HPV Vaccination Behaviors Research Articles

Correlation Between Social Support and HPV Vaccination Behavior of Female Sex Workers in Entertainment Venues in a Region of Guangxi, China.

To understand the current situation for social support and HPV vaccination behavior of female sex workers (FSWs) in entertainment venues and to explore the association between the support and HPV vaccination behavior. 923 FSWs in entertainment venues in a region of Guangxi were selected as survey respondents by using intentional sampling and employing a self-developed basic information questionnaire. The social support rating and the HPV vaccination behavior scales were analyzed to determine the current status of support and HPV vaccination behavior of FSWs in entertainment venues. In addition, the correlations between these parameters were analyzed. The total score of social support of FSWs in entertainment venues was 35.13±8.10, and the score for HPV vaccination behavior was 30.08±5.73. There were significant differences between these two parameters for FSWs of different ages, monthly incomes and working hours (P < 0.05). Objective, subjective and social support were positively correlated with all dimensions of HPV vaccination behavior (r = 0.212~0.236, 0.245~0.334 and 0.113~0.152, respectively; P < 0.01 in all cases). Typical correlation analysis yielded a correlation between these three dimensions of social support as well as with two dimensions of HPV vaccination behavior (self-decision-making and self-efficacy) (r = 0.373; P < 0.01). Social support and HPV vaccination behavior of FSWs in entertainment venues initially low. However, as social support for FSWs was increased, their behavior towards HPV vaccination was elevated. Both subjective and objective support helped FSWs in entertainment venues their behavior to HPV vaccination and to maintain their physical and mental health.

Examining HPV vaccination behavior among young adults: Insights from applying the Health Belief Model.

Despite evidence-based recommendations for HPV vaccination, uptake among young adults is suboptimal. Limited research has explored factors that may influence HPV vaccination among young adults, as well as associated promotion and informational preferences in this group. This study aimed to examine factors associated with HPV vaccination among young adults and preferences for HPV vaccine information and promotion. This study utilized a cross-sectional design to examine factors related to HPV vaccination among young adults on a university campus in Tennessee. Data were collected via an online survey administered to students, aged 18-26 years, from March-May 2023. Study measures included sociodemographic characteristics, health/healthcare-related factors, and perception-related measures. Data analysis included descriptive statistics and multivariable logistic regression analysis. Out of 402 participants that completed the survey, 209 reported being vaccinated against HPV. In the adjusted model, variables associated with HPV vaccination were perceived risk (adjusted OR [aOR] = 1.12; 95% confidence interval [CI]:1.05, 1.20), perceived barriers (aOR = 0.73; 95% CI: 0.66, 0.81), higher HPV knowledge (aOR = 1.17; 95% CI: 1.03, 1.33), and receipt of healthcare provider recommendations (aOR = 12.90; 95% CI: 7.08, 23.51). Study findings suggest that those who are vaccinated were more likely to report receiving healthcare provider recommendations, low perceived barriers, higher HPV knowledge and perceived risk. Future HPV vaccination promotion efforts for young adults may consider increasing HPV vaccine knowledge and awareness, addressing barriers, and strengthening provider recommendations.

Perceptions and acceptability of HPV vaccination among parents of female adolescents 9–14 in China: A cross-sectional survey based on the theory of planned behavior

ABSTRACT HPV vaccine uptake remains low in China, especially among girls. Recently, China has initiated a pilot program on HPV immunization for girls 9–14. From November to December 2021, a cross-sectional study was conducted among parents of girls 9–14 in China through a web-based anonymous online questionnaire survey. Descriptive epidemiological analysis was used to analyze parental acceptability. Hierarchical regression analysis and structural equation modeling were to determine associated factors. A total of 5623 participants were included in the analysis. 21.2% girls had received HPV vaccine, and 94.3% parents intended to receive vaccination for their daughters, the Kappa values between them was −0.016. 31.9% of vaccinated mothers had received HPV vaccine for their daughters, vaccination history had a positive impact on behavior (β = 0.048). Attitude (β = 0.186), subjective norms (β = 0.148) and perceived behavioral control (β = 0.648) had a positive impact on intention. Vaccination intention mediated the relationships between attitude (β = 0.044), subjective norms (β = 0.035), and perceived behavioral control (β = 0.154) with behavior. There is a gap between vaccination intention and behavior in parents of girls 9–14. Perceived behavior control had a strong association on HPV vaccination behavior.

Predictor of HPV Vaccination Uptake among Foreign-Born College Students in the U.S.: An Exploration of the Role of Acculturation and the Health Belief Model.

to measure the HPV vaccination rate and knowledge about HPV and its vaccine among foreign-born college students; additionally, to measure the effect of acculturation and HBM constructs on the HPV vaccination behavior among foreign-born college students. a cross-sectional design with a non-probability sample of foreign-born college students was collected via a web-based self-administered survey that measured the HPV vaccination rate, assessed knowledge about HPV and its vaccine, and evaluated the effect of acculturation and HBM constructs on HPV vaccination behavior among foreign-born college students. Foreign-born college students had moderate knowledge about HPV and the HPV vaccine, and about 63% were HPV-vaccinated. Perceived susceptibility, perceived barriers, and cues to action were significantly associated with the HPV vaccination behavior, while knowledge levels about HPV and the HPV vaccine and acculturation levels were not significantly associated with the HPV vaccination behavior of foreign-born college students. The current study shows a moderate vaccination rate and moderate knowledge about HPV and its vaccine among foreign-born college students. Additionally, vaccination campaigns need to increase awareness about the susceptibility to acquiring HPV and minimize the barriers to receiving the vaccine to increase the HPV vaccination rate among foreign-born college students.

Knowledge cognitive and emotional factors influencing HPV vaccination behavior The Importance of subjective norms surrounding immunization status and general HPV vaccine knowledge

Knowledge cognitive and emotional factors influencing HPV vaccination behavior The Importance of subjective norms surrounding immunization status and general HPV vaccine knowledge

Factors Associated with the HPV Vaccination among Korean Americans and Koreans: A Systematic Review.

Koreans and Korean Americans (KAs) have limited HPV knowledge and awareness. KAs share a culture with Koreans, and this culture has affected their behavior around HPV. This systematic review aimed to synthesize the factors associated with HPV vaccination among Koreans and KAs. The literature search was done with four databases. The vaccination rate, awareness and knowledge of HPV, and factors associated with vaccination intention were identified. Eighteen articles were selected. Koreans and KAs had low levels of HPV knowledge and awareness. Perceived benefits and seriousness were associated with vaccination intention. Cervical cancer history, beliefs that their daughters need a pap smear test, sexual intercourse experiences, occupation, low education, and income were associated with vaccination intention. This systematic review discovered that HPV vaccination behavior is associated with HPV vaccine awareness, perceived benefits of the vaccine, and the perceived seriousness of HPV infection among Koreans and KAs. Based on the results, we suggest healthcare providers provide a HPV vaccine recommendation by emphasizing the benefits of the vaccination to Koreans and KAs. This study can be the basis for developing interventions to increase HPV vaccination by guiding the target population and variables, as well as the intervention content.

Use of cervical cancer preventive services among US women aged 21-29: an assessment of the 2010 Affordable Care Act rollout through 2018.

The 2010 Affordable Care Act (ACA) provided millions of people with health insurance coverage and facilitated routine cancer screening by requiring insurers to cover preventive services without cost-sharing. Despite greater access to affordable cancer screening, Pap testing has declined over time. The aim of this study is to assess participation in Pap test and HPV vaccination, and adherence to guidelines as outlined by the American Cancer Society (ACS) from the 2010 ACA provision eliminating cost-sharing for preventive services. Using multi-year responses from the Behavioral Risk Factor Surveillance System, we examined the association between the ACA and participation in and adherence to Pap testing and HPV vaccination behaviors as set by the ACS. The sample included women aged 21-29 who completed the survey between 2008 and 2018 (every other year) and who live in 24 US States (N = 37,893). Results showed significant decreases in Pap testing rates but increases in the uptake of the HPV vaccine series for all age groups and across all demographics. Post-ACA year significantly predicted increases in HPV + Pap co-testing participation and adherence. Women with health insurance coverage were more likely to engage in both behaviors. Findings raise concerns around declines in the proportion of women receiving and adhering to Pap testing guidelines. A need exists for research to examine the role of increases in HPV vaccination uptake on decreases in Pap testing. Moreover, effective strategies should target increases in cervical cancer screening uptake among women vaccinated against HPV.

Abstract C89: Examining HPV awareness, sexual behavior, and intent to receive the HPV vaccine among racial/ethnic males 18-27

Abstract Background: HPV plays a significant role in cancers and diseases that impact males directly including penile, oral, and anal malignancies, but awareness and positive vaccine intention in males remain problematic. HPV research largely focuses on cervical cancer prevention, ultimately feminizing HPV and erroneously portraying HPV as an infection that does not affect men. Incidence rates of oropharyngeal and anal cancers associated with HPV are increasing, and these cancers disproportionately affect men. Additionally, racial/ethnic minority men are disproportionately affected by HPV-related diseases and cancers. Black and Hispanic men are diagnosed with more HPV-related cancers and HPV-related cancers at later stages compared to other racial/ethnic groups. To date, very few studies have focused on HPV among racial/ethnic minority men and sexual. The purpose of this study is to examine 1) the awareness of men about HPV and their sexual behaviors and 2) the association of their intent to receive the HPV vaccination and sexual behaviors among racial/ethnic men. Methods: Racial/ethnic minority men age 18 to 27 (n=190) attending a large public university in the southeast US completed a 20-minute web-based survey in the fall of 2011. Survey items were adapted from previous research of psychosocial HPV studies among men and women, and were based on constructs from the Health Belief Model and Social Cognitive Theory. This analysis examined self-reported data on participants' sociodemographics, sexual behavior, HPV knowledge, vaccine status, and intent to receive HPV vaccination. Univariate analyses examined the sample distribution; Bivariate analyses were conducted to examine racial/ethnic differences sexual behavior and intent to receive the HPV vaccination, and binomial logistic regression analysis examined associations between intent to receive HPV vaccination and sexual behaviors. Results: The mean age of the sample was 21.31 (SD=2.579) years. The men identified themselves as Hispanic or Latino/a (49.5%), African-American /Black (17.9%), Asian (13.7%), Other (12.1%), and White (6.8%). The majority of the sample was insured (79.5%), unmarried/single (83.7%), heterosexual (91.1%), and completed 2 years of college or less (45.3%). Frequency distributions indicated that 73.2% did not consider themselves to be virgins and 49.5% of the sample was currently sexually active. In addition, 79.5% of the sample had previous knowledge about HPV, 81.6% of the sample had not received a dose of the HPV vaccine, and 77.1% did not plan to receive the HPV vaccine. Bivariate analyses showed that Hispanic and Black men were less likely to identify as virgins (p=0.03), more likely to have had vaginal (p=0.01) and oral (p=0.045) sex, and more likely to have vaginal sex at an earlier mean age compared to Asian, White, and Other men. Men who reported having had vaginal sex (28.6%; p=0.01), not being virgins (28.1%; p=0.008), and who were currently sexually active (31.8%; p=0.06) were more likely to have intentions of getting the HPV vaccination. Binomial logistic regression analysis showed that men who thought the HPV vaccine was of moderate importance were more likely than men who thought the HPV vaccine was of low and high importance to intend to receive the HPV vaccine (p=0.02). Conclusion: Although this mostly racial/ethnic minority sample of men were knowledgeable about the HPV vaccine and reported being sexually active, they were still less likely to intend to receive the vaccine. Providing information about HPV at early ages, particularly for Black and Hispanic men, and that it is transmitted through the different sexual behaviors may increase and emphasize the importance of HPV vaccination. Determining factors associated with HPV vaccine intentions among those at risk for HPV is important in increasing uptake of the vaccine and decreasing the burden of HPV-related diseases. Citation Format: Dexter L. Cooper, Natalie D. Hernandez, Tiffany Zellner-Lawrence. Examining HPV awareness, sexual behavior, and intent to receive the HPV vaccine among racial/ethnic males 18-27 [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C89.

Associations between parents’ satisfaction with provider communication and HPV vaccination behaviors

BackgroundDespite increasing awareness of the importance of a provider recommendation for HPV vaccine, the U.S. has yet to achieve the Healthy people 2020 goal of 80% series completion among adolescents. This failure indicates a need for further examination of the modifiable influences on parents’ decision-making. Healthcare providers can influence parents’ HPV vaccination decision-making, but little is known about parents’ perspectives on the counseling they receive. We sought to assess U.S. parents’ satisfaction with provider communication about HPV vaccine and associations with vaccination behaviors. MethodsParents of 11-to-17-year-old adolescents who discussed HPV vaccination with a healthcare provider at least once (n = 795) completed our online survey in Fall 2016. We assessed their satisfaction with the discussion using the HPV Vaccine Communication Satisfaction Scale (α = 0.94). We examined associations between satisfaction (categorized as low, moderate, or high), and three vaccination behaviors: refusal/delay, series initiation (≥1 dose), and continuation (≥2 doses among initiators) using multivariable logistic regression. ResultsMost parents reported high (36%) or moderate (38%) satisfaction with provider communication about HPV vaccination; fewer reported low (26%) satisfaction. Moderately satisfied parents (vs. low) had lower odds of refusal/delay (aOR = 0.59, 95% CI: 0.38–0.89), and higher odds of initiation (aOR = 1.71, 95% CI:1.15–2.55) and continuation (aOR = 2.05, 95% CI: 1.24–3.40). The associations were stronger for highly satisfied parents (refusal/delay aOR = 0.45, 95% CI: 0.29–0.70, initiation aOR = 3.59, 95% CI: 2.23–5.78, and continuation aOR = 4.08, 95% CI: 2.38–7.01). ConclusionsOur study suggests that parent satisfaction with provider communication may play an important role in HPV vaccination decision-making. Yet, communication satisfaction has been largely unexamined in the HPV-vaccine literature to date. We introduce a brief, 7-item HPV Vaccine Communication Scale that can be used to assess parents’ level of satisfaction with their provider’s communication specific to HPV vaccine. We identify communication areas for providers to prioritize when discussing HPV vaccine with parents.

HPV Vaccination and Sexual Behaviors in Adolescents and Young Women.

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Using narrative intervention for HPV vaccine behavior change among Khmer mothers and daughters: A pilot RCT to examine feasibility, acceptability, and preliminary effectiveness

PurposeTo develop a theory-guided culturally grounded narrative intervention to promote HPV vaccination behavior and examine the feasibility, acceptability, and preliminary effectiveness of the intervention among dyads of Cambodian American mothers and daughters. MethodThe principles of community-based participatory research guided the development and evaluation and involved two phases: Phase 1: Development of storytelling narrative intervention videos which focused on a series of HPV vaccination-related messages and which integrated the narrative theory with the revised network episode model (rNEM); Phase 2: conducting the pilot RCT with 19 dyads of Khmer mothers and daughters aged from 14 to 17years to examine the feasibility and acceptability of the study. FindingsRecruitment was completed in 7months with an overall retention of 84%. The acceptability of the intervention was high, as reflected by the number of positive comments on the narrative video. Preliminary data indicate that vaccine uptake at one-month follow-up was the same (2 vs. 2) between intervention and control groups. However, daughters in the narrative intervention group reported higher intention to receive HPV vaccination within one month compared to the control group (4 vs. 1). ConclusionAll the procedures to inform a full RCT were examined, including identification of eligible participants, recruitment, randomization, intervention adherence, and short-term follow-up. The positive preliminary outcomes and feedback support the feasibility and potential effectiveness of the theory-guided narrative intervention.

Development of a theory-guided storytelling narrative intervention to improve HPV vaccination behavior: Save our daughters from cervical cancer

Development of a theory-guided storytelling narrative intervention to improve HPV vaccination behavior: Save our daughters from cervical cancer

Factors Associated with HPV Vaccination among Cambodian American Teenagers

Parents have general influence over their children's health and health behavior. However, given the dearth of specific literature regarding knowledge level and social and cultural factors influencing HPV vaccination behaviors among Cambodian American (CA) parent, it is difficult to develop an effective, evidence-based public health HPV vaccination program. Therefore, the objectives of this study were to determine the HPV vaccine uptakes among CA teenagers and to examine factors influencing HPV vaccine uptakes. A descriptive, cross-sectional survey design and a combination of network and targeted sampling methods were used. CA mothers (n=130) completed a health survey through face-to-face interviews in either English or Khmer language. Girls vaccination rates were 29% while that of boys was 16%. Awareness and knowledge of HPV among CA mothers was very low, and many believed that their daughters, who speak English and were educated in the U.S., had more knowledge about health than they did. Logistic regression analysis showed that CA girls had significantly higher odds of vaccination when their mothers possessed a higher level of English reading ability and had greater awareness and knowledge of HPV. The strikingly low rates of HPV vaccination among CA girls and boys underscore the need to improve vaccination outreach, education, and uptake. The findings can be used to develop targeted public health HPV vaccination programs for CAs, which will reduce cervical cancer disparities.

Provider communication and HPV vaccination: The impact of recommendation quality

BackgroundReceiving a healthcare provider's recommendation is a strong predictor of HPV vaccination, but little is known empirically about which types of recommendation are most influential. Thus, we sought to investigate the relationship between recommendation quality and HPV vaccination among U.S. adolescents. MethodsIn 2014, we conducted a national, online survey of 1495 parents of 11–17-year-old adolescents. Parents reported whether providers endorsed HPV vaccination strongly, encouraged same-day vaccination, and discussed cancer prevention. Using an index of these quality indicators, we categorized parents as having received no, low-quality, or high-quality recommendations for HPV vaccination. Separate multivariable logistic regression models assessed associations between recommendation quality and HPV vaccine initiation (≥1 dose), follow through (3 doses, among initiators), refusal, and delay. ResultsAlmost half (48%) of parents reported no provider recommendation for HPV vaccination, while 16% received low-quality recommendations and 36% received high-quality recommendations. Compared to no recommendation, high-quality recommendations were associated with over nine times the odds of HPV vaccine initiation (23% vs. 74%, OR=9.31, 95% CI, 7.10–12.22) and over three times the odds of follow through (17% vs. 44%, OR=3.82, 95% CI, 2.39–6.11). Low-quality recommendations were more modestly associated with initiation (OR=4.13, 95% CI, 2.99–5.70), but not follow through. Parents who received high- versus low-quality recommendations less often reported HPV vaccine refusal or delay. ConclusionsHigh-quality recommendations were strongly associated with HPV vaccination behavior, but only about one-third of parents received them. Interventions are needed to improve not only whether, but how providers recommend HPV vaccination for adolescents.

일부 보건계열 대학생의 인유두종 바이러스 지식과 예방접종 관련 건강신념 및 감염 예방행위의도에 관한 융복합 연구

Abstract The purpose of this study was to identify the knowledge level, health beliefs related to HPV vaccination and HPV preventive behavior intention of human papilloma virus among health college student in Korea. A quantitative, descriptive design was used to study 264 students in D-city, M-city recruited from June 1 to June 15, 2014. The data were analyzed SPSS 21.0 program. The average level of HPV knowledge, health beliefs related to HPV vaccination and HPV preventive behavior intention about human papilloma virus were relatively low. No correlation between HPV knowledge and health beliefs. But health beliefs related to HPV vaccination have risen even higher degree of infection prevention behaviors. Therefore, it is necessary for specific methods, such as education programs, including HPV knowledge to improve future health beliefs related to HPV vaccination and HPV preventive behavior intention of human papilloma virus. Key Words : Human papilloma virus, Health belief, HPV knowledge, Preventative behavior intention, onvergence

Risk perception and sexual behavior in HPV-vaccinated and unvaccinated young Colombian women

ObjectiveTo compare sexual behaviors and risk perception between young women vaccinated for HPV and unvaccinated Colombian women. MethodsIn a cross-sectional design study, 1436 women (231 adolescents, <18years; 1205 young women, 18–26years) completed a self-administered questionnaire between May 2011 and March 2012 in Bogotá, Colombia. Data from vaccinated and unvaccinated women were compared by descriptive statistics and multivariate models. ResultsSexual risk behaviors were not associated with vaccination after adjustment for risk perception, age, educational level, and HPV knowledge. By contrast, vaccination was associated with higher routine Pap smear screening (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.69–3.28), use of modern contraceptives (OR, 2.02; 95% CI, 1.26–3.22), and consistent use of condoms (OR, 1.49; 95% CI, 1.11–2.01). Vaccinated young women were more likely to have had sex (OR, 2.08; 95% CI, 1.56–2.78), but sexual debut among adolescents was not associated with vaccination. In bivariate and multivariate analyses, vaccination status was negatively associated with perceived risk of HPV infection, warts, and cervical cancer. There was no association between vaccination and perceived risk of sexually transmitted infections in any model. ConclusionNo association was found between changes in risk perception after HPV vaccination and sexual risk behaviors.

Influential Factors in HPV Vaccination Uptake Among Providers in Four States

To examine health providers' perceived barriers, supports, and vaccination actions in delivering the HPV vaccine to females ages 9-17 in four states. Differences in providers' HPV vaccination of pre-adolescents compared with older adolescents were explored. A random sample of 1,500 pediatricians, family physicians, gynecologists, nurse practitioners, and physician assistants from four states were asked to complete a mail survey. Providers were recruited through state medical and nursing boards. The final sample included 227 respondents. Among those participants, health providers vaccinated older females (ages 13-17) at significantly higher rates than pre-adolescents (ages 9-12) in all four states. Providers who reported increased barriers to HPV vaccination were significantly less likely to vaccinate girls in either age group. The most frequent barriers reported by providers included the financial burden of the HPV vaccine and encountering patients (more often patients' parents) who have negative perceptions of vaccine. Most common supports included a personal belief in the positive impact of the HPV vaccine, followed by providers feeling comfortable talking with parents about the sexual nature of the vaccine, and the importance of adhering to the CDC's recommendations on HPV vaccination. Age of patient will likely influence providers' HPV vaccination behaviors, particularly if parents have concerns about vaccinating their pre-adolescents. Providers can best serve their patients when they are aware of the potential barriers and supports that may influence their HPV vaccination behaviors.