Effects of Socioeconomic Status and Health Care Access on Low Levels of Human Papillomavirus Vaccination Among Spanish-Speaking Hispanics in California

ArticleinAmerican Journal of Public Health 103(2) · December 2012with9 Reads
DOI: 10.2105/AJPH.2012.300920 · Source: PubMed
Abstract
Little is known about the effect of language preference, socioeconomic status, and health care access on human papillomavirus (HPV) vaccination. We examined these factors in Hispanic parents of daughters aged 11 to 17 years in California (n = 1090). Spanish-speaking parents were less likely to have their daughters vaccinated than were English speakers (odds ratio [OR] = 0.55; 95% confidence interval [CI] = 0.31, 0.98). Adding income and access to multivariate analyses made language nonsignificant (OR = 0.68; 95% CI = 0.35, 1.29). This confirms that health care use is associated with language via income and access. Low-income Hispanics, who lack access, need information about free HPV vaccination programs.(Am J Public Health. Published online ahead of print December 13, 2012: e1-e3. doi:10.2105/AJPH.2012.300920).
    • "However, future work comparing the effects of autonomous motivation and other factors on vaccine initiation and completion, and interventions designed to change autonomous motivation, are needed before clear conclusions can be drawn. Past HPV vaccine studies have shown differences in vaccination rates and attitudes toward vaccination between non-Hispanics, Spanish-speaking Hispanics, and English-speaking Hispanics [9,[23][24][25]. Thus, establishing an equivalent underlying structure between language groups was necessary. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: According to Self-Determination Theory, the extent to which the motivation underlying behavior is self-determined or controlled influences its sustainability. This is particularly relevant for behaviors that must be repeated, such as completion of the human papillomavirus (HPV) vaccine series. To date, no measures of motivation for HPV vaccination have been developed. Methods: As part of a larger study, parents (N=223) whose adolescents receive care at safety-net clinics completed a telephone questionnaire about HPV and the vaccine. We modified the Treatment Self-Regulation Questionnaire to assess parents' motivation for HPV vaccination in both Spanish and English. We used confirmatory factor analysis to test a three-factor measurement model. Results: The three-factor model fit the data well (RMSEA=0.04, CFI=0.98, TLI=0.96), and the scales' reliabilities were adequate (autonomous: α=0.87; introjected: α=0.72; external: α=0.72). The factor loading strength for one item was stronger for Spanish- than English-speaking participants (p<0.05); all others were equivalent. The intercorrelations among the scales ranged from -0.17 to 0.32, suggesting discriminant factors. The scales displayed the expected pattern of correlations with other psychosocial determinants of behavior. Vaccination intentions showed a strong correlation with autonomous motivation (r=0.52), but no correlation with external motivation (r=0.02), suggesting autonomous motivation may be particularly important in vaccine decision-making. Conclusion: Findings support the use of three subscales to measure motivation in HPV vaccination and suggest possible cultural differences in motivation.
    Full-text · Article · Aug 2016
    • "Analyses of national data have shown that there is an inverse relationship between socioeconomic status (SES) and mortality and that the magnitude of this association may have increased in recent years [1, 37]. An increased use of preventive services, including vaccinations, has been noted among those with higher household incomes [18]. Further, SES is also associated with disability. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: People with disabilities are known to experience disparities in behavioral health risk factors including smoking and obesity. What is unknown is how disability, race/ethnicity, and socioeconomic status combine to affect prevalence of these health behaviors. We assessed the association between race/ethnicity, socioeconomic factors (income and education), and disability on two behavioral health risk factors. Methods: Data from the 2007-2010 Behavioral Risk Factor Surveillance System were used to determine prevalence of cigarette smoking and obesity by disability status, further stratified by race and ethnicity as well as income and education. Logistic regression was used to determine associations of income and education with the two behavioral health risk factors, stratified by race and ethnicity. Results: Prevalence of disability by race and ethnicity ranged from 10.1 % of Asian adults to 31.0 % of American Indian/Alaska Native (AIAN) adults. Smoking prevalence increased with decreasing levels of income and education for most racial and ethnic groups, with over half of white (52.4 %) and AIAN adults (59.3 %) with less than a high school education reporting current smoking. Education was inversely associated with obesity among white, black, and Hispanic adults with a disability. Conclusion: Smoking and obesity varied by race and ethnicity and socioeconomic factors (income and education) among people with disabilities. Our findings suggest that disparities experienced by adults with disabilities may be compounded by disparities associated with race, ethnicity, and socioeconomic factors. This knowledge may help programs in formulating health promotion strategies targeting people at increased risk for smoking and obesity, inclusive of those with disabilities.
    Article · Apr 2016
    • "There are descriptions in the USA of Latin American girls being less vaccinated, and it is possibly due to cultural or traditional barriers rather than having less facilities [32]. "
    [Show abstract] [Hide abstract] ABSTRACT: Abstract BACKGROUND: HPV vaccine coverage is far from ideal in Valencia, Spain, and this could be partially related to the low knowledge about the disease and the vaccine, therefore we assessed these, as well as the attitude towards vaccination in adolescent girls, and tried to identify independently associated factors that could potentially be modified by an intervention in order to increase vaccine coverage. METHODS: A cross sectional study was conducted in a random selection of schools of the Spanish region of Valencia. We asked mothers of 1278 girls, who should have been vaccinated in the 2011 campaign, for informed consent. Those that accepted their daughters' participation, a questionnaire regarding the Knowledge of HPV infection and vaccine was passed to the girls in the school. RESULTS: 833 mothers (65.1%) accepted participation. All their daughters' responded the questionnaire. Of those, 89.9% had heard about HPV and they associated it to cervical cancer. Only 14% related it to other problems like genital warts. The knowledge score of the girls who had heard about HPV was 6.1/10. Knowledge was unrelated to the number of contacts with the health system (Pediatrician or nurse), and positively correlated with the discussions with classmates about the vaccine. Adolescents Spanish in origin or with an older sister vaccinated, had higher punctuation. 67% of the girls thought that the vaccine prevented cancer, and 22.6% felt that although prevented cancer the vaccine had important safety problems. 6.4% of the girls rejected the vaccine for safety problems or for not considering themselves at risk of infection. 71.5% of the girls had received at least one vaccine dose. Vaccinated girls scored higher knowledge (p = 0.05). CONCLUSION: Knowledge about HPV infection and vaccine was fair in adolescents of Valencia, and is independent to the number of contacts with the health system, it is however correlated to the conversations about the vaccine with their peers and the vaccination status. An action to improve HPV knowledge through health providers might increase vaccine coverage in the adolescents.
    Full-text · Article · Jun 2014
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