Abstract
Objective:To examine cultural barriers and participant solutions regarding acceptance and uptake of the human papillomavirus (HPV) vaccine from the perspective of Black African, White-Caribbean, Arab, Indian, Bangladeshi and Pakistani young people.Methods:In total, 40 young people from minority ethnic communities in Scotland took part in a qualitative study, involving seven focus groups and four paired interviews, to explore their views and experiences of the HPV vaccine. Using critical discursive psychology, the analysis focused on young people’s accounts of barriers and enablers to information, access and uptake of the HPV vaccination programme.Results:Participants suggested innovative strategies to tackle intergenerational concerns, information design and accessibility, and public health communications across diverse contexts. A cross-cultural community engagement model was developed, embracing diversity and contradiction across different ethnic groups. This included four inter-related strategies: providing targeted and flexible information for young people, vaccine provision across the life-course, intergenerational information and specific cross-cultural communications.Conclusion:This is the first HPV cross-cultural model inductively derived from accounts of young people from different ethnic communities. We recommend public health practitioners and policymakers consider using the processes and strategies within this model to increase dialogue around public engagement, awareness and receptivity towards HPV vaccination.
Highlights
Human papillomavirus (HPV) is the most prevalent sexually transmitted infection among young people (Audisio et al, 2015)
This study examined the accounts of young people from Black, Asian and Minority Ethnic (BAME) communities in order to examine understandings and explanations for HPV-related health behaviours within differing cultural contexts
Underpinned by a critical public health paradigm and utilising critical discursive psychology (Potter, 1996; Willig, 2008), we explored how the young people talked about HPV and the vaccine
Summary
Human papillomavirus (HPV) is the most prevalent sexually transmitted infection among young people (Audisio et al, 2015). By 2014, 58 countries had introduced one of the vaccines into their national immunisation programme (World Health Organization [WHO], 2014a), with varying uptake rates reported (Smith et al, 2015). A quadrivalent vaccine has been introduced, which provides protection against HPV6 and HPV11, which cause anogenital warts (Immunisation Scotland, 2015). In Scotland, high vaccination rates have been reported (>90% uptake of full immunisation), these obscure diverse understandings of HPV and intentions within multi-cultural groups (Sinka et al, 2014). The vaccine has been accepted for use among men in several countries, such as Australia and Canada, because it can prevent genital warts and oral, penile and anal cancers (Mirghani et al, 2014). The debate about whether to offer the vaccine to all men in the UK remains contentious (Baker, 2014)
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