1
|
Yim VWC, Wang Q, Li Y, Qin C, Tang W, Tang S, Jit M, Smith JS, Larson HJ, Tucker JD, Li J, Lin L, Wu D. Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China. BMC Public Health 2024; 24:183. [PMID: 38225563 PMCID: PMC10790461 DOI: 10.1186/s12889-024-17697-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Adolescent girls in China have a low HPV vaccination rate. Although vaccination is recommended by the Chinese health authorities, the cost is not covered by the national immunisation programme. Vaccination delay, among other reasons such as supply shortage and poor affordability, may contribute to low uptake. This sequential mixed methods study aimed to identify potential factors of delayed HPV vaccination among Chinese adolescent girls. METHODS Quantitative data about the attitudes and perceptions of HPV vaccination were collected from 100 caregivers of 14-18-year-old girls using an online survey in Chengdu, China. The survey data informed a subsequent qualitative study using four focus group discussions. We conducted a descriptive analysis of the survey data and a thematic analysis of the qualitative data. The findings were interpreted using a health behaviour model adapted from the Health Belief Model and the Andersen's Behavioural Model for Health Services Use. RESULTS A total of 100 caregivers - 85 were mothers and 15 were fathers - participated in the survey; 21 caregivers joined focus group discussions. When asked about their intended course of action if the 9vHPV vaccine was out-of-stock, 74% chose to delay until the 9vHPV vaccine is available while 26% would consider 2vHPV or 4vHPV vaccines or seek alternative ways to procure the vaccine. Qualitative results confirmed that caregivers preferred delaying HPV vaccination for adolescent girls. The intent to delay was influenced by systemic barriers such as supply shortage and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, inadequate health communication, and the belief that adolescents were unlikely to be sexually active. CONCLUSION In urban areas, Chinese caregivers' intent to delay vaccination in favour of 9vHPV vaccine over receiving the more accessible options was influenced by a mix of individual and contextual factors. Focussed health communication strategies are needed to accelerate HPV vaccination among adolescents.
Collapse
Affiliation(s)
| | - Qianyun Wang
- Department of Social Welfare, University of California, Los Angeles, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Yifan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuanyun Qin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Weiming Tang
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Shenglan Tang
- Global Health Research Centre, Duke Kunshan University, Jiangsu, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, GB, UK
| | - Jennifer S Smith
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Joseph D Tucker
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London, WC1E 7HT, UK
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Dan Wu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
- Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue, Nanjing Jiangsu, China.
| |
Collapse
|
2
|
Bustamante G, Liebermann E, McNair K, Fontenot HB. Women's perceptions and preferences for cervical cancer screening in light of updated guidelines. J Am Assoc Nurse Pract 2023; 35:699-707. [PMID: 37498967 DOI: 10.1097/jxx.0000000000000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/13/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Updated risk-based guidelines for cervical cancer screening (CCS) allow for individualized screening that minimizes unnecessary testing. However, these guidelines are complex and may not be easily understandable to patients. PURPOSE To describe women's perceptions and preferences about CCS in light of recent guideline changes. METHODOLOGY This qualitative study conducted in February 2020 used online, text-based focus groups with a sample of US women ( n = 49) ages 27-45. After participants completed a short demographic survey, an experienced moderator used a semistructured guide to solicit participants' perceptions of routine gynecologic care and CCS. We summarized survey data using descriptive statistics. Two authors analyzed transcripts using conventional content analysis and met with other team members to resolve discrepancies and determine final themes. RESULTS Most participants were non-Hispanic White (65%), had health insurance (90%), and reported having a routine gynecologic examination in the past year (70%). We identified four common themes: (1) low perceived risk of human papillomavirus (HPV) coupled with low knowledge about HPV as a causative factor for cervical cancer, (2) confusion about-and mistrust of-recent individual risk-based guidelines that determine the indicated timing and type of CCS test (Pap or HPV testing), (3) mixed opinions about performing a self-swab for HPV testing, and (4) conflicting perceptions of trust toward providers and the health care industry. CONCLUSIONS Findings highlight women's uncertainty and hesitancy about updated CCS guidelines. IMPLICATIONS Provider-patient communication strategies should consider women's gaps in knowledge about HPV, include the rationale for guidelines and types of tests, and build trust between patients and providers.
Collapse
Affiliation(s)
- Gabriela Bustamante
- Instituto de Medicina Social & Desafíos Globales, School of Public Health, Universidad San Francisco de Quito, Quito, Ecuador. Dr. Bustamante is previously at the Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Erica Liebermann
- College of Nursing, University of Rhode Island, Providence, Rhode Island
| | - Katelyn McNair
- Beth Israel Deaconess Lahey Health Breast Center, Plymouth, Massachusetts. Dr. McNair is previously at the Boston College, Connell School of Nursing, Chestnut Hill, Massachusetts
| | - Holly B Fontenot
- School of Nursing, University of Hawaii, Honolulu, Hawaii. Dr. Fontenot is previously at the Boston College, Connell School of Nursing, Chestnut Hill, Massachusetts
| |
Collapse
|
3
|
Asare M, Agyei-Baffour P, Koranteng A, Commeh ME, Fosu ES, Elizondo A, Sturdivant RX. Assessing the Efficacy of the 3R (Reframe, Reprioritize, and Reform) Communication Model to Increase HPV Vaccinations Acceptance in Ghana: Community-Based Intervention. Vaccines (Basel) 2023; 11:890. [PMID: 37242995 PMCID: PMC10223469 DOI: 10.3390/vaccines11050890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
The study examined whether the 3R (reframe, prioritize, and reform) communication model intervention can impact parents' and adolescents' HPV vaccination acceptability. We used face-to-face methods to recruit participants from three local churches in the Ashanti Region of Ghana. Participants completed pre- and post-intervention assessments based on the validated Theory of Planned Behavior survey. We organized two face-to-face presentations for parents and adolescents separately for parents (n = 85) and adolescents (n = 85). Participants' post-intervention vs. pre-intervention scores for attitude (mean = 35.46 ± SD = 5.46 vs. mean = 23.42 ± SD = 8.63), knowledge (M = 28.48 ± SD = 5.14 vs. M = 16.56 ± SD = 7.19), confidence (M = 8.96 ± SD = 3.43 vs. M = 6.17 ± SD = 2.84), and intention for vaccine acceptance (M = 4.73 ± SD = 1.78 vs. M = 3.29 ± SD = 1.87) increased significantly (p < 0.001). The intervention showed that for every one-unit increase in the participants' self-confidence and attitude scores, the odds of the HPV vaccination acceptability increased by 22% (95% CI: 10-36) and 6% (95% CI: 0.1-12), respectively. Intention for vaccine acceptance, F (1167) = 6.89, and attitude toward vaccination, F (1167) = 19.87, were significantly higher among parents than adolescents (p < 0.001), after controlling for the baseline scores. These findings suggest that the intervention targeting parents' and adolescents' attitudes and knowledge has the potential to increase HPV vaccination acceptance in Ghana.
Collapse
Affiliation(s)
- Matthew Asare
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA;
| | - Peter Agyei-Baffour
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi P.O. Box UPO-1279, Ghana; (P.A.-B.); (A.K.)
| | - Adofo Koranteng
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi P.O. Box UPO-1279, Ghana; (P.A.-B.); (A.K.)
| | - Mary E. Commeh
- Non-Communicable Disease Control, Ghana Health Services, Accra P.O. Box MB-582, Ghana;
| | - Emmanuel Sarfo Fosu
- Department of Statistical Science, College of Arts & Sciences, Baylor University, Waco, TX 76798, USA; (E.S.F.); (R.X.S.)
| | - Anjelica Elizondo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA;
| | - Rodney X. Sturdivant
- Department of Statistical Science, College of Arts & Sciences, Baylor University, Waco, TX 76798, USA; (E.S.F.); (R.X.S.)
| |
Collapse
|
4
|
Dwyer AA, Uveges M, Dockray S, Smith N. Advancing qualitative rare disease research methodology: a comparison of virtual and in-person focus group formats. Orphanet J Rare Dis 2022; 17:354. [PMID: 36089593 PMCID: PMC9465872 DOI: 10.1186/s13023-022-02522-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Rare disease research is hampered in part by the fact that patients are geographically dispersed. Rare disease patient communities are recognized for their use of the internet to learn about their condition and find peer-to-peer support. As such, web-based technologies offer promise for overcoming geographic barriers in rare disease research for many. Qualitative focus groups (FGs) are a widely used methodology used to understand patients and parents/families ‘lived experience’ and unmet needs is important to improve care for rare diseases. It is unclear if web-enabled (virtual) FGs are comparable to traditional in-person approaches. We conducted in-person (n = 3) and virtual (n = 3) FGs with rare disease patients to determine if virtual FGs produce similar results in-person FGs.
Results
Three in-person (n = 33 participants) and three virtual (n = 25 participants) FGs were conducted examining attitudes and beliefs regarding genetic testing and family communication of risk. Participants included 30 males, 18 females, and 10 parents/guardians. Two independent investigators identified excerpts (meaningful sections of text) and coded themes/sub-themes using a codebook. Inter-coder agreement across identified excerpts (n = 530) in both FG formats was 844/875 (96.5%). Two additional investigators reviewed coded excerpts and did not identify additional themes/sub-themes—supporting data saturation across FG formats. Virtual FGs accounted for 303/530 (57.2%) of total excerpts and 957/1721 (55.7%) of all identified themes/sub-themes. Formats were similar in terms of overall number of excerpts (101 ± 7.8 vs. 75.7 ± 18.8, p = 0.26) and themes/sub-themes (319 ± 6.1 vs. 254.7 ± 103.6, p = 0.34) between virtual and in-person FGs. However, virtual FGs had significantly more coded excerpts specifically relating to sensitive/intimate topics including ‘attitudes and beliefs’ (n = 320 vs. n = 235, p < 0.001), ‘information and support’ (n = 184 vs. n = 99, p < 0.001), and ‘family communication’ (n = 208 vs. n = 114, p < 0.001).
Conclusions
Virtual FGs yielded similar numbers of coded excerpts compared to traditional in-person FGs. Virtual FGs appear to support the relative anonymity of participants, resulting in richer discussion of highly sensitive, intimate topics. Findings support the validity and methodologic rigor of using web-enabled technologies for conducting FGs in rare diseases.
Collapse
|
5
|
Becker ER, Shegog R, Savas LS, Frost EL, Healy CM, Spinner SW, Vernon SW. Informing Content and Feature Design of a Parent-Focused Human Papillomavirus Vaccination Digital Behavior Change Intervention: Synchronous Text-Based Focus Group Study. JMIR Form Res 2021; 5:e28846. [PMID: 34806991 PMCID: PMC8663705 DOI: 10.2196/28846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/25/2021] [Accepted: 09/18/2021] [Indexed: 01/09/2023] Open
Abstract
Background Human papillomavirus (HPV) is a common and preventable sexually transmitted infection; however, vaccination rates in the United States among the target age group, which is 11-12 years, are lower than national goals. Interventions that address the barriers to and facilitators of vaccination are important for improving HPV vaccination rates. Web-based, text-based focus groups are becoming a promising method that may be well suited for conducting formative research to inform the design of digital behavior change intervention (DBCI) content and features that address HPV vaccination decision-making. Objective This study aims to explore parental HPV vaccination decision-making processes using a web-based, text-based focus group protocol to inform content and feature recommendations for an HPV prevention DBCI. Methods We conducted 4 web-based, text-based synchronous focus groups via Skype with the parents of patients aged 11-13 years within a large urban US pediatric clinic network. Results The 22 parents were mostly female, White, non-Hispanic college graduates, and they mostly had private health insurance for their children. Approximately half (14/25, 56%) of the parents' 11-13 year old children had initiated HPV vaccination. Most parents had experience using Skype (19/22, 86%). Approximately half (8/17, 47%) of parents expressed no preference for the focus group format, whereas 47% (8/17) requested a text-only chat format and 6% (1/17) requested an audiovisual format. The three main themes from the qualitative data were barriers to HPV vaccination, facilitators of HPV vaccination, and suggestions for improving the HPV vaccination clinic experience. A total of 11 intervention content and feature recommendations emerged from the themes, including addressing HPV knowledge barriers using trusted sources, designing for a family audience, focusing on the framing of messages, reporting reputable HPV research in a comprehensible format, and expanding the clinic visit experience. Conclusions Synchronous text-based focus groups are feasible for conducting formative research on HPV vaccination decision-making. Among well-educated and well-resourced parents, there are barriers such as misinformation and facilitators such as pediatrician recommendations that influence HPV vaccination decision-making. Parents want to conduct their own HPV research as well as receive relevant HPV vaccination advice from their child’s pediatrician. In addition, parents want an enhanced clinic visit experience that lets them access and connect to tailored information before and after clinic visits. The results gathered provide guidance for content and features that may inform a more responsive DBCI to address HPV vaccination decision-making among parents.
Collapse
Affiliation(s)
- Elisabeth Rb Becker
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Ross Shegog
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Lara S Savas
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Erica L Frost
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - C Mary Healy
- Baylor College of Medicine, Houston, TX, United States
| | | | - Sally W Vernon
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| |
Collapse
|
6
|
Sitaresmi MN, Rozanti NM, Simangunsong LB, Wahab A. Improvement of Parent's awareness, knowledge, perception, and acceptability of human papillomavirus vaccination after a structured-educational intervention. BMC Public Health 2020; 20:1836. [PMID: 33256697 PMCID: PMC7708115 DOI: 10.1186/s12889-020-09962-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/23/2020] [Indexed: 11/20/2022] Open
Abstract
Background Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11–13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability. Methods We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. Results A total of 506 parents participated. Before receiving the structured-educational intervention, parents’ awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p < 0.001). HPV vaccine’s acceptability increased from 74.3 to 87.4% (p < 0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r = 0.32 to 0.53, p < 0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine’s acceptability with OR 1.90 (95%CI:1.40–2.57) and OR 1.31(95%CI,1.05–1.63), respectively. Conclusions A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability.
Collapse
Affiliation(s)
- Mei Neni Sitaresmi
- Department of Pediatrics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ DR. Sardjito Hospital, Jalan Gejayan CT X no 18 Pelemkecut, Yogyakarta, 55281, Indonesia.
| | - Nisrina Maulida Rozanti
- School of Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lamria Besty Simangunsong
- Department of Pediatrics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ DR. Sardjito Hospital, Jalan Gejayan CT X no 18 Pelemkecut, Yogyakarta, 55281, Indonesia
| | - Abdul Wahab
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
7
|
Quinn DA, Lewin A. Family factors associated with emerging adults' human papillomavirus vaccine behavior. J Am Coll Health 2020; 68:528-535. [PMID: 30908148 DOI: 10.1080/07448481.2019.1583240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/23/2019] [Accepted: 02/07/2019] [Indexed: 06/09/2023]
Abstract
Objective: The current study examined the role of family influences on the vaccine behavior of emerging adults. Participants: In Spring 2017, we conducted anonymous online surveys of undergraduate students (n = 608) at a large, public university in the mid-Atlantic. Methods: Logistic regression was used to examine associations between family factors and students' awareness of the HPV vaccine, vaccine receipt, and vaccine intentions. Family factors included sex communication, religiosity, parental monitoring, family structure, and parents' birthplace. Results: More comprehensive family sex communication is associated with less uncertainty regarding HPV vaccine receipt and greater likelihood of being already vaccinated. More frequent family religiosity and more parental monitoring are associated with greater likelihood of having decided against vaccination rather than already being vaccinated. Significant gender and racial disparities exist. Conclusion: Further research, policy, and programmatic intervention are needed to reduce disparities and to improve emerging adults' compliance with HPV vaccine recommendations.
Collapse
Affiliation(s)
- Deirdre A Quinn
- Center for Health Equity Research & Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Amy Lewin
- Department of Family Science, University of Maryland School of Public Health, College Park, MD, USA
| |
Collapse
|
8
|
Lin Y, Su Z, Chen F, Zhao Q, Zimet GD, Alias H, He S, Hu Z, Wong LP. Chinese mothers' intention to vaccinate daughters against human papillomavirus (HPV), and their vaccine preferences: a study in Fujian Province. Hum Vaccin Immunother 2020; 17:304-315. [PMID: 32401617 DOI: 10.1080/21645515.2020.1756152] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 01/13/2023] Open
Abstract
Little is known regarding Chinese mothers' intention to vaccinate their daughters against human papillomavirus (HPV) since the HPV vaccine was approved for use in China in 2016. The aim was to explore maternal HPV vaccination acceptance, preference for 2-, 4- or 9-valent HPV vaccine and acceptance of domestically manufactured HPV vaccines. Study participants were mothers of primary school children in Southeastern region of Fujian. An online cross-sectional survey was undertaken between June and August 2019. Among the total of 3,586 completed responses (response rate 28.5%), the intention to vaccinate daughter against HPV was high (83.3%). Higher maternal education and perceived benefit and barriers were associated with greater intention to vaccinate. Among mothers who did not intend to vaccinate their daughters, the three most common reasons were daughter being too young to receive HPV vaccination (40.6%), fear of side effects (31.9%) and vaccine price is too high (16.0%). The largest proportion (41.4%) preferred their daughter to be vaccinated with the 9-valent HPV vaccine (9vHPV). Greater preference for 9vHPVwas strongly associated with higher maternal education level and annual household income. The majority of mothers expressed a preference for imported HPV vaccine (56.3%). Our result indicates that lower intentions to vaccinate daughters against HPV among less educated and lower-income mothers may lead to significant social inequalities in HPV vaccine uptake in the country.
Collapse
Affiliation(s)
- Yulan Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University , Fuzhou, Fujian Province, China.,Department of Nutrition, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Zhitai Su
- Yongding Health Inspection Bureau , Longyan City, Fujian Province, China
| | - Fulian Chen
- Longyan Health Inspection Bureau , Longyan City, Fujian Province, China
| | - Qinjian Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University , Xiamen, Fujian, PR China
| | - Gregory D Zimet
- Department of Pediatrics, School of Medicine, Indiana University , Indianapolis, IN, USA
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Shuqiong He
- Prenatal Diagnosis Center, Fujian Provincial Maternity andChildren's Hospital of Fujian Medical University , Fuzhou, Fujian Province, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University , Fuzhou, Fujian Province, China
| | - Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| |
Collapse
|
9
|
Teitelman AM, Gregory EF, Jayasinghe J, Wermers Z, Koo JH, Morone JF, Leri DC, Davis A, Feemster KA. Vaccipack, A Mobile App to Promote Human Papillomavirus Vaccine Uptake Among Adolescents Aged 11 to 14 Years: Development and Usability Study. JMIR Nurs 2020; 3:e19503. [PMID: 34345789 PMCID: PMC8279454 DOI: 10.2196/19503] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/31/2020] [Accepted: 09/28/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND More than 90% of human papillomavirus (HPV)-related cancers could be prevented by widespread uptake of the HPV vaccine, yet vaccine use in the United States falls short of public health goals. OBJECTIVE The purpose of this study was to describe the development, acceptability, and intention to use the mobile app Vaccipack, which was designed to promote uptake and completion of the adolescent HPV vaccine series. METHODS Development of the mobile health (mHealth) content was based on the integrated behavioral model (IBM). The technology acceptance model (TAM) was used to guide the app usability evaluation. App design utilized an iterative process involving providers and potential users who were parents and adolescents. App features include a vaccine-tracking function, a discussion forum, and stories with embedded messages to promote intention to vaccinate. Parents and adolescents completed surveys before and after introducing the app in a pediatric primary care setting with low HPV vaccination rates. RESULTS Surveys were completed by 54 participants (20 adolescents aged 11 to 14 years and 34 parents). Notably, 75% (15/20) of adolescents and 88% (30/34) of parents intended to use the app in the next 2 weeks. Acceptability of the app was high among both groups: 88% (30/34) of parents and 75% (15/20) of adolescents indicated that Vaccipack was easy to use, and 82% (28/34) of parents and 85% (17/20) of adolescents perceived the app to be beneficial. Higher levels of app acceptability were found among parents with strong intentions to use the app (P=.09; 95% CI -2.15 to 0.15). CONCLUSIONS mHealth technology, such as Vaccipack, may be an acceptable and nimble platform for providing information to parents and adolescents and advancing the uptake of important vaccines.
Collapse
Affiliation(s)
- Anne M Teitelman
- University of Pennsylvania School of Nursing Philadelphia, PA United States
| | - Emily F Gregory
- Children's Hospital of Philadelphia Philadelphia, PA United States
- Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
| | - Joshua Jayasinghe
- University of Pennsylvania School of Nursing Philadelphia, PA United States
| | | | - Ja H Koo
- University of Pennsylvania School of Nursing Philadelphia, PA United States
| | - Jennifer F Morone
- Yale University New Haven, CT United States
- Veterans Affairs West Haven, CT United States
| | - Damien C Leri
- Big Yellow Star, Inc. Philadelphia, PA United States
| | - Annet Davis
- University of Pennsylvania School of Nursing Philadelphia, PA United States
| | - Kristen A Feemster
- Children's Hospital of Philadelphia Philadelphia, PA United States
- Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Division of Disease Control Department of Public Health Philadelphia, PA United States
| |
Collapse
|
10
|
Gidengil C, Chen C, Parker AM, Nowak S, Matthews L. Beliefs around childhood vaccines in the United States: A systematic review. Vaccine 2019; 37:6793-802. [PMID: 31562000 DOI: 10.1016/j.vaccine.2019.08.068] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/30/2019] [Accepted: 08/26/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND While childhood vaccines are safe and effective, some parents remain hesitant to vaccinate their children, which has led to outbreaks of vaccine preventable diseases. The goal of this systematic review was to identify and summarize the range of beliefs around childhood vaccines elicited using open-ended questions, which are better suited for discovering beliefs compared to closed-ended questions. METHODS PubMed, Embase, and PsycINFO were searched using keywords for childhood vaccines, decision makers, beliefs, and attitudes to identify studies that collected primary data using a variety of open-ended questions regarding routine childhood vaccine beliefs in the United States. Study designs, population characteristics, vaccine types, and vaccine beliefs were abstracted. We conducted a qualitative analysis to conceptualize beliefs into themes and generated descriptive statistics. RESULTS Of 1727 studies identified, 71 were included, focusing largely on parents (including in general, and those who were vaccine hesitant or at risk of hesitancy). Seven themes emerged: Adverse effects was most prominent, followed by mistrust, perceived lack of necessity, pro-vaccine opinions, skepticism about effectiveness, desire for autonomy, and morality concerns. The most commonly described beliefs included that vaccines can cause illnesses; a child's immune system can be overwhelmed if receiving too many vaccines at once; vaccines contain harmful ingredients; younger children are more susceptible to vaccine adverse events; the purpose of vaccines is profit-making; and naturally developed immunity is better than that acquired from vaccines. Nearly a third of the studies exclusively assessed minority populations, and more than half of the studies examined beliefs only regarding HPV vaccine. CONCLUSIONS Few studies used open-ended questions to elicit beliefs about vaccines. Many of the studies that did so, focused on HPV vaccine. Concerns about vaccine safety were the most commonly stated beliefs about childhood vaccines, likely because studies were designed to capture barriers and challenges to vaccination.
Collapse
|
11
|
Suryadevara M, Bonville CA, Cibula DA, Domachowske JB. Cancer Prevention Education for Providers, Staff, Parents, and Teens Improves Adolescent Human Papillomavirus Immunization Rates. J Pediatr 2019; 205:145-152.e2. [PMID: 30314663 DOI: 10.1016/j.jpeds.2018.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To develop a program to educate providers, office staff, patients, and parents on life-long cancer prevention strategies, including the use of human papillomavirus (HPV) vaccine to improve adolescent HPV vaccination rates. STUDY DESIGN A 2-phase program was implemented at 6 pediatric practices across upstate New York. Phase 1 included provider and staff education regarding practice-specific vaccination challenges and discussion of the contents of a study-specific cancer-prevention booklet, which included HPV vaccine information. Throughout phase 2, the booklets were distributed to all adolescents and their parents during office visits over a 12-month period. Practice-specific, countywide, and statewide HPV vaccination rates were assessed before phase 1, and 6 and 12 months after the launch of phase 2. RESULTS One year after implementing phase 2 in 6 practices, adolescent HPV vaccine series initiation increased by at least 10% in 3 practices, and at least 5% in 5 practices. Similarly, adolescent vaccine series completion rates increased by more than 10% in 3 practices. The percent change in vaccine series completion rates across all study sites postintervention ranged from 12% to 20% for 11- to 12-year-olds, and from 7% to 23% for 13- to 18-year-olds. CONCLUSIONS Cancer prevention education targeting providers, office staff, patients, and parents was modestly effective for improving adolescent HPV vaccination rates.
Collapse
Affiliation(s)
- Manika Suryadevara
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY.
| | | | - Donald A Cibula
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY
| | | |
Collapse
|
12
|
Fontenot HB, Rosenberger JG, McNair KT, Mayer KH, Zimet G. Perspectives and preferences for a mobile health tool designed to facilitate HPV vaccination among young men who have sex with men. Hum Vaccin Immunother 2019; 15:1815-1823. [PMID: 30625049 DOI: 10.1080/21645515.2019.1568156] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
We sought to understand young men who have sex with men (YMSM) perspectives and preferred features for a mobile health (mHealth) tool designed to facilitate human papillomavirus (HPV) vaccination. YMSM were recruited on a popular social/sexual networking app to participate in online focus groups. Discussions were designed to elicit what the men would want in a mHealth tool specific for sexual health and HPV. Demographic data were analyzed using descriptive statistics and focus group data were analyzed using conventional content analysis. Forty-eight YMSM participated. Mean age was 23.4 years, and 70.0% reported their race as Black. Qualitative themes included general HPV knowledge and awareness, current patterns in technology use, desired app qualities, and desired app content. Youth described varying levels of HPV knowledge, utilized apps to engage socially, and for travel, banking, gaming, news and entertainment, and few used apps to facilitate personal health or engage with healthcare systems. Participants desired credible, relatable, secure, and easy to use interfaces that provided sexual health and HPV information in a positive context. They described ways to creatively engage and directly connect youth to health providers. We identified a culturally relevant youth driven approach to facilitate HPV vaccination and sexual health among YMSM.
Collapse
Affiliation(s)
- Holly B Fontenot
- a Connell School of Nursing, Boston College , Chestnut Hill , MA , USA.,b Fenway Health/The Fenway Institute , Boston , MA , USA
| | - Joshua G Rosenberger
- c Department of Behavioral Health, Penn State University , University Park , PA , USA
| | - Katelyn T McNair
- a Connell School of Nursing, Boston College , Chestnut Hill , MA , USA
| | - Kenneth H Mayer
- b Fenway Health/The Fenway Institute , Boston , MA , USA.,d Beth Israel Deaconess Medical Center, Department of Medicine, Boston MA/Harvard Medical School , Boston , MA , USA
| | - Gregory Zimet
- e Section of Adolescent Medicine, Indiana University School of Medicine , Indianapolis , IN , USA
| |
Collapse
|
13
|
McNair KT, Fontenot HB. Understanding the Two-Dose HPV Vaccine Schedule. Nurs Womens Health 2018; 22:175-180. [PMID: 29628056 DOI: 10.1016/j.nwh.2018.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/10/2018] [Indexed: 06/08/2023]
Abstract
Recent advances in human papillomavirus (HPV) science have led to updates to national HPV vaccine recommendations. This column takes a second look at two recent studies that provide evidence to support the current two-dose HPV vaccination schedule for youth ages 9 to 14 years. This short review will help nurses and other clinicians understand the health and economic benefits of the current dosing recommendation. Nurses are leaders in national vaccination efforts; therefore, it is vital that they remain up to date on the latest evidence that supports vaccination practice as well as health counseling and HPV vaccine recommendations.
Collapse
|
14
|
Takamatsu R, Nabandith V, Pholsena V, Mounthisone P, Nakasone K, Ohtake K, Yoshimi N. Cervical cytology and human papillomavirus among asymptomatic healthy volunteers in Vientiane, Lao PDR. BMC Cancer 2017; 17:872. [PMID: 29258466 PMCID: PMC5738160 DOI: 10.1186/s12885-017-3900-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 12/08/2017] [Indexed: 12/03/2022] Open
Abstract
Background Cervical cancer is the most common cancer in women living in Vientiane, Lao People’s Democratic Republic (PDR). This study examines cervical cytology using a liquid-based cytology (LBC) method and reports the presence of high-risk (HR) human papillomavirus (HPV). Methods We collected cervical samples from 1475 asymptomatic and healthy volunteers from six hospitals in Lao PDR. A total of 1422 volunteers (mean age 39.1 ± 6.4 years, range 30-54 years) were included in the final analysis. We performed HPV typing using the polymerase chain reaction technique to detect HR-HPV samples with abnormal cytology. Results The overall rates of abnormal cytology and HR-HPV–positive in the samples were 9.3% (132/1422) and 47.7% (63/132), respectively. The samples with abnormal cytology included 13 high-grade squamous intraepithelial lesions and one squamous cell carcinoma case. The results showed that the most common type of HPV was HPV16 (20.5%) followed by HPV58 (9.1%). Conclusions Healthy women in Vientiane, the capital of Lao PDR, have high rates of abnormal cervical cytology and are likely to be HR-HPV-positive. A system for detection and prevention of cervical cancer in these women should be developed in the near future. Electronic supplementary material The online version of this article (10.1186/s12885-017-3900-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Reika Takamatsu
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan.
| | - Viengvansay Nabandith
- Setthathirath Hospital, Donekoi Village, Sisatthanak District, P.O.Box 527, Vientiane, Lao PDR
| | - Vatsana Pholsena
- Setthathirath Hospital, Donekoi Village, Sisatthanak District, P.O.Box 527, Vientiane, Lao PDR
| | - Phouthasone Mounthisone
- Mittaphab Hospital, Phonsavang Village, Chanthabouly District, P.O.Box 6035, Vientiane, Lao PDR
| | - Katsu Nakasone
- Department of Pathology, Ryukyu University Hospital, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Kentarou Ohtake
- Clinical Laboratory, Medical Examination Center of Chubu Medical Association, 1-584 Miyagi, Chatan-cho, Nakagami-gun, Okinawa, 904-0113, Japan
| | - Naoki Yoshimi
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
| |
Collapse
|
15
|
Kornides ML, Calo WA, Heisler-MacKinnon JA, Gilkey MB. U.S. Primary Care Clinics' Experiences During Introduction of the 9-Valent HPV Vaccine. J Community Health 2017; 43:291-296. [PMID: 28856551 DOI: 10.1007/s10900-017-0420-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/29/2023]
Abstract
Changes in the routine immunization schedule are common and may pose challenges to primary care clinics. We sought to assess the experiences of U.S. providers and clinic staff during the introduction of 9-valent HPV vaccine. In 2015-2016, we conducted a survey in a probability sample of 127 pediatric (40%) and family medicine (60%) clinics in three U.S. states. The 211 respondents included clinicians (63%) and staff (37%). Overall, 83% of clinics stocked 9-valent HPV vaccine, with adoption ranging from 60% among early respondents to 100% among later respondents. Almost all respondents believed that providers in their clinics would recommend the 9-valent vaccine as strongly as (66%) or more strongly than (33%) the quadrivalent vaccine. Over half (61%) had no concerns about the 9-valent vaccine, while others reported concerns about increased parental hesitancy (29%), private insurance coverage (17%), or other issues (10%). Respondents from pediatric versus family medicine clinics more often reported a concern (OR = 2.06, 95% CI 1.02-4.15). Among the 169 respondents who stocked 9-valent vaccine, about half (56%, n = 94) anticipated that providers in their clinics would recommend a "booster" dose of 9-valent HPV vaccine for adolescents who had completed the 3-dose series with prior versions. Among the 42 respondents who did not stock 9-valent vaccine, few (17%, n = 7) believed providers would recommend adolescents delay vaccination until it was available. In conclusion, providers and staff generally had positive views of 9-valent HPV vaccine and many had no concerns. For others, responses regarding parental hesitancy, insurance coverage, and the use of booster doses suggests opportunities for enhancing future educational support.
Collapse
Affiliation(s)
- Melanie L Kornides
- Department of Population Medicine, Center for Healthcare Research in Pediatrics (CHeRP), Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, USA.
| | - William A Calo
- Department of Public Health Sciences and Penn State Cancer Institute, Penn State College of Medicine, Hershey, PA, USA
| | - Jennifer A Heisler-MacKinnon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
16
|
Westrick SC, Hohmann LA, McFarland SJ, Teeter BS, White KK, Hastings TJ. Parental acceptance of human papillomavirus vaccinations and community pharmacies as vaccination settings: A qualitative study in Alabama. Papillomavirus Res 2016; 3:24-29. [PMID: 28720453 PMCID: PMC5883249 DOI: 10.1016/j.pvr.2016.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/10/2016] [Accepted: 12/21/2016] [Indexed: 11/19/2022]
Abstract
Purpose To determine parents’ knowledge and attitudes regarding human papillomavirus (HPV) vaccinations in their adolescent children and to describe parents’ perceptions of adolescent vaccinations in community pharmacies. Methods In-depth interviews were completed with parents or guardians of children ages 11–17 years from Alabama's Lee and Macon counties. One-hour long, open-ended telephonic or in-person interviews were conducted until the saturation point was reached. Using ATLAS.ti software and thematic analysis, interview transcripts were coded to identify themes. Results Twenty-six parents were interviewed, most of whom were female (80.8%) and white (50%). A total of 12 themes were identified. First, two themes emerged regarding elements facilitating children's HPV vaccination, the most common being positive perception of the HPV vaccine. Second, elements hindering children's vaccination contained seven themes, the top one being lack of correct or complete information about the HPV vaccine. The last topic involved acceptance/rejection of community pharmacies as vaccination settings, and the most frequently cited theme was concern about pharmacists’ clinical training. Conclusions Physician-to-parent vaccine education is important, and assurances of adequate pharmacy immunization training will ease parents’ fears and allow pharmacists to better serve adolescents, especially those who do not see physicians regularly. Physicians play a crucial role in parents’ HPV vaccination decisions. Parents are reluctant to use pharmacists as HPV vaccine providers. Parents are concerned about pharmacists’ training and pharmacy infrastructure. Community pharmacists must work in conjunction with physicians.
Collapse
Affiliation(s)
- Salisa C Westrick
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| | - Lindsey A Hohmann
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| | - Stuart J McFarland
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| | - Benjamin S Teeter
- University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA.
| | - Kara K White
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| | - Tessa J Hastings
- Health Outcomes Research and Policy, Harrison School of Pharmacy Auburn University, 020 James E. Foy Hall, Aub urn University, AL 36849, USA.
| |
Collapse
|
17
|
Forster AS, Waller J. Taking stock and looking ahead: Behavioural science lessons for implementing the nonavalent human papillomavirus vaccine. Eur J Cancer 2016; 62:96-102. [PMID: 27235782 PMCID: PMC4920641 DOI: 10.1016/j.ejca.2016.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/11/2016] [Accepted: 04/14/2016] [Indexed: 11/24/2022]
Abstract
The development and licensing of a nonavalent human papillomavirus (HPV) vaccine has the potential to reduce morbidity and mortality from HPV-related cancers beyond that of first generation HPV vaccines. However, this benefit can only be realised if the offer of vaccination is accepted. Uptake of first generation HPV vaccines is not complete and shows huge global variation. In addition to practical and financial challenges to optimising coverage, behavioural issues explain a large proportion of the variance in vaccine receipt. This commentary draws on the findings of over a decade of behavioural science research seeking to understand uptake of first generation HPV vaccines, in order to anticipate challenges to implement the nonavalent HPV vaccine. Challenges include distrust of combination vaccines, uncertainty about long-term efficacy, distrust of a new and (perceived to be) untested vaccine, cost and uncertainty regarding interchanging doses of first generation and nonavalent vaccines and the appropriateness of revaccination. We use behavioural science theory and existing evaluations of interventions to increase uptake of vaccines to identify evidence-based approaches that can be implemented by vaccine stakeholders to address parents' concerns and maximise uptake of the nonavalent HPV vaccine.
Collapse
Affiliation(s)
- Alice S Forster
- Health Behaviour Research Centre, UCL, Gower Street, London, WC1E 6BT, UK.
| | - Jo Waller
- Health Behaviour Research Centre, UCL, Gower Street, London, WC1E 6BT, UK
| |
Collapse
|
18
|
Kasting ML, Wilson S, Dixon BE, Downs SM, Kulkarni A, Zimet GD. A qualitative study of healthcare provider awareness and informational needs regarding the nine-valent HPV vaccine. Vaccine 2016; 34:1331-4. [PMID: 26859240 DOI: 10.1016/j.vaccine.2016.01.050] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 12/14/2022]
Abstract
The 9-valent Human Papillomavirus (HPV) vaccine, 9vHPV, was licensed in the U.S. in December, 2014. We assessed healthcare provider (HCP) awareness of the newly approved vaccine and identified questions HCPs have about the vaccine. As part of a larger study, we used semi-structured interviews to ask 22 pediatric HCPs about their awareness of 9vHPV, questions they have about the vaccine, and questions they anticipate from patients and parents. Interviews were audio-recorded and transcribed then analyzed using inductive content analysis. Over half were aware of the vaccine but few HCPs claimed to be familiar with it. HCPs indicated several questions with common themes pertaining to efficacy, side effects, and cost. Only half of HCPs believed patients or parents would have questions. The results suggest strategies and areas for health systems and public health organizations to target in order to resolve unmet educational needs among HCPs regarding 9vHPV.
Collapse
Affiliation(s)
- Monica L Kasting
- Indiana University Fairbanks School of Public Health, Department of Epidemiology, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202, USA.
| | - Shannon Wilson
- Indiana University School of Medicine, Department of Pediatrics, 410 W 10th Street Suite 1001, Indianapolis, IN 46202, USA.
| | - Brian E Dixon
- Indiana University Fairbanks School of Public Health, Department of Epidemiology, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St., Indianapolis, IN 46202, USA; Center for Health Information and Communication Department of Veterans Affairs Veterans Health Administration Health Services Research and Development Service, CIN 13-416 1481 W. 10th St, 11H, Indianapolis, IN 46202, USA.
| | - Stephen M Downs
- Indiana University School of Medicine, Department of Pediatrics, 410 W 10th Street Suite 1001, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St., Indianapolis, IN 46202, USA.
| | - Amit Kulkarni
- Merck & Co., 2000 Galloping Hill Road, Kenilworth, NJ 07033, USA.
| | - Gregory D Zimet
- Indiana University School of Medicine, Department of Pediatrics, 410 W 10th Street Suite 1001, Indianapolis, IN 46202, USA.
| |
Collapse
|