowledges, HPV related involvements and optimistic bias, subject's characteristics including opinion about HPV vaccine. Mann-Whitney U test, uni-variate and multi-variate logistic regression were used for data analysis with SPSS/WIN.

RESULTS

Intention to receive vaccine were 22.0% of men and 25.0% of women. There were significantly different in HPV knowledge (Z=-2.74, p=.006), optimistic bias (Z=-4.60, p<.001), vaccine is necessary for women (Z=-4,30, p<.001), vaccine is necessary for men (Z=-4.37, p<.001), vaccine is necessary if only symptom exist (Z=-4.52, p<.001), but there were not different in intention to receive vaccine, involvement between men and women. Concern about vaccine safety (OR=3.19, 95% CI 1.63~6.23) was determinant of intention to receive HPV vaccine for men.

CONCLUSION

This study showed gender differences in HPV knowledge, HPV related optimistic bias and opinion about HPV vaccine, which would be assessed and well managed in tailored HPV education for enhancing HPV vaccine acceptance.

Factors Influencing Mothers' Acceptance of Human Papillomavirus Vaccination to Prevent Cervical Cancer in their Daughters

PURPOSE

This study was done to examine mothers' acceptance and its influencing factors in daughters' human papillomavirus (HPV) vaccination to prevent cervical cancer.

METHODS

From July 20 to August 31, 2010, 220 mothers of unmarried daughters responded to self-administered questionnaires about their acceptance of HPV vaccination for their daughters and the optimal age for HPV vaccination. Descriptive statistics, univariate logistic and multiple logistic regression were used for data analysis with SPSS/WIN 12.0.

RESULTS

Mothers indicating their willingness to pay for their daughters to receive HPV vaccination accounted for 61.8%, and willingness with health insurance coverage, 84.5%. Mean optimal age for HPV vaccination was 19.78+/-3.96) years. With self-payment the factor influencing mothers willingness was necessity of HPV vaccination (OR=30.45, 95% CI=10.33~89.15). With health insurance coverage, income (OR=3.02, 95% CI: 1.19~7.62), necessity of HPV vaccination (OR=15.05, 95% CI=4.15~54.64), concern about HPV vaccine safety (OR=2.99, 95% CI=1.15~7.76), and experience of Pap test (OR=3.16, 95% CI=1.24~8.05) were factors influencing mothers willingness. Other influencing factors were optimal age for HPV vaccination, knowing about HPV (OR=7.66, 95% CI=2.19~26.82), and age of youngest daughter (OR=3.95, 95% CI=1.34~11.68).

CONCLUSION

Financial support is anticipated for low income families in a primary approach to increase HPV vaccination. And focusing on earlier age and concerns about vaccination are necessary to gain mothers' acceptance.