Acceptance of the HPV vaccine among women, parents, community leaders, and healthcare providers in Ohio Appalachia

The Ohio State University Comprehensive Cancer Center and College of Public Health, Columbus, OH, United States.
Vaccine (Impact Factor: 3.62). 05/2009; 27(30):3945-52. DOI: 10.1016/j.vaccine.2009.04.040
Source: PubMed


To assess HPV vaccine acceptability, focus groups of women (18-26 years), parents, community leaders, and healthcare providers were conducted throughout Ohio Appalachia. Themes that emerged among the 23 focus groups (n=114) about the HPV vaccine were: barriers (general health and vaccine specific), lack of knowledge (cervical cancer and HPV), cultural attitudes, and suggestions for educational materials and programs. Important Appalachian attitudes included strong family ties, privacy, conservative views, and lack of trust of outsiders to the region. There are differences in HPV vaccine acceptability among different types of community members highlighting the need for a range of HPV vaccine educational materials/programs to be developed that are inclusive of the Appalachian culture.

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Available from: Mack T Ruffin IV, Oct 07, 2015
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    • "Small groups of caregivers and providers were used in both settings, and they may not reflect the viewpoints of all caregivers and providers from their communities. However, many of the issues about the HPV vaccine raised by the caregivers and health care providers in the initial focus groups have been raised by caregivers and providers in previous focus group studies (Katz et al., 2009; Reiter, Oldach, Randle, & Katz, 2014). Furthermore, some caregivers and providers did not participate in all intervention development and review sessions and that could also bias the findings. "
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    ABSTRACT: We describe a community-engaged research process used to develop multilevel interventions (caregivers, providers, system) to improve the uptake of human papillomavirus vaccine among adolescents by partnering with members from two underserved populations in Ohio. We began by conducting focus groups to better understand the knowledge and attitudes of caregivers and providers about the human papillomavirus vaccine and to develop teams of community members to assist with development of the interventions. The process continued with conducting writing sessions to determine the content and format of the interventions, and initial feedback was obtained during review sessions to refine the interventions prior to implementation. Using this approach, we were able to consider contextual factors that made the interventions more acceptable and relevant to members of the priority populations. Challenges included development and maintenance of a team of community members to participate in the entire intervention development process, rejection of ideas presented by academic researchers, the need to balance community members' suggestions with what was known from evidence-based research, and the time, cost, and effort associated with partnering with community members. The benefits, however, outweigh the challenges associated with using a community-engaged research process to develop interventions aimed at reducing cancer disparities among underserved populations. © 2014 Society for Public Health Education.
    Health Promotion Practice 11/2014; 16(3). DOI:10.1177/1524839914559776 · 0.55 Impact Factor
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    • "Because of the target age for HPV vaccination, parental consent is either essential or strongly preferred. A number of parents were worried that they could be excluded from the decision-making process [38,65]. Other parents appeared less engaged: “I didn’t realise how ill-informed I am. "
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    ABSTRACT: Background Vaccination against Human Papillomavirus (HPV) is recommended for adolescent young women prior to sexual debut to reduce cervical cancer related mortality and morbidity. Understanding factors affecting decision-making of HPV vaccination of young women is important so that effective interventions can be developed which address barriers to uptake in population groups less likely to receive the HPV vaccine. Methods We undertook a qualitative systematic review and evidence synthesis to examine decision-making relating to the HPV vaccination of young women in high-income countries. A comprehensive search of databases from inception to March 2012 was undertaken to identify eligible studies reporting the perspectives of key stakeholders including policy makers, professionals involved in programme, parents, and young women. Factors affecting uptake of the vaccine were examined at different levels of the socio-ecological model (policy, community, organisational, interpersonal and intrapersonal). Results Forty-one studies were included. Whether young women receive the HPV vaccine is strongly governed by the decisions of policy makers, healthcare professionals, and parents. These decisions are shaped by: financial considerations; social norms and values relating to sexual activity, and; trust in vaccination programmes and healthcare providers. Financial constraints may be overcome through universal healthcare systems offering the HPV vaccine free at the point of delivery. In the healthcare setting, judgements by healthcare professionals about whether to recommend the vaccine may restrict a young woman’s access to the vaccine irrespective of her own beliefs and preferences. Parents may decide not to allow their daughters to be vaccinated, based on cultural or religious perceptions about sexual activity. Conclusions Barriers to the uptake of the HPV vaccine have implications for young women’s future sexual, physical and reproductive health. Interventions to address barriers to uptake of the vaccine should target appropriate, and multiple, levels of the socio-ecological model. Issues of trust require clear, accessible, and sometimes culturally appropriate, information about the HPV vaccination programme. Although young women are central to the HPV vaccination programme, their views are underrepresented in the qualitative literature. Future research should consider young women’s perceptions of, and involvement in, consent and decision-making.
    BMC Public Health 07/2014; 14(1):700. DOI:10.1186/1471-2458-14-700 · 2.26 Impact Factor
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    • "In another large US-based study (n = *1,500), Bernat et al. (2009) found that 'Born-again' Protestants and Catholics had lower levels of HPV vaccine acceptance than Protestants and Catholics who were not 'Born-again', though this was not significant in adjusted analyses (Barnack et al. 2010). Several studies have reported lower HPV vaccine acceptance and more negative attitudes among parents who strongly identify with religious views that prohibit sex before marriage or adhere to beliefs about monogamy and abstinence (Brabin et al. 2006; Marlow et al. 2009; McCaffery et al. 2003; Katz et al. 2009). Parental concerns that HPV vaccination will contribute to sexual promiscuity, which is not condoned by most religious traditions, have also been reported (Constantine and Jerman 2007; Marlow et al. 2009a, b). "
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    ABSTRACT: We conducted a web-based survey among 476 white, Black, and Hispanic parents or caregivers with daughter(s) between the ages of 9-17 to better understand how religion influences HPV vaccine acceptance. Catholic parents were more likely than nonaffiliated parents to have already vaccinated their daughters (vs. being undecided) (OR = 3.26, 95% CI = 1.06, 10.06). Parents with frequent attendance at religious services were more likely than parents who do not attend services to have decided against vaccination (vs. being undecided) (OR = 2.92, 95% CI = 1.25, 6.84). Directions for research and implications for interventions are addressed.
    Journal of Religion and Health 11/2011; 52(4). DOI:10.1007/s10943-011-9553-x · 1.02 Impact Factor
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