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Vamos CA, Puccio JA, Griner SB, Logan RG, Piepenbrink R, Richardson Cayama M, Lovett SM, Mahony H, Daley EM. Health literacy needs and preferences for a technology-based intervention to improve college students' sexual and reproductive health. J Am Coll Health 2024; 72:477-486. [PMID: 35298353 DOI: 10.1080/07448481.2022.2040517] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 01/13/2022] [Accepted: 02/06/2022] [Indexed: 06/14/2023]
Abstract
Objective: To explore health literacy needs and preferences for a technology-based intervention (app) to improve sexual and reproductive health (SRH) among college students. Participants: In Spring 2019, in-depth interviews were conducted with 20 participants (10 male, 10 female) from a large, public university. Methods: Interview guide was developed based on Integrated Model of Health Literacy domains and Diffusion of Innovation constructs. Data were analyzed in MaxQDA using applied thematic analysis. Results: Dominant themes included accessing health information and services, evaluating options to make decisions, intervention utility and characteristics, and the emergent theme of credibility. Specific topics included accessing STI testing, contraceptive decision making, information on human papillomavirus (HPV) and the HPV vaccine, patient-provider communication, app design and function elements, and modifying the app to meet the SRH needs of diverse college students. Conclusions: Findings identified areas where an app could address college students' SRH literacy, ultimately improving SRH outcomes among this population.
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Affiliation(s)
- Cheryl A Vamos
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Joseph A Puccio
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Stacey B Griner
- University of North Texas Health Science Center at Fort Worth, School of Public Health, Fort Worth, TX, USA
| | | | | | | | - Sharonda M Lovett
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Helen Mahony
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Ellen M Daley
- University of South Florida, College of Public Health, Tampa, FL, USA
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Garg A, Galvin AM, Griner SB, Rosberger Z, Daley EM, Thompson EL. HPV self-sampling among women in the United States: preferences for implementation. Cancer Causes Control 2024; 35:167-176. [PMID: 37633857 DOI: 10.1007/s10552-023-01778-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/09/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE With the inclusion of primary HPV testing in 2018 U.S. Preventive Services Taskforce guidelines, at-home HPV self-sampling may provide a future option for cervical cancer screening, especially among hard-to-reach populations in the U.S. This study evaluated the association of implementation preferences with the willingness of at-home HPV self-sampling. METHODS We conducted a cross-sectional study in 2018 among U.S. women ages 30-65 years, without a hysterectomy (n = 812). The outcome was willingness to have at-home HPV self-sampling (yes/no). Primary predictor variables (i.e., information source, methods of payment, methods of sending or receiving self-sampling kits) measured self-sampling implementation preferences. Adjusted logistic regression identified associations with willingness to have at-home HPV self-sampling. RESULTS Participants who preferred receiving information from healthcare providers (OR = 2.64; 95% CI 1.54,4.52) or from media or other sources (OR = 2.30; 95% CI 1.51,3.48) had higher HPV self-sampling willingness than participants who did not prefer those sources. Participants who did not want to pay for self-sampling (OR = 0.21; 95% CI 0.14,0.32) or did not know if they would pay for self-sampling (OR = 0.35; 95% CI 0.22,0.54) had lower odds of HPV self-sampling willingness compared to participants willing to pay. Participants who did not know which method they preferred for receiving a self-sampling kit (OR = 0.15, 95% CI 0.07,0.31) or preferred delivering the sample to the lab themselves (OR = 0.59; 95% CI 0.36,0.96) had lower odds for self-sampling willingness compared to participants who preferred the mail. CONCLUSION Understanding the preferences of women regarding the implementation of HPV self-sampling can improve uptake in cervical cancer screening, especially among hard-to-reach populations.
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Affiliation(s)
- Ashvita Garg
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Annalynn M Galvin
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Stacey B Griner
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Zeev Rosberger
- Department of Oncology, Psychiatry and Psychology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika L Thompson
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
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Vamos CA, Cayama MR, Mahony H, Griner SB, Quinonez RB, Boggess K, Beckstead J, Daley EM. Oral health during pregnancy: an analysis of interprofessional guideline awareness and practice behaviors among prenatal and oral health providers. BMC Pregnancy Childbirth 2023; 23:721. [PMID: 37821843 PMCID: PMC10566079 DOI: 10.1186/s12884-023-06032-3] [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: 07/02/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Poor oral health during pregnancy has significant implications across the life course, including increased risk for adverse pregnancy, birth outcomes, and the development of early childhood caries. In efforts to improve perinatal oral health in the United States, a set of national interprofessional guidelines were developed that include recommended practice behaviors for both oral health providers and prenatal providers. The purpose of this study was to examine guideline awareness, familiarity, beliefs, and practice behaviors among both provider types. METHODS Prenatal providers and oral health providers in Florida were recruited via random and convenience sampling to complete an online survey guided by the Consolidated Framework for Implementation Research (CFIR) and the Cabana Framework. The present analysis focused on the Individuals Involved domain (CFIR), awareness and familiarity with the guidelines (Cabana Framework), confidence, and practice behaviors as recommended by prenatal oral health guidelines (assess, advise, refer, share/coordinate). Data were analyzed using chi-square tests, independent samples t-tests, Pearson correlation coefficients, and one-way analysis of variance (ANOVA) and analyses were conducted in SPSS. RESULTS Prenatal and oral health providers did not differ significantly in their awareness of the guidelines, but awareness was significantly associated with three of the four practice behaviors for prenatal providers. Familiarity with the guidelines was significantly higher among oral health providers and was associated with all four practice behaviors for both provider types. Five out of ten oral health belief items were significantly associated with practicing the guidelines among prenatal providers, but only two among oral health providers. Confidence in performing the practice behaviors was significantly associated with guideline implementation among both groups. Years in practice was significantly associated with performing practice behaviors for prenatal providers, but not for oral health providers. CONCLUSIONS Our findings highlight the importance of professional organizations and the role of clinical guidelines on practice behaviors. Although provider education is a key implementation strategy, organizational and policy-level system changes could also be critical in supporting practice behaviors.
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Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA.
| | - Morgan Richardson Cayama
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
| | - Helen Mahony
- College of Social Sciences and Public Policy, Florida State University, 113 Collegiate Loop, Tallahassee, FL, 32304, USA
| | - Stacey B Griner
- School of Public Health, The University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd Fort Worth, Fort Worth, TX, 76107, USA
| | - Rocio B Quinonez
- Division of Pediatric Dentistry and Public Health, Department of Pediatrics, Schools of Dentistry and Medicine, University of North Carolina at Chapel Hill, 385 S. Columbia St., Chapel Hill, NC, 27599, USA
| | - Kim Boggess
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, 3009 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599, USA
| | - Jason Beckstead
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
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Vamos CA, Salinas-Miranda AA, Daley EM, Kirby RS, Liller KD, Marshall J, Sappenfield WM, Wilson RE, Petersen DJ. MCH Leadership Training Program: An Innovative Application of an Implementation Science Framework. Matern Child Health J 2023; 27:597-610. [PMID: 36828973 PMCID: PMC9955516 DOI: 10.1007/s10995-023-03607-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2023] [Indexed: 02/26/2023]
Abstract
INTRODUCTION MCH training programs in schools of public health provide specialized training to develop culturally competent and skilled MCH leaders who will play key roles in public health infrastructure. Previous literature has reported on the effectiveness of MCH training programs (e.g., number of trainees, improvement in knowledge/skills); less attention has been devoted to understanding factors influencing program implementation during times of rapid change, while considering internal and external contexts (e.g., global pandemic, social unrest, uncertainty of funding, mental health issues, and other crises). PURPOSE This article describes a graduate-level MCH leadership training program and illustrates how an implementation science framework can inform the identification of determinants and lessons learned during one year of implementation of a multi-year program. ASSESSMENT Findings reveal how CFIR can be applicable to a MCH training program and highlight how constructs across domains can interact and represent determinants that serve as both a barrier and facilitator. Key lessons learned included the value of accountability, flexibility, learner-centeredness, and partnerships. CONCLUSION Findings may apply to other programs and settings and could advance innovative training efforts that necessitate attention to the multi-level stakeholder needs (e.g., student, program, institution, community, and local/regional/national levels). Applying CFIR could be useful when interpreting process and outcome evaluation data and transferring findings and lessons learned to other organizations and settings. Integrating implementation science specifically into MCH training programs could contribute to the rigor, adaptability, and dissemination efforts that are critical when learning and sharing best practices to expand leadership capacity efforts that aim to eliminate MCH disparities across systems.
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Affiliation(s)
- Cheryl A Vamos
- USF's Center of Excellence in MCH Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, USA.
| | - Abraham A Salinas-Miranda
- USF's Center of Excellence in MCH Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
- The Harrell Center for the Study of Family Violence, College of Public Health, University of South Florida, Tampa, USA
| | - Ellen M Daley
- USF's Center of Excellence in MCH Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Russell S Kirby
- USF's Center of Excellence in MCH Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Karen D Liller
- USF's Center of Excellence in MCH Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
- Activist Lab, College of Public Health, University of South Florida, Tampa, USA
| | - Jennifer Marshall
- USF's Center of Excellence in MCH Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
- Sunshine Education and Research Center, College of Public Health, University of South Florida, Tampa, USA
| | - William M Sappenfield
- USF's Center of Excellence in MCH Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
- Florida Perinatal Quality Collaborative, College of Public Health, University of South Florida, Tampa, USA
| | - Roneé E Wilson
- USF's Center of Excellence in MCH Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Donna J Petersen
- USF's Center of Excellence in MCH Education, Science & Practice, College of Public Health, University of South Florida, Tampa, USA
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Griner SB, Beckstead JW, Vamos CA, Puccio JA, Perrin K, Daley EM. Characteristics associated with the adoption of consumer-based -self-sampling methods for sexually transmitted infection screening. J Am Coll Health 2023:1-8. [PMID: 36701488 DOI: 10.1080/07448481.2022.2162823] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 09/22/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Objective: To identify theory-based innovation characteristics associated with the adoption of consumer-based self-sampling methods for sexually transmitted infection screening. Participants: Guided by the Diffusion of Innovation, survey data from people assigned female at birth (AFAB) (n = 92) were analyzed. Methods: Forward regression models and a path analysis were used to predict adoption by characteristics, using maximum likelihood estimation. Measures included acceptability, comfort, addresses healthcare needs, willingness to adopt self-sampling methods, and innovation characteristics. Results: Predictors of willingness to adopt were no clinic visit (relative advantage), convenient pick-up (relative advantage), and low cost. Variables with direct effects on adoption included: addresses healthcare needs, comfort, acceptability, and no clinic visit. Conclusions: Relative advantage was a salient factor and prioritizing this construct in intervention development may facilitate adoption. Results can guide the development of an innovative, theory-based intervention that promotes adoption of self-sampling methods, ultimately improving STI screening rates.
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Affiliation(s)
- Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Jason W Beckstead
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Joseph A Puccio
- Division of Adolescent Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
- University of South Florida Student Health Services, Tampa, Florida, USA
| | - Kay Perrin
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, Florida, USA
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Tatar O, Haward B, Zhu P, Griffin-Mathieu G, Perez S, McBride E, Lofters AK, Smith LW, Mayrand MH, Daley EM, Brotherton JML, Zimet GD, Rosberger Z. Understanding the Challenges of HPV-Based Cervical Screening: Development and Validation of HPV Testing and Self-Sampling Attitudes and Beliefs Scales. Curr Oncol 2023; 30:1206-1219. [PMID: 36661742 PMCID: PMC9858121 DOI: 10.3390/curroncol30010093] [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: 12/09/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
The disrupted introduction of the HPV-based cervical screening program in several jurisdictions has demonstrated that the attitudes and beliefs of screening-eligible persons are critically implicated in the success of program implementation (including the use of self-sampling). As no up-to-date and validated measures exist measuring attitudes and beliefs towards HPV testing and self-sampling, this study aimed to develop and validate two scales measuring these factors. In October-November 2021, cervical screening-eligible Canadians participated in a web-based survey. In total, 44 items related to HPV testing and 13 items related to HPV self-sampling attitudes and beliefs were included in the survey. For both scales, the optimal number of factors was identified using Exploratory Factor Analysis (EFA) and parallel analysis. Item Response Theory (IRT) was applied within each factor to select items. Confirmatory Factor Analysis (CFA) was used to assess model fit. After data cleaning, 1027 responses were analyzed. The HPV Testing Attitudes and Beliefs Scale (HTABS) had four factors, and twenty-two items were retained after item reduction. The HPV Self-sampling Attitudes and Beliefs Scale (HSABS) had two factors and seven items were retained. CFA showed a good model fit for both final scales. The developed scales will be a valuable resource to examine attitudes and beliefs in anticipation of, and to evaluate, HPV test-based cervical screening.
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Affiliation(s)
- Ovidiu Tatar
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Research Center, Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC H2X 0A9, Canada
| | - Ben Haward
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Patricia Zhu
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Gabrielle Griffin-Mathieu
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Samara Perez
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Cedars Cancer Centre, McGill University Health Centre (MUHC), Montreal, QC H4A 3J1, Canada
- Department of Oncology, McGill University, Montreal, QC H4A 3T2, Canada
| | - Emily McBride
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Aisha K. Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Department of Family and Community Medicine, Women’s College Hospital, Toronto, ON M5S 1B3, Canada
| | | | - Marie-Hélène Mayrand
- Research Center, Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC H2X 0A9, Canada
- Département d’Obstétrique-Gynécologie, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Ellen M. Daley
- College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Julia M. L. Brotherton
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VI 3010, Australia
- Population Health, Australian Centre for the Prevention of Cervical Cancer, Melbourne, VI 3053, Australia
| | - Gregory D. Zimet
- School of Medicine, Indiana University, Indianapolis, IN 46202, USA
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Department of Oncology, McGill University, Montreal, QC H4A 3T2, Canada
- Department of Psychology, McGill University, Montreal, QC H3A 1G1, Canada
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Griner SB, Vamos CA, Phillips AC, Puccio JA, Thompson EL, Daley EM. Assessing college students' interest in university-based oral health information and services. J Am Coll Health 2023; 71:5-9. [PMID: 33577423 DOI: 10.1080/07448481.2021.1876706] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/18/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Objective: To assess US college students' (1) oral health behaviors and (2) interest in university-based oral health information and services. Participants: Students at a large public university in the southeast participated in the survey (n = 102). All participants were over the age of 18 and able to speak and read English. Methods:An online quantitative survey was administered to collect information on oral health behaviors, interest in university-based oral health information and services, and sociodemographic factors. Frequencies, descriptive statistics, and bivariate analyses were utilized for this study. Results: Approximately 11% of students rated their oral health as fair/poor and 27% currently had a dental problem. Over half (53%) were interested in receiving oral health information from the university, 87% felt campus-based dental services were important, and 79% were likely to use campus-based dental services. Conclusions: College students may benefit from information and services to promote oral health within the college context.
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Affiliation(s)
- Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Amelia C Phillips
- Director of Wellbeing, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Joseph A Puccio
- Division of Adolescent Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA
- Executive and Medical Director, University of South Florida Student Health Services, Tampa, FL, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
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Owens H, Beckstead J, Walker K, Thompson EL, Tomar SL, Griner S, Desch J, Daley EM. Dental patients' communication preferences for learning about HPV-related topics. Gen Dent 2023; 71:38-43. [PMID: 36592357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Oropharyngeal cancer (OPC) has the highest incidence of any cancer caused by human papillomavirus (HPV). Oral health providers are urged to support the use of the HPV vaccine, which was approved by the US Food and Drug Administration for the prevention of OPC in 2020. This study evaluated the preferences of dental patients regarding 11 modalities for learning about HPV-related topics from their oral health providers. An online survey was administered to US adults aged 18 to 45 years (n = 285) to assess their communication modality preferences, prior experience discussing HPV with oral health providers, and demographic characteristics. Multiple items were combined to obtain preference scores for each modality. Preference scores were compared using 2 × 3 mixed analysis of variance. Age, sex, income, and HPV vaccination status were assessed as potential confounders. One-on-one discussions were the most preferred modality for learning about HPV-related topics; however, the preference scores differed based on whether the patient had prior HPV-related discussions with oral health providers (partial η2 = 0.054). Patients who had prior discussions showed a weaker preference for one-on-one discussions than did patients who had not had prior discussions. Oral health providers are called on to promote HPV vaccination, which will require increasing communication on this subject with patients. To assure greater acceptance of their recommendations, providers will need to match their communication styles to those desired by their patients. As part of a comprehensive HPV prevention strategy that includes administration of the vaccine, oral health providers should be educated on how to confidently discuss HPV-related issues with their patients.
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Marhefka SL, Noble CA, Walsh-Buhi ER, Turner D, Mahony H, Singleton A, DeBate R, Daley EM. Key Considerations and Recommended Strategies for Conducting a School-Based Longitudinal RE-AIM Evaluation: Insights From a 28-School Cluster Randomized Trial. Health Promot Pract 2023; 24:160-171. [PMID: 34605711 DOI: 10.1177/15248399211042339] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
RE-AIM is an implementation science framework that provides a structure to promote data collection and analysis in the domains of Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance. The RE-AIM approach promotes more data collection and reporting than typical evaluations so potential adopters can determine the potential program fit for their setting. RE-AIM has been used to evaluate a variety of programs; however, there are few resources that provide strategies for conducting a RE-AIM evaluation in the school setting. The purpose of this article is to inform future studies by elucidating experiences conducting a large, complex, multisite, longitudinal RE-AIM evaluation in schools in partnership with the state's Departments of Education and Health, and to share strategies for overcoming obstacles. With the long-term goal of facilitating the translation of school-based intervention research into practice, we provide key considerations and recommend strategies for school-based RE-AIM evaluation success.
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Affiliation(s)
| | - Charlotte A Noble
- University of North Texas Health Science Center, Fort Worth, TX, USA
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10
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Logan RG, Vamos CA, Daley EM, Louis-Jacques A, Marhefka SL. Understanding young Black women's socialisation and perceptions of sexual and reproductive health. Cult Health Sex 2022; 24:1760-1774. [PMID: 34915810 DOI: 10.1080/13691058.2021.2014976] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
Although sexual and reproductive health inequities acutely and disproportionately affect Black women in the USA, there are few studies that consider the sociocultural context in which Black women transition to adulthood and develop their sexuality. The objective of this study was to describe the lived realities of young Black women to elucidate how the sociocultural context informs their current perceptions of sexual and reproductive health. We conducted phenomenological interviews with 22 Black women aged 18-29 years to elicit their life stories. The main categories identified in the findings include how the sociocultural environment informs the self-concept; how the sociocultural environment informs early learning about sexual health; and how together these experiences inform women's development of a sexual self-concept. Three main groupings of experiences were identified relative to women's sexual self-concept: fear-based disease and pregnancy prevention; a deeper understanding of bodies and sexuality beyond disease and pregnancy prevention; and sexual pleasure and fulfilment as a priority. To address ongoing sexual and reproductive health inequities that particularly disadvantage young Black women, health systems and interventions should address the sociocultural contexts in which young Black women develop and manage their sexual health.
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Affiliation(s)
- Rachel G Logan
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Adetola Louis-Jacques
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- College of Nursing, University of South Florida, Tampa, FL, USA
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11
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Vamos CA, Griner SB, Daley EM, Cayama MR, Beckstead J, Boggess K, Quinonez RB, Damschroder L. Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews. Implement Sci Commun 2022; 3:126. [PMID: 36443891 PMCID: PMC9703729 DOI: 10.1186/s43058-022-00363-6] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Pregnancy presents an opportune time for oral health promotion and intervention; however, implementation of the prenatal oral health guidelines remains a challenge among prenatal and oral health providers. The purpose of this study was twofold: To employ a theory-based approach to identify high-priority Consolidated Framework for Implementation Research (CFIR) constructs with the greatest potential to impact prenatal oral health guideline implementation, and to operationalize and pre-test survey items based on the prioritized CFIR constructs. Identifying barriers and facilitators to guideline implementation will inform the development of targeted interventions that address gaps in adherence which can positively impact oral-systemic health. METHODS The online survey development process employed three rounds of a modified-Delphi technique with prenatal (i.e., MD/DO, CNM) and oral health (i.e., DMD) Practice Advisory Board Members, cognitive interviews with prenatal and oral health providers, and deliberations among the research team and a Scientific Advisory Board (OBGYN, pediatric dentist, and researchers). High-impact CFIR constructs were identified and translated into survey items that were subsequently piloted and finalized. RESULTS During three modified-Delphi rounds, a total of 39 CFIR constructs were evaluated with final input and deliberations with the Practice Advisory Board, Scientific Advisory Board, and the research team achieving consensus on 19 constructs. The instrument was pre-tested with four prenatal and two oral health providers. Overall, participants reported that the survey items were feasible to respond to, took an appropriate length of time to complete, and were well-organized. Participants identified specific areas of improvement to clarify CFIR items. The final survey instrument included 21 CFIR items across four domains, with five constructs included from the intervention characteristics domain, two from the process domain, two from the outer setting domain, and 12 from the inner setting domain. CONCLUSIONS Lessons learned from the survey development process include the importance of soliciting diverse scientific and practice-based input, distinguishing between importance/impact and direction of impact (barrier/facilitator), and the need for additional qualitative methods during interdisciplinary collaborations. Overall, this study illustrated an iterative approach to identifying high-priority CFIR constructs that may influence the implementation of the prenatal oral health guidelines into practice settings.
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Affiliation(s)
- Cheryl A. Vamos
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Stacey B. Griner
- grid.266871.c0000 0000 9765 6057School of Public Health, The University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
| | - Ellen M. Daley
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Morgan Richardson Cayama
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Jason Beckstead
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Kim Boggess
- grid.10698.360000000122483208Department of Obstetrics and Gynecology, School of Medicine, University of North, Carolina at Chapel Hill, CB 7516, Chapel Hill, NC 27599 USA
| | - Rocio B. Quinonez
- grid.10698.360000000122483208Department of Pediatric Dentistry, Schools of Dentistry, Pediatrics and Public Health, University of North Carolina at Chapel Hill, CB 7450, Chapel Hill, NC 27599 USA
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Vamos CA, Kline N, Vázquez-Otero C, Lockhart EA, Lake PW, Wells KJ, Proctor S, Meade CD, Daley EM. Stakeholders' perspectives on system-level barriers to and facilitators of HPV vaccination among Hispanic migrant farmworkers. Ethn Health 2022; 27:1442-1464. [PMID: 33733962 DOI: 10.1080/13557858.2021.1887820] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 03/07/2020] [Accepted: 01/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Latinx populations suffer from a disproportionate burden of HPV-related cancers, yet vaccination completion rates nationally among this population remain low, with 46% of females and 35% of males completing the vaccine series. Given the heterogeneity of Latinx populations, sub-populations such as Latinx individuals who live in migrant farmworker communities experience additional system-level barriers to healthcare utilization. Thus, we examined stakeholder perceptions of barriers and facilitators to Human Papillomavirus (HPV) vaccination among Latinx migrant farmworkers. Such information is critical to informing intervention development targeting vaccination uptake and completion, ultimately decreasing HPV-related cancer disparities. DESIGN Guided by the PRECEDE-PROCEED model and the Social Ecological Model (SEM), interviews were conducted with diverse stakeholders (n = 13) representative of health, social services, and political sectors. Stakeholders were asked about their perceptions of barriers to and facilitators of HPV vaccination among migrant farmworkers. Interviews were audio-recorded, transcribed, and thematically analyzed. Responses were coded according to components of the SEM. RESULTS Micro-level facilitators identified included positive attitudes and vaccine acceptance among parents. Meso-level facilitators included availability of free or low-cost health care clinics, and macro-level facilitators included federal programs (e.g. Medicaid, Vaccine for Children). Micro-level barriers included lack of education and low health literacy. Meso-level barriers included poor patient-provider communication, lack of access (e.g. clinics not stocking/administering the vaccine; limited clinic hours; lack of reminder systems; insufficient organizational structure), public perceptions/attitudes towards HPV vaccination, and lack of healthcare service continuity due to migratory patterns. Macro-level barriers included public perceptions and attitudes towards HPV vaccination, transportation, vaccine availability and coverage for non-citizens, and lack of school entry policy. CONCLUSIONS Findings suggest that multi-level interventions should be developed to leverage existing facilitators while addressing system-level barriers, ultimately creating a supportive environment for HPV vaccine initiation and completion among this marginalized population comprised of individuals living in migrant farmworker communities.
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Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Nolan Kline
- Anthropology, Rollins College, Winter Park, FL, USA
| | - Coralia Vázquez-Otero
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health and Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Paige W Lake
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Kristi J Wells
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Sara Proctor
- Catholic Charities Diocese of St. Petersburg, Inc., Dover, FL, USA
| | - Cathy D Meade
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
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Griffin-Mathieu G, Haward B, Tatar O, Zhu P, Perez S, Shapiro GK, McBride E, Thompson EL, Smith LW, Lofters AK, Daley EM, Guichon JR, Waller J, Steben M, Decker KM, Mayrand MH, Brotherton JML, Ogilvie GS, Zimet GD, Norris T, Rosberger Z. Ensuring a successful transition from Pap to HPV-based primary cervical cancer screening in Canada by investigating the psychosocial correlates of women’s intentions: Protocol for an observational study (Preprint). JMIR Res Protoc 2022; 11:e38917. [PMID: 35708742 PMCID: PMC9247817 DOI: 10.2196/38917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 12/18/2022] Open
Abstract
Background Objective Methods Results Conclusions International Registered Report Identifier (IRRID)
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Affiliation(s)
- Gabrielle Griffin-Mathieu
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
| | - Ben Haward
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
- Research Center, Centre Hospitalier de l'Université de Montreal, Montreal, QC, Canada
| | - Patricia Zhu
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Samara Perez
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
- Cedars Cancer Center, McGill University Health Centre, Montreal, QC, Canada
- Department of Oncology, McGill University, Montreal, QC, Canada
- HPV Global Action, Montreal, QC, Canada
| | - Gilla K Shapiro
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Emily McBride
- Department of Behavioural Science & Health, University College London, London, United Kingdom
| | - Erika L Thompson
- Department of Biostatistics and Epidemiology, School of Public Health, The University of North Texas Health Science Center, Fort Worth, TX, United States
| | | | - Aisha K Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Juliet R Guichon
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Marc Steben
- HPV Global Action, Montreal, QC, Canada
- School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Kathleen M Decker
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Cancer Care Manitoba Research Institute, Winnipeg, MB, Canada
| | - Marie-Helene Mayrand
- Research Center, Centre Hospitalier de l'Université de Montreal, Montreal, QC, Canada
- Département d'obstétrique-gynécologie, Université de Montreal, Montreal, QC, Canada
| | - Julia M L Brotherton
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Population Health, Australian Centre for the Prevention of Cervical Cancer, Melbourne, Australia
| | - Gina S Ogilvie
- BC Cancer Agency, Vancouver, BC, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- BC Women's Hospital, Vancouver, BC, Canada
| | - Gregory D Zimet
- School of Medicine, Indiana University, Bloomington, IN, United States
| | | | - Zeev Rosberger
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Oncology, McGill University, Montreal, QC, Canada
- HPV Global Action, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
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Lorenzo-Pouso AI, Mariño-Méndez H, Varela-Ponte C, Pérez-Sayáns M, Palmeiro-Fernández G, González-Palanca S, Daley EM. Awareness Levels of the Link Between Oropharyngeal Cancer and HPV Infection Among Spanish Women: a Hospital-Based Cross-sectional Study. J Cancer Educ 2022; 37:296-303. [PMID: 32578035 DOI: 10.1007/s13187-020-01811-4] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Several observational studies have demonstrated the increased awareness of human papillomavirus (HPV) as an etiological factor of oropharyngeal cancers (OPCs). The incidence of OPCs has increased in recent times, particularly among younger women, and the efficacy of the HPV vaccine in preventing these cancers has gained attention among the medical community. The aim of this study was to explore the health literacy of Spanish adult women regarding factors associated with HPV and its link to OPCs, as well as their awareness of the HPV vaccination. A survey was distributed to 508 women, and 409 (70.5%) were considered as valid participants. The majority of the participants were Caucasian (97.8%) with a mean age of 44.1 ± 11.6. Out of all the participants, only 48.9% women identified HPV as a possible etiology of OPC. The most common sources of information regarding this association were the internet (31.3%), video media (28.9%), and healthcare professionals (28.9%), whereas 16.1% of the participants reported that they had obtained information from three or more sources. The average number of correct answers in the 16-item survey which was used to determine the participants' knowledge of HPV-related diseases was 8.7 ± 4.2, and the average number of correct answers in the 6-item survey regarding the usefulness of the HPV vaccination was 3.3 ± 1.6. According to bivariate models, the variables associated with a poorer level of awareness were related mainly to education (p < 0.001), sexual behavior (p < 0.001), and employment status (p < 0.001). This study contributes toward the discovery of the previously unforeseen psychosocial burden of HPV and its related diseases among Spanish women.
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Affiliation(s)
- Alejandro I Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, MedOralRes. Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Helia Mariño-Méndez
- Department of Gynecology & Obstetrics, Valdeorras Hospital, El Barco de Valdeorras, Ourense, Spain
| | - Carla Varela-Ponte
- Department of Gynecology & Obstetrics, Valdeorras Hospital, El Barco de Valdeorras, Ourense, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, MedOralRes. Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Gerardo Palmeiro-Fernández
- Primary Health Care Unit, EOXI Ourense, Verín, and El Barco de Valdeorras, Galician Health Service, Ourense, Spain
| | - Sergio González-Palanca
- Department of Gynecology & Obstetrics, Valdeorras Hospital, El Barco de Valdeorras, Ourense, Spain
| | - Ellen M Daley
- College of Public Health, The Chiles Center, University of South Florida, Tampa, Florida, USA
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Daley EM, Thompson EL, Beckstead J, Driscoll A, Vamos C, Piepenbrink RP, Desch J, Merrell L, Richardson Cayama MB, Owens H, Lovett SM. Discussing HPV and oropharyngeal cancer in dental settings: gender and provider-type matter. Hum Vaccin Immunother 2021; 17:5454-5459. [PMID: 34890526 DOI: 10.1080/21645515.2021.1996809] [Citation(s) in RCA: 3] [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] [Indexed: 10/19/2022] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and the leading cause of oropharyngeal cancer (OPC), an oral cancer most often identified by dental providers. Given the rise in HPV-associated OPC and recent Food and Drug Administration (FDA) approval of the HPV vaccine to prevent OPC, dental providers have a unique role in HPV prevention. This study assessed US adults' comfort levels discussing HPV and OPC with dental providers. An online survey platform was used to recruit a nationally representative sample of US adults (n = 300). The questionnaire assessed participants' knowledge, acceptability, and comfort discussing HPV-related topics with dental providers. SPSS 24 was utilized for data analyses. In general, participants reported feeling comfortable discussing HPV and OPC with dental providers. Participants reported feeling more comfortable with dentists than dental hygienists when discussing (t = 2.85, p < .01) and receiving recommendations about the HPV vaccine (t = 2.09, p < .05). Participants were less comfortable discussing HPV as a risk factor for OPC compared to non-HPV related risk factors (t = 2.94, p < .01). Female participants preferred female providers, whereas male participants had no preference. Previous research has indicated dental providers recognize their role in HPV prevention, but research is needed to understand patients' perceptions of dental providers' role in HPV prevention. Findings demonstrate that US adults are comfortable discussing HPV and OPC with dental providers, which may be key to OPC-HPV prevention. Future research is needed to facilitate HPV communication between patients and dental providers.
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Affiliation(s)
- Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Jason Beckstead
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Annelise Driscoll
- Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Cheryl Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | | | - Jill Desch
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Laura Merrell
- Department of Health Sciences, James Madison University, Harrisonburg, VA, USA
| | | | - Heather Owens
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Sharonda M Lovett
- College of Public Health, University of South Florida, Tampa, FL, USA
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Mahony H, Spinner C, Vamos CA, Daley EM. Social Network Influences on Young Women's Choice to Use Long-Acting Reversible Contraception: A Systematic Review. J Midwifery Womens Health 2021; 66:758-771. [PMID: 34491002 DOI: 10.1111/jmwh.13280] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Long-acting reversible contraception (LARC; including intrauterine devices and implants) is recommended as the first-line contraceptive choice by several professional organizations (eg, American College of Obstetricians and Gynecologists); however, rates of uptake are lower than those of other contraceptive methods. A young woman's social network may influence the decision to use LARC. The purpose of this review was to determine the role of health care providers (HCPs), family, peers, and sexual partner(s) on young women's decisions to initiate LARC. METHODS Several databases (PubMed, CINAHL, and PsycINFO) were searched for articles published between 2000 and 2020 that studied the social network influences of HCPs, family, peers, and sexual partner(s) on LARC initiation among women in the United States aged 18 to 25. A narrative synthesis of the included articles was conducted. RESULTS Twenty-nine articles met the inclusion criteria (21 qualitative, 6 quantitative, 2 mixed methods). HCPs are an important influence on a young woman's LARC decision-making. Peers and family also have a role but were often sources of negative or inaccurate information. Gaps in the literature were identified, including a lack of data on implant users and a dearth of studies on the role of sexual partner influence; most studies were not guided by theory. DISCUSSION HCPs are integral to LARC initiation and may be more influential than other social network members. Future research should focus on understanding how social network members interact to result in LARC initiation. Gaining insight into these influences may improve existing interventions or contribute to the development of new interventions and ultimately promote LARC use among young women.
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Affiliation(s)
- Helen Mahony
- College of Public Health, University of South Florida, Tampa, Florida
| | - Chelse Spinner
- College of Public Health, University of South Florida, Tampa, Florida
| | - Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, Florida
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, Florida
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Thompson EL, Daley EM, Washburn T, Salisbury-Keith K, Saslow D, Fontenot HB, Zimet GD. School-entry requirements for HPV vaccination: part of the patchwork for HPV-related cancer prevention. Hum Vaccin Immunother 2021; 17:1975-1979. [PMID: 33327839 DOI: 10.1080/21645515.2020.1851130] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Human papillomavirus (HPV) vaccination can prevent six types of HPV-related cancers, and approximately, 54.2% of adolescents are up-to-date with the HPV vaccine in the United States. While moderate success has been achieved with provider- and parent-focused interventions, HPV vaccination in the U.S. lags well behind desired goals. In order to maximize HPV vaccination and prevention of HPV-related cancers, it may be prudent to consider state policy approaches, such as school-entry requirements as part of the patchwork of provider, parent, and structural interventions. In this paper, we reviewed the history of efforts to implement school-entry requirements for HPV vaccine, the challenges and benefits associated with implementing these requirements, and the evidence for the effectiveness of school-entry requirements. In addition, we presented new data from Rhode Island's Immunization Information System (IIS) showing how their school-entry requirement, implemented in 2015, has impacted HPV vaccination rates. These registry data indicate that HPV vaccination rates improved significantly after the 2014-2015 school year and policy implementation, and add to the ongoing evidence supporting the value of school-entry requirements for HPV vaccination. School-entry requirements should be considered alongside other initiatives and policies for promoting HPV vaccine uptake. Taking a comprehensive systems approach to HPV vaccination is needed.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Tricia Washburn
- Office of Immunization, State of Rhode Island Department of Health, Providence, RI, USA
| | - Kim Salisbury-Keith
- Office of Immunization, State of Rhode Island Department of Health, Providence, RI, USA
| | - Debbie Saslow
- Department of Cancer Control, American Cancer Society, Atlanta, GA, USA
| | - Holly B Fontenot
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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Logan RG, Daley EM, Vamos CA, Louis-Jacques A, Marhefka SL. "When Is Health Care Actually Going to Be Care?" The Lived Experience of Family Planning Care Among Young Black Women. Qual Health Res 2021; 31:1169-1182. [PMID: 33622078 PMCID: PMC8114454 DOI: 10.1177/1049732321993094] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
While family planning care (FPC) visits may serve as opportunities to address gaps in knowledge and access to limited resources, young Black women may also face structural barriers (i.e., racism, discrimination, bias) to engaging in care due to the intersections of racial identity, age, and socioeconomic status. Findings from interviews with 22 Black women, ages 18 to 29 years, about the lived experience of FPC highlighted dynamic patient-provider encounters. Women's narratives uncovered the following essences: silence around sex impedes engagement in care, patient-provider racial concordance as protection from harm, providers as a source of discouragement and misinformation, frustration as a normative experience, decision making excludes discussion and deliberation, medical mistrust is pervasive and a part of Black consciousness, and meaningful and empathic patient-provider encounters are elusive. Health systems should prioritize developing and enhancing young Black women's relationship with FPC providers to help mitigate persistent inequities that perpetuate disadvantage among this population.
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Vamos CA, Vázquez-Otero C, Kline N, Lockhart EA, Wells KJ, Proctor S, Meade CD, Daley EM. Multi-level determinants to HPV vaccination among Hispanic farmworker families in Florida. Ethn Health 2021; 26:319-336. [PMID: 30260243 DOI: 10.1080/13557858.2018.1514454] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 02/02/2018] [Accepted: 07/23/2018] [Indexed: 06/08/2023]
Abstract
Background: HPV vaccination is the primary prevention method for HPV-related cancers, although among Hispanic populations, migrant farmworkers may experience exacerbated challenges to HPV vaccination due to intersecting political, social, and personal contexts. This study explored multi-level determinants of HPV vaccination among Hispanic migrant farmworker families.Methods: Using a community-engaged approach and guided by the socio-ecological model, Intervention Mapping, and PRECEDE-PROCEED constructs, we recruited parents who had a daughter and/or son age 9-15 years from a rural, faith-based, community organization in Florida. Three focus groups (n = 13) were conducted in Spanish and constant comparison methods were used to analyze qualitative data.Results: Micro-level determinants included moderate HPV vaccine knowledge, desire for more HPV vaccine information, concerns about HPV vaccine completion, health/preventive motivations, past experiences with the healthcare system, and parental gender roles related to health care. Macro-level determinants included facilitators (e.g. transportation services, clinics open after work hours, governmental programs) and barriers (e.g. supervisor/employment inflexibility, long clinic wait times) to accessing health care and vaccination in general (including HPV vaccination). Participants shared their preferences for future interventions that would meet the needs of this community, and discussed potential content and mechanisms for receiving HPV information, as well as what might facilitate their overall access, uptake, and completion of the HPV vaccine series.Discussion: Determinants to HPV vaccination emerged and underscore the importance of addressing the multi-level factors when designing and delivering an HPV vaccine intervention for this Hispanic migrant farmworker population. Improving HPV vaccination rates requires responding to situational and structural hardships that disproportionately impact this group. Thus, community-tailored and culturally appropriate multi-level interventions are needed, while emphasizing existing knowledge assets and preferences favorable towards HPV vaccination, with the ultimate goal of the decreasing HPV-related disparities. Findings suggest interventions must reach beyond the individual level to account for this unique population's lived experiences.
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Affiliation(s)
- Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Coralia Vázquez-Otero
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | | | - Elizabeth A Lockhart
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Kristen J Wells
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Sara Proctor
- Catholic Mobile Medial Services, Catholic Charities Diocese of St. Petersburg, Inc., San Jose Mission, Dover, FL, USA
| | - Cathy D Meade
- Division of Population Science, Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
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Vázquez-Otero C, Daley EM, Vamos CA, Romero-Daza N, Beckstead J, Tyson DM. The Intersection of Problems, Policy, and Politics: The Adoption of an HPV Vaccine School-Entry Requirement in Puerto Rico. Qual Health Res 2021; 31:859-870. [PMID: 33733935 PMCID: PMC8081062 DOI: 10.1177/1049732321991507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Persistent human papillomavirus (HPV) infections can cause cancer (e.g., cervical/vaginal/penile/anal/oropharyngeal). The HPV vaccine prevents cancer, yet U.S. vaccination rates remain low. We explored sociopolitical factors in the adoption of Puerto Rico's HPV vaccine school-entry requirement. Multiple streams framework explains how the intersection of problems, policy, and politics streams influence policy adoption. Policy entrepreneurs work on joining these streams. Interviews (n = 20) were conducted with stakeholders (e.g., physicians/researchers/nonprofit organizations' leaders). Data were analyzed using applied thematic analysis. High incidence of HPV and HPV-related cancers in Puerto Rico were indicators of problems. Focusing events included Rhaiza's case and the HPV-Advisory Panel Report. During summer 2017, a policy window opened; the Department of Health (DOH) adopted the requirement in summer 2018. Stakeholders discussed policy initiatives. Political turnover positively influenced the process. Policy entrepreneurs created an extended period of intersection resulting in the adoption of the requirement. Findings can inform policy initiatives to improve HPV vaccination rates and reduce HPV-related cancers.
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Affiliation(s)
- Coralia Vázquez-Otero
- Harvard T.H. Chan School of Public Health and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Griner SB, Vamos CA, Thompson EL, Logan R, Vázquez-Otero C, Daley EM. The Intersection of Gender Identity and Violence: Victimization Experienced by Transgender College Students. J Interpers Violence 2020; 35:5704-5725. [PMID: 29294863 DOI: 10.1177/0886260517723743] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
College students disproportionately experience victimization, stalking, and relationship violence when compared with other groups. Few studies explore victimization by the gender identity of college students, including those who identify as transgender. The purpose of this study is to explore the rates of violence experienced by transgender students compared with male and female college students. This study utilized the National College Health Assessment-II (NCHA-II) and included data from students (n = 82,538) across fall 2011, 2012, and 2013. Bivariate statistics and binary logistic regression were conducted to test the relationships between gender identity and victimization. Transgender students (n = 204) were compared with male (n = 27,322) and female (n = 55,012) students. After adjusting for individual factors, transgender students had higher odds of experiencing all nine types of violence when compared with males and higher odds of experiencing eight types of violence than females. Transgender students experienced the highest odds in crimes involving sexual victimization, including attempted sexual penetration (adjusted odds ratio [aOR]: 9.49, 95% confidence interval [CI] = [6.17, 14.59], d = 1.00), sexual penetration without consent (aOR: 9.06, 95% CI = [5.64, 14.53], d = 0.94), and being in a sexually abusive relationship (aOR: 6.48, 95% CI = [4.01, 10.49], d = 0.48), than did male students. Findings reveal increased odds of victimization among transgender students when compared with male and female students. Results demonstrate the need for more comprehensive violence prevention efforts in college settings.
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Affiliation(s)
- Stacey B Griner
- Department of Community and Family Health, University of South Florida, Tampa, USA
| | - Cheryl A Vamos
- Department of Community and Family Health, University of South Florida, Tampa, USA
| | - Erika L Thompson
- Department of Community and Family Health, University of South Florida, Tampa, USA
| | - Rachel Logan
- Department of Community and Family Health, University of South Florida, Tampa, USA
| | | | - Ellen M Daley
- Department of Community and Family Health, University of South Florida, Tampa, USA
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Hernandez ND, Chandler R, Nava N, Tamler I, Daley EM, Baldwin JA, Buhi ER, O’Rourke K, Romero-Daza N, Grilo S. Young adult US-born Latina women's thoughts, feelings and beliefs about unintended pregnancy. Cult Health Sex 2020; 22:920-936. [PMID: 31382840 PMCID: PMC7002175 DOI: 10.1080/13691058.2019.1642517] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 07/08/2019] [Indexed: 06/10/2023]
Abstract
Current measures of unintended pregnancy underestimate the co-occurring, complex set of social, cultural, economic and structural factors that influence how women interpret unintended pregnancy. The purpose of this study was to prospectively explore young adult US-born Latinas' thoughts, feelings and beliefs about pregnancy, specifically unintended pregnancies and the sociocultural factors identified as contributors to those beliefs. In-depth interviews (n = 20) were conducted with US-born, English-speaking Latinas aged 18-25 years in south Florida. Seventeen participants did not intend to get pregnant, while the remaining participants (n = 3) reported that their intentions kept changing. Participants' beliefs regarding their unintended pregnancy were influenced by social and economic hardship and cultural factors such as fatalism and familismo. Ideas and the meaning of pregnancy differed based on the woman's pregnancy resolution decision. Many women felt the term 'unintended pregnancy' placed blame on women and was stigmatising. When discussing pregnancy planning, most participants felt that women should not plan their pregnancies and doing so was going against fate. Findings suggest that salient influences such as culture and the social determinants related to unintended pregnancy should be incorporated into measurements examining unintended pregnancy.
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Affiliation(s)
- Natalie D. Hernandez
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | | | - Nancy Nava
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Ilyssa Tamler
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ellen M. Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Julie A. Baldwin
- Northern Arizona University, Department of Health Sciences, College of Health and Human Services, Flagstaff, AZ, USA
| | - Eric R. Buhi
- San Diego State University, Graduate School of Public Health, San Diego, CA, USA
| | - Kathleen O’Rourke
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Nancy Romero-Daza
- Department of Anthropology, University of South Florida, Tampa, FL, USA
| | - Stephanie Grilo
- Chronic Disease Epidemiology, Yale School of Public Heath, New Haven, CT, USA
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23
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Thompson EL, Galvin AM, Daley EM, Tatar O, Zimet GD, Rosberger Z. Recent changes in cervical cancer screening guidelines: U.S. women's willingness for HPV testing instead of Pap testing. Prev Med 2020; 130:105928. [PMID: 31756351 DOI: 10.1016/j.ypmed.2019.105928] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/04/2019] [Accepted: 11/18/2019] [Indexed: 12/14/2022]
Abstract
Cervical cancer screening guidelines in the United States were revised in 2018 to include the option of primary human papillomavirus (HPV) testing. The transition to this screening method may face difficulties as Pap testing has been the primary screening modality in the United States. The objective of this study is to assess information, motivation, and behavioral skills associated with willingness to receive an HPV test instead of a Pap test among women. The sample included U.S. 812 women, ages 30 to 65 years. Participants completed an online survey in 2018. The Information, Motivation, and Behavioral Skills (IMB) model was used to measure predictors of willingness for HPV testing. The outcome variables were willingness to receive the HPV test instead of the Pap test, with and without time interval details. Logistic regression modeling was used with SAS 9.4. Over half of the sample (55%) were willing to receive the HPV test. For the information domain, HPV knowledge was significantly associated with willingness for HPV testing (OR = 1.08, 95%CI 1.04-1.13). Significant motivating factors included: positive attitudes, social norms, perceived benefits, worry about cervical cancer, and worry about abnormal HPV tests. For behavioral skills, women were significantly more willing to get the HPV test if a provider recommended it (OR = 2.43, 95%CI 1.53-3.87) and currently up-to-date on cervical cancer screening guidelines (OR = 1.52, 95%CI 1.52-2.26). Addressing barriers and facilitators to willingness to transition to primary HPV testing over Pap testing is needed as the United States has updated guidelines for cervical cancer screening.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Annalynn M Galvin
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ovidiu Tatar
- Research Center-Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Gregory D Zimet
- Indiana University School of Medicine, Division of Adolescent Medicine, Indianapolis, IN, USA
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Departments of Oncology, Psychology, & Psychiatry, McGill University, Montréal, Québec, Canada
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Vamos CA, Thompson EL, Logan RG, Griner SB, Perrin KM, Merrell LK, Daley EM. Exploring college students' sexual and reproductive health literacy. J Am Coll Health 2020; 68:79-88. [PMID: 30388946 DOI: 10.1080/07448481.2018.1515757] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 04/05/2018] [Revised: 08/03/2018] [Accepted: 08/20/2018] [Indexed: 06/08/2023]
Abstract
Objective: To assess college students' sexual and reproductive health (SRH) literacy experiences, specific to contraception use and STI prevention. Participants: In Spring 2015, participants (n = 43) from a large institution participated in six focus groups (two male and four females groups). Methods: Focus groups were guided by the health literacy domains (access; understand; appraise; apply); data were analyzed in MaxQDA using the constant comparative method. Results: The Internet was the most commonly accessed source for SRH information. Participants discussed facilitators (eg, use of visuals) and barriers (eg, medical jargon) to understanding information; and personal lifestyle, advice from family/friends, symptoms, and sexual partners as appraisal factors. Participants applied information by communicating with friends/providers and seeking healthcare. However, findings were not linear nor mutually exclusive, representing the interaction of health literacy skills. Conclusion: Findings suggest that a patient-centered intervention capitalizing on technology and trusted individuals (providers/peer educators) may facilitate college students' SRH literacy.
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Affiliation(s)
- Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Rachel G Logan
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Karen M Perrin
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Laura K Merrell
- Department of Health Sciences, James Madison University, Harrisonburg, VA, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
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Vamos CA, Griner SB, Kirchharr C, Green SM, DeBate R, Daley EM, Quinonez RB, Boggess KA, Jacobs T, Christiansen S. The development of a theory-based eHealth app prototype to promote oral health during prenatal care visits. Transl Behav Med 2019; 9:1100-1111. [PMID: 31009536 PMCID: PMC6875649 DOI: 10.1093/tbm/ibz047] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Poor maternal oral health during pregnancy is associated with adverse maternal and child outcomes, including preterm birth and early childhood caries. Subsequently, professional associations have developed prenatal oral health guidelines, but significant gaps exist in implementing guidelines into clinical practice. The purpose of this study was to develop and test the usability of an innovative, theory-driven, eHealth application ("app") to facilitate prenatal providers' (nurse practitioners and midwives) implementation of oral health promotion during prenatal care visits. App development was guided by previous research, an integrated conceptual framework, Scientific Advisory Board input, and consumer-engaged iterative processes utilizing mixed-methods (observations, surveys, in-depth interviews) among providers (n = 4) during 10 unique prenatal care visits at a federally qualified health care center. Triangulation of quantitative and qualitative data analysis produced descriptive frequencies and salient themes. Concepts and principles from the following theoretical frameworks informed intervention development and testing: Consolidated Framework for Implementation Research; Information-Motivation-Behavioral Skills Model; Health Literacy; and Brief Motivational Interviewing. Overall, providers reported the app was effective at providing the information, motivation, and behavioral skills needed to integrate oral health promotion (e.g., easy to use; provided cues to action via scripts and tailored education; and documented findings into the patient's record). Although providers reported high usability, time constraints and detailed patient counseling scripts were identified areas for improvement. Findings suggest that the eHealth app could serve as an innovative mechanism to assist providers in implementing the prenatal oral health guidelines into practice. Future research is needed to continue app development efforts and to determine efficacy and effectiveness in practice settings.
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Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Stacey B Griner
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Claire Kirchharr
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Shana M Green
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rita DeBate
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rocio B Quinonez
- Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Kim A Boggess
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Tom Jacobs
- Custom Thinking Media, LLC, Eugene, OR, USA
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Thompson EL, Vamos CA, Jones J, Liggett LG, Griner SB, G Logan R, Daley EM. Perceptions of Zika Virus Prevention Among College Students in Florida. J Community Health 2019; 43:673-679. [PMID: 29380211 DOI: 10.1007/s10900-018-0468-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/28/2022]
Abstract
Zika virus in Florida prompted a strong public health response, due to its causal association with birth defects. While primarily spread by mosquitos, Zika can be transmitted sexually. The spread of Zika may influence reproductive behaviors among sexually active persons in Florida. This study examined factors associated with willingness to change birth control method use in response to Zika virus among college women and men in Florida. Women and men ages 18-44 at a Florida university (N = 328) were surveyed about Zika knowledge, beliefs about Zika, use of contraceptives and condoms, and socio-demographics between November 2016-April 2017. The outcome variable was willingness to change birth control method were Zika in their area. Logistic regression models in SAS 9.4 were used. Most participants were women (80%), and 47% were 20-22 years old. Only 27% of participants said they would change their birth control method if Zika were in their area. Participants who knew that Zika was sexually transmitted were more likely to be willing to change their birth control method (aOR = 1.71, 95%CI 1.01-2.91). Participants who agreed or strongly agreed that they were fearful of being infected with Zika virus were more likely to be willing to change their birth control methods (aOR = 1.98, 95%CI 1.07-3.67). This study found that, among Florida college students, Zika beliefs and knowledge were associated with a willingness to change birth control method in response to Zika. Understanding the factors that motivate individuals to change reproductive behaviors during an emerging health issue can help tailor preventative messages.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA. .,Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Julianna Jones
- Department of Global Health and Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Langdon G Liggett
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Rachel G Logan
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
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Hernandez ND, Daley EM, Young L, Kolar SK, Wheldon C, Vamos CA, Cooper D. HPV Vaccine recommendations: does a health care provider's gender and ethnicity matter to Unvaccinated Latina college women? Ethn Health 2019; 24:645-661. [PMID: 28826257 DOI: 10.1080/13557858.2017.1367761] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 08/11/2015] [Accepted: 08/09/2017] [Indexed: 06/07/2023]
Abstract
Objectives: There are disparities in the uptake of HPV vaccine among racial/ethnic minority women. The strongest predictor of HPV vaccine uptake among adult women is health care provider (HCP) recommendation; however, it is unclear how issues relating to race/ethnicity may mitigate these recommendations. Research shows that racial/ethnic and gender concordance between a patient and HCP can improve patient satisfaction, access and quality of care. If concordance contributes to improved patient-provider interactions, then it may be a factor in patient decisions regarding HPV vaccination. The objectives of this study were to (1) explore gender and ethnicity HCP preference regarding HPV vaccination among unvaccinated; and (2) understand factors associated with those preferences. Design: Unvaccinated Latina college students (n = 187) completed a survey that assessed HCP preferences, medical mistrust, cultural assimilation and HPV vaccine recommendation. Logistic regression models evaluated associations between above variables with HPV knowledge and preference for a female and/or Latina HCP. Results: Most respondents had health insurance (71%), a regular HCP (64%), were US-born (67%), with foreign-born parents (74%). Thirty-four percent and 18% agreed that they would be more likely to get the HPV vaccine if the recommending HCP was female and Latino, respectively. Latina women reporting higher medical mistrust preferred a HPV vaccine recommendation from a Latino/a provider. Conclusions: Latinas' preferences regarding gender and ethnicity of their HCPs may affect patient-provider interactions. Increasing diversity and cultural awareness among HCPs, and providing linguistically and culturally-appropriate information may decrease patient-provider mistrust, increase uptake of the HPV vaccine, and decrease persistent cervical cancer disparities.
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Affiliation(s)
- Natalie D Hernandez
- a Department of Community Health and Preventive Medicine , Prevention Research Center, Morehouse School of Medicine , Atlanta , GA , USA
| | - Ellen M Daley
- b Department of Community and Family Health , College of Public Health, University of South Florida , Tampa , FL , USA
| | - Lauren Young
- c Arizona Department of Health Services , STD Control Program , Phoenix , AZ , USA
| | - Stephanie K Kolar
- b Department of Community and Family Health , College of Public Health, University of South Florida , Tampa , FL , USA
| | - Christopher Wheldon
- b Department of Community and Family Health , College of Public Health, University of South Florida , Tampa , FL , USA
| | - Cheryl A Vamos
- b Department of Community and Family Health , College of Public Health, University of South Florida , Tampa , FL , USA
| | - Dexter Cooper
- a Department of Community Health and Preventive Medicine , Prevention Research Center, Morehouse School of Medicine , Atlanta , GA , USA
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Abstract
While Pap testing has significantly reduced the burden of cervical cancer, not all women follow prevention recommendations of cervical cancer screening every 3 years. Health literacy regarding Pap testing may influence the adoption of this behavior. The objective of this study was to assess the health literacy-related factors associated with Pap testing among a nationally representative sample of women in the USA. The Health Information National Trends Survey Cycles 4.4 and 5.1 were restricted to women 21-65 years of age (N = 2992). Questions were selected using the Integrated Model of Health Literacy domains: access (i.e., seeking cancer information), understand (i.e., HPV awareness, HPV knowledge), appraise (i.e., prevention not possible, chance of getting cancer), and apply (i.e., received a Pap in last 3 years [outcome]). Survey-weighted, logistic regression models estimated how the health literacy domains were associated with Pap testing, using SAS 9.4. In the sample, 81.1% of women received a Pap test within the last 3 years. The analysis revealed women who knew HPV is an STD (aOR = 1.64, 95% CI 1.20-2.26) were more likely to have received a Pap test in the last 3 years, while controlling for sociodemographic factors. These findings indicate that knowledge about HPV may be associated with Pap testing behavior among US women. Continued research is needed to examine the impact of health literacy on Pap testing given the changes in screening guidelines, with the ultimate goal of decreasing cervical cancer.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, EAD 709M, Fort Worth, TX, 76107, USA.
| | - Christopher W Wheldon
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
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Lorenzo-Pouso AI, Gándara-Vila P, Banga C, Gallas M, Pérez-Sayáns M, García A, Daley EM, Gasamáns I. Human Papillomavirus-Related Oral Cancer: Knowledge and Awareness Among Spanish Dental Students. J Cancer Educ 2019; 34:782-788. [PMID: 29748906 DOI: 10.1007/s13187-018-1373-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Human papillomavirus (HPV) infections are responsible for a significant part of the global burden of cancer. Epidemiologic studies have shown increasing trends of HPV-related oral cancers worldwide. Dental professionals need comprehensive up-to-date HPV-related information to be able to provide correct advice to their patients. The aim of this paper is to describe knowledge and awareness levels of dental students from Spain on HPV infection, HPV vaccination, oral cancer prevention, and HPV-related oropharyngeal cancer. A survey was distributed to 240 dental students, of which 158 returned it. Most students reported not been vaccinated against HPV (n = 81, 51.3%) and believed that HPV infection was linked to oropharyngeal cancer (75%). Overall, advanced students showed better knowledge, attitudes, and perceptions regarding this issue while novice students showed relevant shortcomings. However, their attitudes in relation to the diagnosis of oral cancer were adequate. These results suggest that there are important HPV-related knowledge deficits among Spanish dental students, which hinders their interventions in oropharyngeal primary prevention efforts. Findings of this study suggest the inclusion and standardization of HPV-related educational information to the dental curriculum.
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Affiliation(s)
- Alejandro Ismael Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain.
- GI-1319 Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Pilar Gándara-Vila
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain
- GI-1319 Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Cristina Banga
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain
| | - Mercedes Gallas
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain
- GI-1319 Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain
- GI-1319 Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Abel García
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain
- GI-1319 Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, Florida; The Chiles Center, College of Public Health, University of South Florida, Tampa, FL, USA
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Abstract
Purpose Describe the development of an innovative teaching activity that applies organizational health literacy to maternal and child health (MCH). Description Health literacy is a strong predictor of health behavior and outcomes. While the study of health literacy has traditionally been confined to skills and capacities of individuals, the significant role of the social and physical environmental contexts in facilitating or hindering one's ability to obtain, understand, and make informed decision about their health has been recognized. MCH organizations play a critical role in influencing health literacy across system levels. This teaching activity aims to equip students with knowledge and skills needed to foster organizational health literacy. Assessment The teaching activity is assembled within a toolkit which includes the following: (1) instructor lesson plan; (2) interactive PowerPoint presentation with instructor notes; (3) field assignment description; (4) health literacy attribute assessment worksheets; and (5) grading rubric. The teaching tool was pilot tested by a student research team member to assess the educational value and assignment logistics, resulting in minor edits (i.e., addition of interviewer probes, and option of a group project-format to permit triangulation of multiple organizational interviews). Conclusion The field of MCH is expanding in complexity, and the demands of health systems on women, children, and families must be mediated by conscious efforts within organizations. Through teaching the importance and function of organizational health literacy to students in MCH, educators can prepare an emerging workforce to improve health literacy, and ultimately the quality of healthcare for women, children, and families.
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Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA. .,The Chiles Center, College of Public Health, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL, 33613, USA.
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Stacey B Griner
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Langdon G Liggett
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA.,The Chiles Center, College of Public Health, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL, 33613, USA
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Thompson EL, Vamos CA, Logan RG, Bronson EA, Detman LA, Piepenbrink R, Daley EM, Sappenfield WM. Patients and providers’ knowledge, attitudes, and beliefs regarding immediate postpartum long-acting reversible contraception: a systematic review. Women Health 2019; 60:179-196. [DOI: 10.1080/03630242.2019.1616042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Erika L. Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, USA
- The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Cheryl A. Vamos
- The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Rachel G. Logan
- The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Emily A. Bronson
- Florida Perinatal Quality Collaborative & The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Linda A. Detman
- Florida Perinatal Quality Collaborative & The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Rumour Piepenbrink
- The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - Ellen M. Daley
- The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
| | - William M. Sappenfield
- Florida Perinatal Quality Collaborative & The Chiles Center, College of Public Health, University of South Florida, Tampa, USA
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Rapkin RB, Griner SB, Godcharles CL, Vamos CA, Neelamegam M, Thompson EL, Daley EM. Obstetrics and Gynecology and Family Medicine Residents' Training and Knowledge on Emergency Contraception. J Womens Health (Larchmt) 2019; 28:794-801. [PMID: 30939069 DOI: 10.1089/jwh.2018.7297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/12/2022] Open
Abstract
Background: Emergency contraception (EC) has the potential to play a vital role in preventing unintended pregnancies after unprotected sexual intercourse or contraceptive failure. Residency training can influence practice behaviors, however, the extent to which EC-related information is taught in training programs remains unknown. This study examined where residents obtain information about EC and whether knowledge differs by resident program characteristics. Materials and Methods: Program coordinators of Obstetrics and Gynecology (OB/GYN) and Family Medicine residency programs (n = 689) were emailed and requested to forward the survey link to residents. The survey included measures of EC education (hours, sources, including lectures, grand rounds), and EC-related knowledge. EC knowledge items assessed the three methods of EC (copper intrauterine device, ulipristal acetate, and oral levonorgestrel), effectiveness, mechanism of action, contraindications, and side effects. t-Tests and analysis of variances were used to compare mean knowledge scores (maximum = 20; higher scores indicating higher knowledge). Results: Among participants (n = 676), 61% were Family Medicine residents, 66% were white, and 72% were female. Overall, 34% received <1 hour of EC education, with OB/GYN residents receiving significantly more hours than Family Medicine residents. OB/GYN residents (mean = 14.40, standard deviation [SD] = 2.69) had a significantly higher mean knowledge score than Family Medicine residents (12.12, SD = 2.63; p < 0.000). Mean knowledge score differences were found by region of residency program, with residents in the Northeast reporting higher knowledge. Conclusions: Overall, residents received very little EC education, with OB/GYN residents receiving more training and having higher knowledge than their Family Medicine counterparts. Additional training is needed to ensure that residents are knowledgeable about this effective method to decrease unintended pregnancies.
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Affiliation(s)
- Rachel Becker Rapkin
- 1 Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, Florida
| | - Stacey B Griner
- 2 College of Public Health, University of South Florida, Tampa, Florida
| | - Cheryl L Godcharles
- 3 Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Cheryl A Vamos
- 2 College of Public Health, University of South Florida, Tampa, Florida
| | | | - Erika L Thompson
- 4 Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas
| | - Ellen M Daley
- 2 College of Public Health, University of South Florida, Tampa, Florida
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Thompson EL, Vamos CA, Piepenbrink R, Kadono M, Vázquez-Otero C, Matthes S, Daley EM. Human papillomavirus risk perceptions and relationship status: a barrier to HPV vaccination? J Behav Med 2019; 42:991-997. [PMID: 30879225 DOI: 10.1007/s10865-019-00025-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/09/2019] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to assess the association between relationship status and perceived risk for human papillomavirus (HPV) among young adults. College adults, aged 18-26 years, completed an online survey from November 2016-April 2017 (n = 385). The survey assessed HPV vaccination status, perceived HPV risk, and current relationship status. Logistic regression models estimated the odds of perceived high risk for HPV, stratified by vaccination status. Among unvaccinated women, relationship status and HPV risk perception were significantly associated, with dating women more likely (OR = 5.33, 95%CI 1.16-24.50) to perceive a high risk for HPV compared to women in a committed relationship. Women in relationships were less likely to perceive themselves at high risk for HPV, even though HPV infection is prevalent among young adults. This association is not present for vaccinated women, suggesting that relationship status and risk perceptions may represent barriers to HPV vaccine uptake.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Cheryl A Vamos
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Rumour Piepenbrink
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Mika Kadono
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
- Department of Anthropology, College of Arts and Sciences, University of South Florida, 4202 East Fowler Ave SOC107, Tampa, FL, 33620, USA
| | - Coralia Vázquez-Otero
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Sarah Matthes
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Ellen M Daley
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
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Daley EM, Vamos CA, Thompson E, Vázquez-Otero C, Griner SB, Merrell L, Kline N, Walker K, Driscoll A, Petrila J. The Role of Dental Providers in Preventing HPV-Related Diseases: A Systems Perspective. J Dent Educ 2019; 83:161-172. [PMID: 30709991 DOI: 10.21815/jde.019.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/08/2018] [Indexed: 01/22/2023]
Abstract
Successfully educating dental providers and patients about the link between human papillomavirus (HPV) and oropharyngeal cancer requires coordinated efforts to increase HPV-related prevention practices. The aim of this study was to identify, using a systems perspective, the multi-level determinants related to how dental providers can promote HPV prevention in dental practices. Data for this qualitative study were collected in 2015-16 from focus groups with dentists (four focus groups, n=33), focus groups with dental hygienists (four focus groups, n=48), and in-depth interviews with dental opinion leaders (n=13). Results were triangulated and mapped along micro, meso, and macro system levels. At the micro level, participants identified patient characteristics and low self-efficacy as influential determinants when discussing HPV prevention. At the meso level, relationships among dentists, dental hygienists, and the physical practice environment were factors affecting dental providers' HPV prevention efforts. At the macro level, professional organizations impacted how dental providers interacted with their patients on this topic. These results suggest that improving HPV prevention among dental providers requires a multi-level approach that considers the distinctive context of dental settings, dental training, and perceptions of professional roles. The findings suggested that the macro- and meso-level determinants may be challenging to modify due to the distinctive culture and practice models of dentistry. Nevertheless, the association between HPV and oral cancer requires an expansion of prevention strategies used in dental practices. Improving dental providers' self-efficacy to communicate HPV prevention through continuing education and integration of skill-guided training in dental and dental hygiene curricula could facilitate this process.
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Affiliation(s)
- Ellen M Daley
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX.
| | - Cheryl A Vamos
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Erika Thompson
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Coralia Vázquez-Otero
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Stacey B Griner
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Laura Merrell
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Nolan Kline
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Kimberly Walker
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - Annelise Driscoll
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
| | - John Petrila
- Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX
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Griner SB, Thompson EL, Vamos CA, Chaturvedi AK, Vazquez-Otero C, Merrell LK, Kline NS, Daley EM. Dental opinion leaders' perspectives on barriers and facilitators to HPV-related prevention. Hum Vaccin Immunother 2019; 15:1856-1862. [PMID: 30735476 DOI: 10.1080/21645515.2019.1565261] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 12/19/2022] Open
Abstract
Evidence suggests a causal connection between the Human Papillomavirus (HPV) and oropharyngeal cancers. HPV-related oropharyngeal cancers are increasing and are the most common HPV-associated cancer. Previous research suggests that dental professionals recognize a role in the prevention of HPV and oropharyngeal cancers. As an initial step to investigating effective mechanisms of incorporating HPV prevention into dental practices, including the HPV vaccine, this qualitative study explored dental opinion leaders' perspectives on barriers and facilitators to HPV-related prevention in the dental profession. Dental opinion leaders were identified through: (1) national professional organizations and advocacy groups, (2) by indication of an expert panel, and (3) focus groups conducted with oral health providers. Thirteen participants representing 11 organizations were interviewed via telephone. Interview recordings were transcribed verbatim and thematically coded using a priori and emergent codes. Opinion leaders described multi-level factors influencing dental providers' HPV-related prevention practice behaviors. Barriers included HPV as a sensitive topic and the need for HPV-related education and skills. Facilitators included perceptions of HPV prevention as part of the dental providers' role and the potential development of passive educational methods to provide HPV-related information to patients. Opinion leaders reported dental providers have a role in the prevention of HPV and oropharyngeal cancer; yet, to fully incorporate this topic into their practice, dental providers need further education and skill-based training. Opinion leaders have significant role in shaping this topic as a priority and identifying potential interventions to assist dental providers' HPV-related prevention. Future research should maximize the role of opinion leaders as key change agents.
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Affiliation(s)
- Stacey B Griner
- a College of Public Health, University of South Florida , Tampa , FL , USA
| | - Erika L Thompson
- b Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center , Fort Worth , TX , USA
| | - Cheryl A Vamos
- a College of Public Health, University of South Florida , Tampa , FL , USA
| | - Anil K Chaturvedi
- c National Cancer Institute, Division of Cancer Epidemiology & Genetics, Infections and Immunoepidemiology Branch, NCI Shady Grove , Bethesda , MD , USA
| | | | - Laura K Merrell
- d Department of Health Sciences, James Madison University , Harrisonburg , VA , USA
| | - Nolan S Kline
- e Department Anthropology, Rollins of College , Winter Park , FL , USA
| | - Ellen M Daley
- a College of Public Health, University of South Florida , Tampa , FL , USA
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Poelman MR, Brand HS, Forouzanfar T, Daley EM, Jager DHJ. Prevention of HPV-Related Oral Cancer by Dentists: Assessing the Opinion of Dutch Dental Students. J Cancer Educ 2018; 33:1347-1354. [PMID: 28741269 PMCID: PMC6280774 DOI: 10.1007/s13187-017-1257-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The aim of this study is to assess dental students' opinions of the dentists' role in primary prevention of human papillomavirus (HPV)-related oral cancer using a cross-sectional web-based survey. A questionnaire, containing questions about knowledge of HPV and oral cancer, confidence in head and neck examination and role of the dentist in preventing HPV-related oral cancer, was sent to all students of the Academic Centre of Dentistry Amsterdam (n = 912). One hundred and twenty-six (n = 126) students completed the questionnaire. Significantly, more master students (75%) than bachelor students (54.3%) were aware that HPV is a causative factor for oral cancer. Master students had more knowledge of HPV than bachelor students, but knowledge about HPV vaccination was irrespective of the study phase. The majority of dental students agreed that it is important to discuss HPV vaccination with patients. Eighty-nine percent of the students think that more education about symptoms of oral cancer will increase screening for oral cancer. Development of a protocol for screening in dental practices was considered even more important. According to dental students, dentists should discuss HPV as a risk factor for oral cancer with patients. Future dentists are willing to be involved in both primary and secondary prevention of HPV-related oral cancer. Therefore, screening for oral cancer and education about HPV vaccination should be integral elements of the dental curriculum.
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Affiliation(s)
- Marcella R Poelman
- Centre for Special Care Dentistry (Stichting Bijzondere Tandheelkunde), Gustav Mahlerlaan 3004, Amsterdam, 1081 LA, the Netherlands
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, Amsterdam, 1081 LA, the Netherlands
| | - Thymour Forouzanfar
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam Movement Sciences, VU University Medical Center, VU University, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, MDC 56, 13201 Bruce B. Downs Blvd, Tampa, 33612, FL, USA
| | - Derk H Jan Jager
- Centre for Special Care Dentistry (Stichting Bijzondere Tandheelkunde), Gustav Mahlerlaan 3004, Amsterdam, 1081 LA, the Netherlands.
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam Movement Sciences, VU University Medical Center, VU University, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Department of Oral Health Sciences - Prosthetics section, KU Leuven & University Hospitals Leuven, Box 7001, Kapucijnenvoer 7, Leuven, BE-3000, Belgium.
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Best AL, Logan RG, Vázquez-Otero C, Fung W, Chee V, Thompson EL, Villalona S, Thompson LMA, Gwede CK, Daley EM. Application of a Health Literacy Framework to Explore Patients' Knowledge of the Link between HPV and Cancer. J Health Commun 2018; 23:695-702. [PMID: 30153087 PMCID: PMC6413510 DOI: 10.1080/10810730.2018.1508257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The human papillomavirus (HPV) is a sexually transmitted infection and causes most oropharyngeal (e.g., throat) and anogenital (e.g., anal, cervical) cancers. Research indicates low knowledge about the link between HPV and cancer among the general population, and similar low knowledge of HPV among individuals diagnosed with HPV-associated cancers. This is important because HPV status can have implications for treatment, prognosis, and future sexual decisions. Using a health literacy framework, this study explored how patients diagnosed with HPV-associated cancers accessed, understood, appraised, and applied HPV information. We conducted 27 in-depth interviews with patients seeking care at a comprehensive cancer center; and data were analyzed using applied thematic analysis. Findings revealed that patients' primary source of HPV information was medical providers (access); and many patients exhibited limited understanding of HPV and its role in their cancer diagnosis (understand). Most patients (17 of 27) did not mention HPV as the cause of their cancer. Many patients displayed difficulty connecting HPV with their lifestyles (appraise); and few discussed plans to engage in HPV prevention practices going forward (apply). Future research should focus on strategies to improve understanding of HPV which could increase vaccine uptake, reduce stigma, and enhance informed decision-making among HPV-associated cancer patients.
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Affiliation(s)
- Alicia L Best
- a Department of Community and Family Health, College of Public Health , University of South Florida , Tampa , Florida , USA
| | - Rachel G Logan
- a Department of Community and Family Health, College of Public Health , University of South Florida , Tampa , Florida , USA
| | - Coralia Vázquez-Otero
- a Department of Community and Family Health, College of Public Health , University of South Florida , Tampa , Florida , USA
| | - Whitney Fung
- a Department of Community and Family Health, College of Public Health , University of South Florida , Tampa , Florida , USA
| | - Vanessa Chee
- a Department of Community and Family Health, College of Public Health , University of South Florida , Tampa , Florida , USA
| | - Erika L Thompson
- b Department of Health Behavior & Health Systems, School of Public Health , University of North Texas Health Science Center , Fort Worth , Texas , USA
| | - Seiichi Villalona
- c Department of Anthropology, College of Arts and Sciences , University of South Florida , Tampa , Florida , USA
| | - Lora M A Thompson
- d Department of Supportive Care Medicine , Behavioral Medicine Service, Moffitt Cancer Center and Research Institute , Tampa , Florida , USA
| | - Clement K Gwede
- e Department of Health Outcomes and Behavior , Population Science Division Moffitt Cancer Center and Research Institute , Tampa , Florida , USA
| | - Ellen M Daley
- f Office of Research and Practice, Department of Community and Family Health , College of Public Health, University of South Florida , Tampa , Florida , USA
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Daley EM, Thompson EL, Vamos CA, Griner SB, Vazquez-Otero C, Best AL, Kline NS, Merrell LK. HPV-Related Knowledge Among Dentists and Dental Hygienists. J Cancer Educ 2018; 33:901-906. [PMID: 28039675 DOI: 10.1007/s13187-016-1156-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Dental providers, such as dentists and dental hygienists, play an important role in HPV-related oropharyngeal cancer prevention. Dental professional organizations recommend dental providers educate patients about HPV and oral cancers. The objective of this study was to assess HPV knowledge among dental providers. Dentists (n = 36) and dental hygienists (n = 146) attending a professional conference completed a continuing education post-test survey, which included socio-demographics, an HPV knowledge scale, and measure of HPV discussion with patients ("no," "yes," and "yes, but only with some patients"). Chi-square tests, t tests, and ANOVA tests were used for this analysis. Although dental hygienists (35.4%) reported less discussion with patients about HPV than dentists (52.8%), these differences were not significant. The mean knowledge score was 24.7 (SD = 3.8) with no significant differences by profession. Among dentists, knowledge did not significantly differ by discussion category (p = 0.28). In contrast, dental hygienists who did not discuss HPV with patients had significantly lower mean knowledge scores (mean = 23.4) than those who discussed with patients (mean = 26.5, p < 0.01) or discussed only with some patients (mean = 26.0, p = 0.01). Knowledge deficits included outcomes associated with HPV, HPV in men, and curability. Specifically, participants incorrectly answered that HPV can affect a women's ability to get pregnant (81.9%), that one can never get rid of HPV once they have it (69.2%), and that HPV can cause herpes (43.4%). This study identified HPV knowledge deficits among dental providers. Given the recommendation for dental providers to discuss HPV prevention with their patients, additional education and training on this emerging topic may benefit these professionals.
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Affiliation(s)
- Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
- The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Coralia Vazquez-Otero
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Alicia L Best
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Nolan S Kline
- Department of Anthropology, Rollins College, 1000 Holt Avenue, Winter Park, FL, 32789, USA
| | - Laura K Merrell
- Department of Health Sciences, James Madison University, 800 S. Main St., Harrisonburg, VA, 22807, USA
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Thompson EL, Livingston MD, Daley EM, Zimet GD. Human Papillomavirus Vaccine Initiation for Adolescents Following Rhode Island's School-Entry Requirement, 2010-2016. Am J Public Health 2018; 108:1421-1423. [PMID: 30024803 DOI: 10.2105/ajph.2018.304552] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess changes in human papillomavirus (HPV) vaccine initiation for adolescent girls and boys in Rhode Island compared with all other states. METHODS We estimated the gender-specific effects of Rhode Island's school-entry HPV vaccination policy on self-reported HPV vaccination initiation by using a difference-in-differences design with the National Immunization Survey-Teen from 2010 through 2016. RESULTS Compared with boys in other states, boys in Rhode Island increased their HPV vaccine initiation rate by 11% (b = 0.11; 95% confidence interval [CI] = 0.05, 0.18) after enactment of the requirement. No difference was seen in the probability of HPV vaccine initiation among girls in Rhode Island compared with girls in the multistate control (b = -0.01; 95% CI = -0.08, 0.05). CONCLUSIONS Our analysis identified an 11% increase in HPV vaccine initiation rate among boys in Rhode Island after the school-entry requirement was enacted, whereas no significant change was observed for girls. Public Health Implications. Given suboptimal vaccine uptake rates in the United States, continued pursuit of state-level public policy to improve HPV vaccination is needed. School-entry requirements for HPV vaccination may be a strategy for closing the gap in HPV vaccine uptake for boys and girls.
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Affiliation(s)
- Erika L Thompson
- Erika L. Thompson is with the Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth. Melvin D. Livingston III, is with the Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center. Ellen M. Daley is with the Department of Community and Family Health, College of Public Health, University of South Florida, Tampa. Gregory D. Zimet is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | - Melvin D Livingston
- Erika L. Thompson is with the Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth. Melvin D. Livingston III, is with the Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center. Ellen M. Daley is with the Department of Community and Family Health, College of Public Health, University of South Florida, Tampa. Gregory D. Zimet is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | - Ellen M Daley
- Erika L. Thompson is with the Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth. Melvin D. Livingston III, is with the Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center. Ellen M. Daley is with the Department of Community and Family Health, College of Public Health, University of South Florida, Tampa. Gregory D. Zimet is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | - Gregory D Zimet
- Erika L. Thompson is with the Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth. Melvin D. Livingston III, is with the Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center. Ellen M. Daley is with the Department of Community and Family Health, College of Public Health, University of South Florida, Tampa. Gregory D. Zimet is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis
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Thompson EL, Vamos CA, Liggett LG, Griner SB, Daley EM. Using a Health Literacy Analytic Framework to Explore Zika Virus and Reproductive Health. Health Lit Res Pract 2018; 2:e78-e87. [PMID: 31294280 PMCID: PMC6607804 DOI: 10.3928/24748307-20180226-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/07/2018] [Indexed: 12/02/2022] Open
Abstract
Background: The emergence of Zika virus as sexually transmissible and associated with birth defects may affect reproductive planning and contraception use for people in Florida. Objective: This exploratory study employed a health literacy analytic framework to explore knowledge, attitudes, beliefs, and behaviors related to reproductive health in the context of Zika among reproductive-age women and men in Florida. Methods: Reproductive-age people in Florida (N = 40) were interviewed between September and December 2016 about their knowledge, attitudes, beliefs, and behaviors regarding Zika and reproductive health. Thematic analysis using a health literacy framework was employed. Key Results: Participants reported they would use reputable online sources to access Zika information. Whereas participants generally understood Zika outcomes, transmission, and symptoms, they reported hearing more prevention messages on mosquito transmission compared to sexual transmission. Overall, participants reported Zika was not concerning given their appraisal of personal circumstances. Participants were confident they could prevent Zika via sexual transmission despite not following the recommended guidelines. Participants discussed how their understanding of Zika changed their behaviors related to mosquito control but not through sexual transmission. Conclusions: This study illustrated a disconnect between reproductive-age people's understanding of Zika-related prevention information and their reproductive decision-making behavior. Strategies to promote appraisal of risk for sexual transmission of Zika, infection, and unintended pregnancy are needed. [HLRP: Health Literacy Research and Practice. 2018;2(2):e78–e87.] Plain Language Summary: Men and women of reproductive age in Florida may be at risk for Zika virus and related negative health outcomes. This study assessed how Florida men and women find, understand, and evaluate Zika-related health information, and how that applies to their prevention behaviors. This study used health literacy as an analytic framework for an emerging health issue.
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Affiliation(s)
- Erika L. Thompson
- Address correspondence to Erika L. Thompson, PhD, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107;
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Abstract
The human papillomavirus (HPV) can cause anogenital cancers and genital warts; however, it can be prevented through the HPV vaccine, which has been available since 2006. While this vaccine is targeted toward 11-to-12-year-olds, 18-to-26-year-old young adult women are eligible for "catch-up" vaccination. Knowledge of HPV may impact HPV vaccine uptake among this population. The purpose of this study was to assess changes in HPV knowledge and HPV vaccine information sources among young adult college women over a 7-year period. Two independent samples (N = 223 for 2008; N = 323 for 2015) completed a 23-item knowledge scale and survey regarding HPV. Adjusted logistic regression models compared the odds of correctly answering each knowledge item between each time period. The study found that HPV knowledge increased significantly over time (p < 0.01). The participants in 2015 were more likely than the 2008 participants to accurately report that a condom can decrease the chance of HPV transmission; there is a vaccine for women that prevents certain types of HPV; HPV can cause genital warts; HPV can be passed to a newborn at birth; and even if you do not see a wart, you can transmit HPV. Recent participants were also more likely to correctly report only women can get HPV as false. While improvements in HPV knowledge were found over time, misperceptions regarding outcomes associated with HPV persist. In order to promote HPV vaccination among this population, health literacy skills, in addition to knowledge, should be improved.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
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Wheldon CW, Kolar SK, Hernandez ND, Daley EM. Factorial Invariance and Convergent Validity of the Group-Based Medical Mistrust Scale across Gender and Ethnoracial Identity. J Health Care Poor Underserved 2018; 28:88-99. [PMID: 28238990 DOI: 10.1353/hpu.2017.0011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this study was to assess the factorial invariance and convergent validity of the Group-Based Medical Mistrust Scale (GBMMS) across gender (male and female) and ethnoracial identity (Latino and Black). Minority students (N = 686) attending a southeastern university were surveyed in the fall of 2011. Psychometric analysis of the GBMMS was performed. A three-factor solution fit the data after the omission of two problematic items. This revised version of the GBMMS exhibited sufficient configural, metric, and scalar invariance. Convergence of the GBMMS with conceptually related measures provided further evidence of validity; however, there was variation across ethnoracial identity. The GBMMS has viable psychometric properties across gender and ethnoracial identity in Black and Latino populations.
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Anstey EH, Coulter M, Jevitt CM, Perrin KM, Dabrow S, Klasko-Foster LB, Daley EM. Lactation Consultants' Perceived Barriers to Providing Professional Breastfeeding Support. J Hum Lact 2018; 34:51-67. [PMID: 28820951 DOI: 10.1177/0890334417726305] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems. METHODS This qualitative study was conducted with a grounded theory methodological approach. In-depth interviews were conducted with 30 International Board Certified Lactation Consultants across Florida. Lactation consultants were from a range of practice settings, including hospitals, Special Supplemental Nutrition Program for Women, Infants, and Children clinics, private practice, and pediatric offices. Data were digitally recorded, transcribed, and analyzed in Atlas.ti. RESULTS A range of barriers was identified and grouped into the following categories/themes: indirect barriers (social norms, knowledge, attitudes); direct occupational barriers (institutional constraints, lack of coordination, poor service delivery); and direct individual barriers (social support, mother's self-efficacy). A model was developed illustrating the factors that influence the role enactment of lactation consultants in managing breastfeeding problems. CONCLUSION Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.
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Affiliation(s)
- Erica H Anstey
- 1 Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Martha Coulter
- 1 Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | | | - Kay M Perrin
- 1 Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Sharon Dabrow
- 3 Department of Pediatrics, College of Medicine, University of South Florida, Tampa, FL, USA
| | - Lynne B Klasko-Foster
- 1 Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen M Daley
- 1 Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
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Daley EM, Vamos CA, Zimet GD, Rosberger Z, Thompson EL, Merrell L. The Feminization of HPV: Reversing Gender Biases in US Human Papillomavirus Vaccine Policy. Am J Public Health 2018; 106:983-4. [PMID: 27153015 DOI: 10.2105/ajph.2016.303122] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ellen M Daley
- Ellen M. Daley, Cheryl Vamos, Erika Thompson, and Laura Merrell are with the Department of Community and Family Health, University of South Florida, College of Public Health, Tampa. Gregory Zimet is with the Department of Adolescent Medicine, Indiana University, College of Medicine, Indianapolis. Zeev Rosberger is with the Department of Oncology, McGill University, College of Medicine, Montreal, Quebec, Canada
| | - Cheryl A Vamos
- Ellen M. Daley, Cheryl Vamos, Erika Thompson, and Laura Merrell are with the Department of Community and Family Health, University of South Florida, College of Public Health, Tampa. Gregory Zimet is with the Department of Adolescent Medicine, Indiana University, College of Medicine, Indianapolis. Zeev Rosberger is with the Department of Oncology, McGill University, College of Medicine, Montreal, Quebec, Canada
| | - Gregory D Zimet
- Ellen M. Daley, Cheryl Vamos, Erika Thompson, and Laura Merrell are with the Department of Community and Family Health, University of South Florida, College of Public Health, Tampa. Gregory Zimet is with the Department of Adolescent Medicine, Indiana University, College of Medicine, Indianapolis. Zeev Rosberger is with the Department of Oncology, McGill University, College of Medicine, Montreal, Quebec, Canada
| | - Zeev Rosberger
- Ellen M. Daley, Cheryl Vamos, Erika Thompson, and Laura Merrell are with the Department of Community and Family Health, University of South Florida, College of Public Health, Tampa. Gregory Zimet is with the Department of Adolescent Medicine, Indiana University, College of Medicine, Indianapolis. Zeev Rosberger is with the Department of Oncology, McGill University, College of Medicine, Montreal, Quebec, Canada
| | - Erika L Thompson
- Ellen M. Daley, Cheryl Vamos, Erika Thompson, and Laura Merrell are with the Department of Community and Family Health, University of South Florida, College of Public Health, Tampa. Gregory Zimet is with the Department of Adolescent Medicine, Indiana University, College of Medicine, Indianapolis. Zeev Rosberger is with the Department of Oncology, McGill University, College of Medicine, Montreal, Quebec, Canada
| | - Laura Merrell
- Ellen M. Daley, Cheryl Vamos, Erika Thompson, and Laura Merrell are with the Department of Community and Family Health, University of South Florida, College of Public Health, Tampa. Gregory Zimet is with the Department of Adolescent Medicine, Indiana University, College of Medicine, Indianapolis. Zeev Rosberger is with the Department of Oncology, McGill University, College of Medicine, Montreal, Quebec, Canada
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Thompson EL, Best AL, Vamos CA, Daley EM. "My mom said it wasn't important": A case for catch-up human papillomavirus vaccination among young adult women in the United States. Prev Med 2017; 105:1-4. [PMID: 28823755 DOI: 10.1016/j.ypmed.2017.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 04/03/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 12/26/2022]
Abstract
The human papillomavirus (HPV) vaccine prevents HPV-related diseases, including anogenital cancers and genital warts. In the United States, while it is recommended to adolescents ages 11 to 12, catch-up vaccination is available for those previously unvaccinated until age 26. Parental decisions or lack of provider recommendation during adolescence are barriers to on-time vaccination. Young adult women, ages 18 to 26, are a key catch-up vaccination population as this is a period for autonomous decision-making, high healthcare utilization, and other recommended prevention behaviors. Additional intervention research is required to promote HPV vaccine uptake among young adult women. Evidence-based and theory-informed interventions need to be developed and evaluated to reach a large number of women. In order to improve HPV vaccination among young adult women, future research should integrate the themes of health literacy, alternative healthcare settings, and OB/GYN providers to facilitate improved access and shared decision-making for the vaccine. This last chance for HPV-related cancer prevention should not be forgotten in public health efforts.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA.
| | - Alicia L Best
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA.
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA.
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Vázquez-Otero C, Vamos CA, Thompson EL, Merrell LK, Griner SB, Kline NS, Catalanotto FA, Giuliano AR, Daley EM. Assessing dentists' human papillomavirus-related health literacy for oropharyngeal cancer prevention. J Am Dent Assoc 2017; 149:9-17. [PMID: 29031503 DOI: 10.1016/j.adaj.2017.08.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/30/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Oropharyngeal cancers related to human papillomavirus (HPV) are on the rise. Dentists may be the next group of providers participating in the prevention of HPV. The aim of this study was to assess dentists' health literacy regarding the connection of HPV and oropharyngeal cancer. METHODS The authors conducted 4 focus groups with dentists (N = 33) during a regional dental conference in 2016. Guided by the health literacy competencies (that is, access, understand, appraise, and apply), the authors used constant comparison methods for data analysis. RESULTS Dentists mentioned a variety of informational sources (for example, dental journals and colleagues). Knowledge about the link between HPV and oropharyngeal cancer varied among participants. Participants appraised multiple patient and practice factors when deciding to have the discussion with patients. Some dentists discussed the HPV and oropharyngeal cancer connection with patients, and most conducted secondary screenings. CONCLUSIONS Findings indicate areas for intervention, including creating awareness of trusted informational sources, as well as increasing HPV knowledge and understanding the multiple patient (for example, age) and practice (for example, open operatories) appraisal factors. Moreover, enhancing the communication skills of dentists with patients is needed to improve HPV-related cancer prevention education. PRACTICAL IMPLICATIONS Addressing dentists' HPV-related health literacy has the potential to improve dentists' HPV-related prevention practices, including expanding patient education about this topic and increasing HPV vaccination knowledge, ultimately contributing to the reduction of oropharyngeal cancers.
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Thompson EL, Rosen BL, Vamos CA, Kadono M, Daley EM. Human Papillomavirus Vaccination: What Are the Reasons for Nonvaccination Among U.S. Adolescents? J Adolesc Health 2017; 61:288-293. [PMID: 28842066 DOI: 10.1016/j.jadohealth.2017.05.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [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: 02/13/2017] [Revised: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE Human papillomavirus (HPV) vaccination is recommended for 11- to 12-year-old U.S. adolescents. Unfortunately, HPV vaccine rates have been suboptimal. Parents are key decision agents regarding their adolescents' health; thus, it is necessary to understand their reasons for not vaccinating their adolescents. The purpose of this study was to compare parents' primary reasons for non-HPV vaccination by calendar year, sex of the child, and level of vaccine hesitancy. METHODS The National Immunization Survey-Teen 2012-2015 was subset to parents who did not intend for their adolescent to receive the HPV vaccine in the next 12 months (N = 59,897). Survey-weighted logistic regression models assessed the impact of year, sex, and level of hesitancy on main reasons for nonvaccination. RESULTS Not receiving a recommendation and lack of knowledge were significantly more likely to be the reasons for nonvaccination in 2012 and 2013 compared with 2015. The following reasons were significantly less likely to be reported for females compared with males: not recommended (odds ratio [OR] = .63, 95% confidence interval [CI], .58-.69) and lack of knowledge (OR = .86, 95% CI, .79-.94). In contrast, parents of females were more likely to state they were concerned about safety and side effects (OR = 2.19, 95% CI, 1.98-2.41). Differences in reasons for nonvaccination were observed between those who were unlikely and unsure regarding receiving the HPV vaccine. CONCLUSIONS Findings indicate that U.S. parental attitudes about HPV vaccination have changed over time and reasons for nonvaccination vary based on the sex of the adolescent and the level of hesitancy of the parent. This information can shape how providers respond to parental concerns and HPV vaccine hesitancy.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida; The Chiles Center, College of Public Health, University of South Florida, Tampa, Florida.
| | - Brittany L Rosen
- School of Human Services, University of Cincinnati, Cincinnati, Ohio
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida; The Chiles Center, College of Public Health, University of South Florida, Tampa, Florida
| | - Mika Kadono
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida; The Chiles Center, College of Public Health, University of South Florida, Tampa, Florida
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Thompson EL, Mahony H, Noble C, Wang W, Ziemba R, Malmi M, Maness SB, Walsh-Buhi ER, Daley EM. Rural and Urban Differences in Sexual Behaviors Among Adolescents in Florida. J Community Health 2017; 43:268-272. [DOI: 10.1007/s10900-017-0416-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Thompson EL, Vázquez-Otero C, Vamos CA, Marhefka SL, Kline NS, Daley EM. Rethinking Preconception Care: A Critical, Women's Health Perspective. Matern Child Health J 2017; 21:1147-1155. [PMID: 28078529 DOI: 10.1007/s10995-016-2213-8] [Citation(s) in RCA: 16] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives Preconception care aims to provide care to reproductive aged individuals in order to improve pregnancy and birth outcomes. Given that preconception care is a public health priority, it is important to evaluate the evolution of this health paradigm and the promotion of preconception messages that are obtained by the public. We identified online preconception health messages, which were critically assessed through a women's health perspective. Methods We searched for "preconception care" on three major search engines. Websites were included if they were U.S.-based, provided content in English, and mentioned preconception care. Blogs and journal articles were excluded. The final sample included 52 websites. Using a content analysis approach, we assessed the presence of gender bias and identified other emergent themes. Results The majority of websites focused on preconception care for women only (67%). The recommendations centered on: (1) health behaviors for women (e.g., folic acid, drinking, smoking); (2) visiting healthcare providers; and (3) evaluating medical risks. Moreover, most content implied that women desired, or should desire, pregnancy. Overall, the messages used biomedical language and rarely mentioned other important health topics, such as social support and violence. Conclusions The primary messages presented on preconception care websites emphasized biomedical aspects of women's health. The current context of preconception care medicalizes this pre-pregnancy period by defining it as a biomedical condition requiring lifestyle changes and interventions. Additionally, the biases presented in these messages assumed women want and are capable of pregnancies and excluded an integral factor for heteronormative reproduction-men.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA. .,The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
| | - Coralia Vázquez-Otero
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.,The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Stephanie L Marhefka
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.,The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Nolan S Kline
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.,Department of Anthropology, Rollins College, 1000 Holt Avenue, Winter Park, FL, 32789, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.,The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
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Thompson EL, Daley EM, Vamos CA, Horowitz AM, Catalanotto FA, DeBate RD, Merrell LK, Griner SB, Vazquez-Otero C, Kline NS. Health Literacy Approaches to Improving Communication between Dental Hygienists and Patients for HPV-Related Oral Cancer Prevention. J Dent Hyg 2017; 91:37-45. [PMID: 29118082] [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] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/30/2017] [Indexed: 06/07/2023]
Abstract
Purpose: Human Papillomavirus (HPV) has been identified as a causal agent for oropharyngeal cancers, suggesting a new role for dental hygienists in HPV-related cancer prevention strategies. Health literacy assessment is an approach that can be used to understand providers' informational assets and needs for educating and discussing HPV prevention with patients. This study aimed to understand dental hygienists' level of health literacy regarding HPV-related oropharyngeal cancers.Methods: Four focus group sessions with dental hygienists (n=48) were conducted at a national conference. The constant comparison method, with a priori codes for health literacy competencies (i.e., access/understand/appraise/apply), was utilized for this qualitative study.Results: Participants mentioned a variety of modes (e.g., magazines, journals) for accessing HPV-information; however, descriptions of understanding HPV and its relationship to oropharyngeal cancer varied. Participants considered patients' personal characteristics, the dental practice environment, and professional factors to appraise HPV-related information. Additionally, participants self-described themselves as being "prevention specialists." These factors influenced how dental hygienists applied primary and secondary prevention of HPV-related care issues with their patients (e.g., education and oral-cancer screenings).Conclusions: Dental hygienists recognized the importance of HPV and oropharyngeal cancer prevention efforts, including oral-cancer screenings and promotion of the HPV vaccine. The study findings identified opportunities for intervention focusing on primary prevention.
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