Associations of Maternal Age, Education, and Marital Status with HPV Vaccine Uptake and Hesitancy among United States Youth: A Cross-Sectional Analysis of the 2020 National Immunization Survey

STUDY OBJECTIVE

Human papillomavirus (HPV) vaccination is proven to reduce the risk of HPV-associated cancers and lesions. Factors associated with HPV vaccine receipt or rejection have been studied, but specific maternal characteristics driving uptake among teens requires further investigation. The aim of this study was to examine maternal characteristics influencing teen vaccine uptake and intent to vaccinate.

STUDY DESIGN

Cross-sectional analysis METHODS: We analyzed data on 27,320 teens aged 13-17 using the 2020 National Immunization Survey-Teen. We constructed regression models to determine the associations, via relative risk, between child vaccination status and maternal characteristics.

RESULTS

Compared with mothers with less education, those with a college degree were significantly more likely to have their children receive HPV vaccination (RR = 1.18; 95% CI, 1.11-1.26). Compared to mothers under 35 years, those aged 35-44 (RR 1.07; 95% CI 1.01-1.14) and over 45 (RR = 1.13; 95% CI, 1.07-1.21) were more likely to provide HPV vaccination to their child. Among children not previously vaccinated (n = 12,098; N = 5,752,355), educated mothers were significantly less likely to report intent to vaccinate their child in the next year. There was no significant difference in vaccination rates in mothers who were married compared with never married (RR = 0.99; 95% CI, 0.97-1.02).

CONCLUSION

Maternal education was the strongest predictor of teens receiving the HPV vaccine. Among mothers with teens not previously vaccinated, intent to obtain the HPV vaccine for their child was higher among mothers with less education compared with college-level educated mothers. Understanding maternal characteristics driving HPV vaccine hesitancy can inform targeted approaches to improve vaccine uptake in children. Additionally, adequate and consistent health messaging on the safety, efficacy, and benefits of HPV vaccination from health providers and public health agencies could increase uptake among adolescents and teens of vaccine-hesitant mothers.

Exploring Physiological Linkage in Same-Sex Male Couples

We explore physiological linkage (i.e., covariation of physiological channels between interacting partners; PL) among 34 same-sex male couples. Interbeat interval, an indicator of cardiovascular arousal, was collected across four conversational contexts in the lab: (1) a baseline period that did not involve conversation, (2) a conversation about body image, (3) a conversation about health goals, and (4) a recovery period that allowed for unstructured conversation. We used a newly developed R statistical package (i.e., rties; Butler and Barnard, 2019) that simplifies the use of dynamic models for investigating interpersonal emotional processes. We identified two different PL patterns: (1) a simple one that was characterized by stable synchronization and low frequency of oscillation; and (2) a complex one that was characterized by drifting synchronization, high frequency of oscillation, and eventual damping. Guided by social baseline theory and the reactive flexibility perspective, we explored the interactions between couple relationship functioning (i.e., love, conflict, commitment, sexual satisfaction, and relationship length) and conversational context as predictors of the PL patterns. The results suggest that partners in well-functioning relationships and emotionally challenging situations may be especially likely to show complex PL patterns that may reflect (or support) coregulatory processes.

A cross-country examination of emotional eating, restrained eating and intuitive eating: Measurement Invariance across eight countries

This study examined the measurement invariance of three scales that assessed emotional eating, restrained eating, and intuitive eating across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States) in order to determine their suitability for cross-country body image research. A total of 6272 young adults took part in this study. Participants completed an online survey including the Emotional Eating subscale of the Three Factor Eating Questionnaire-Revised 21, the Restraint subscale of the Eating Disorder Examination Questionnaire, and the Reliance on Hunger and Satiety Cues subscale of The Intuitive Eating Scale-2. Multi-group confirmatory factor analysis was used to evaluate potential cross-country differences in functioning of the measures. Partial invariance for all three scales was found, with only minor levels of non-invariance identified. Multiple indicator multiple cause models identified BMI and gender as potential influences on scores for these measures. Sources of invariance across groups are discussed, as well as implications for further substantive research across countries involving these measures.

Development and testing of a model for risk and protective factors for eating disorders and higher weight among emerging adults: A study protocol

Research has demonstrated that eating disorders (ED) and higher weight have lifetime co-occurrence suggesting that they may be best considered within a common etiological model. Although we know that body dissatisfaction is likely to be a risk factor for both outcomes, other proposed risk and protective factors for each condition have not been adequately explored. The current paper tests a conceptual model that is based on a review of the existing literature from both areas of scholarship. It considers biological, sociocultural, psychological, and behavioral factors that may contribute to both outcomes. The model will be tested in a longitudinal design with an initial sample of 600 emerging adults (aged 18-30) per country in nine different countries (total sample = 5400 participants). Questionnaires will be completed online on two occasions, 12 months apart. The first full phase of the study commenced in July 2018, the same time Body Image was approached to publish this protocol paper (the final revised paper was submitted in September 2019), and data collection will be finalized in December 2019. Multi-group path analysis will identify the biopsychosocial predictors - both cross-sectionally and longitudinally - of both ED and higher weight, and how these vary across countries and gender.

Using Behavioral Mapping to Examine the Validity of the IPIP-IPC

Behavioral mapping, a method designed to relate behaviors to circumplex models, was used to examine the predictive validity of the International Personality Item Pool–Interpersonal Circumplex (IPIP-IPC). In this study, 96 participants first completed the IPIP-IPC and then were videotaped in a social interaction with a confederate. At the conclusion of this interaction, the Riverside Behavioral Q-Sort was used to code 64 different behaviors expressed by the participants. Results indicated that participants’ Riverside Behavioral Q-Sort interpersonal behaviors occurred in a manner predicted by their IPIP-IPC scores. Such findings suggest that the IPIP-IPC can predict a multitude of interpersonal behaviors expressed during a dyadic interaction.

Romantic partners, weight status, and weight concerns: an examination using the actor-partner interdependence model

In this study, romantic partners' weight status and weight concerns were examined using the Actor-Partner Interdependence Model. One hundred and four heterosexual couples' (N = 208 participants) weight and height were assessed by researchers to compute body mass index and participants' weight concerns were assessed. As expected, results indicated that participants' weight concerns were associated with their weight status. Further, men and women who were relatively heavy and who had relatively thin romantic partners were most likely to express weight concerns. These findings extend our understanding of romantic partners' relevance to individuals' weight management and weight concerns.

Matching in sexual experience for married, cohabitating, and dating couples

The present study examined heterosexual romantic partners' number of intercourse partners prior to the initiation of their relationship to determine if a significant positive correlation (matching) occurred between partners, and if this matching was associated with their level of love, satisfaction with, and commitment to the relationship. One hundred and six couples who were dating, cohabitating, or married participated in this study. Results indicated that, with the exception of cohabitating couples, romantic partners showed a significant level of matching in the prior number of intercourse partners. Further, among the married couples, a higher discrepancy between men's and women's number of previous intercourse partners was related to lower levels of love, satisfaction, and commitment in the relationship.

An electron microscopic study of the effects of portacaval shunts on the ultrastructure of the rat liver after partial hepatectomy

The normally quiescent stable adult liver has a generous capacity for reparative hypertrophy and hyperplasia after loss of functional tissue. The large reserve of the liver's functional capacity permits survival of the animal even if over 70 per cent of its liver is removed. It retains an inherent capacity for regenerative growth which subsides once the original organ deficit is restored. This study attempted to resolve the question of whether alteration in hepatic hemodynamics affects the regenerative stimulus of the liver after partial (70 per cent) hepatectomy. It has shown that the liver remnant regenerates after reduction of portal blood flow by construction of a portacaval anastomosis. The diversion of blood from the liver exerts its own histologic and electron microscopic effects on the liver. Reduction of portal blood flow affects the temporal patterns of regeneration after partial hepatectomy but does not prevent completion of the regenerative process. Correlation of this study with the biochemical data available in the literature indicates that the structural changes in the cellular organelles during the process of regeneration reflect dynamic biochemical events that are based on a predetermined genetic code representing the key to life that is uniquely found in the liver.