Predictors Of Human Papillomavirus Vaccination Research Articles

The interdependent roles of the psychosocial predictors of human papillomavirus vaccination among Christian parents of unvaccinated adolescents

ABSTRACT Despite the availability of the human papillomavirus (HPV) vaccine, uptake has been sub-optimal among certain religious groups. Psychosocial factors (threat appraisal, coping appraisal, and attitudes) have been identified as independent determinants of HPV vaccination. However, their interdependent effects have not been tested. We examined the interdependency of these psychosocial factors in predicting HPV vaccination intention among Christian parents of unvaccinated adolescents (using a theory-driven conceptual model). A cross-sectional study of 342 participants showed that perceived self-efficacy (β = 0.2, 0.11–0.29, p = <0.0001) and perceived response efficacy of HPV vaccine (β = 0.65, 0.53–0.77. p < .0001) were positively associated with vaccination intention. Our mediation analysis (using the Preachers and Hayes’ approach) shows that attitudes toward HPV vaccination mediated 59% of the relationship between perceived self-efficacy to vaccinate child and HPV vaccination intention; and 61% of the relationship between perceived response efficacy of HPV vaccine and HPV vaccination intention. Attitudes may be the psychosocial factor that drives the effects of coping appraisal. Therefore, designing an attitude-based intervention to address religious barrier beliefs among Christian parents may nullify the impact of low self-efficacy and response efficacy on HPV vaccination.

Abstract PO-070: Knowledge, attitudes, beliefs, practices regarding human papillomavirus (HPV), and barriers to vaccination against HPV infection: A cross-sectional survey of Guam residents

Abstract Background Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is linked to cervical, anal, vaginal, vulvar, penile, and oropharyngeal cancers. In the U.S. territory of Guam, the incidence of cervical cancer is six times higher in Micronesians and over three times higher for CHamorus than the U.S. population. Though nasopharyngeal cancer has other contributing factors beyond HPV infection such as smoking and drinking, the CHamorus, who are the Indigenous people of Guam, have an incidence rate of nasopharyngeal cancer 20 times that of the U.S. population. In Guam, HPV vaccination rate is sub-optimally short of the National Healthy People 2020 goal to have at least 80% of females and males between the ages 13-15 years complete the HPV vaccine series. In 2016, 55.8% females and 33.2% males completed the HPV vaccination. Objective Our study sought to analyze a representative sample of Guam residents to examine their knowledge, attitudes, beliefs, practices regarding HPV, and barriers to HPV vaccination. Methods The cross-sectional survey of 776 respondents included 38% males and 62% females. The three major ethnic groups in the sample were CHamoru (48%), Filipino (26%), and Micronesians (11%). Sixty-eight percent of the respondents had at least one child. The aggregated scores were calculated for the following scale items: attitude (A), knowledge (K), subjective norms (SN), and perceived behavioral control (PBC) regarding HPV. Results Almost 45% of respondents admitted that they do not have enough knowledge to have their children vaccinated. However, 88% of those respondents stated that they would have their children vaccinated if the doctor told them. Women had significantly higher mean scores than men for A, K, and PBC/SN. Participants with more than high school education and higher incomes have significantly higher mean scores for all three measures. There were significant differences among different ethnic groups, with Micronesians having the lowest average score for all three measures. There were no significant differences between participants who had their children vaccinated and those who did not. Only 48% of respondents with children reported having their children vaccinated. Only ethnicity and having insurance were significant predictors of HPV vaccination. The respondents with medical insurance were almost three times as likely to have their children vaccinated for HPV (OR=2.8; 95% CI: 1.4, 5.2) Conclusions The results highlighted the significance of the physician’s role in having the HPV vaccination. Our results will serve as a guide to implement effective strategies for the development of targeted behavioral interventions and to develop appropriate interventions to increase the HPV vaccination uptake on Guam. Citation Format: Ana Joy Mendez, Lilnabeth Somera, Grazyna Badowski, Angelina Mummert, Lucy Castro, Angrenilda Antolin. Knowledge, attitudes, beliefs, practices regarding human papillomavirus (HPV), and barriers to vaccination against HPV infection: A cross-sectional survey of Guam residents [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-070.

Predictors of Human Papillomavirus Vaccination of female Adolescent mothers

Predictors of Human Papillomavirus Vaccination of female Adolescent mothers

Socioeconomic predictors of human papillomavirus vaccination in Danish men – A nationwide study

BackgroundThe quadrivalent human papillomavirus vaccine was licensed in Denmark in 2006. Unlike women, men are not offered human papillomavirus vaccination free of charge but can have it at their own expense. We investigated human papillomavirus vaccine uptake by men in Denmark and the socioeconomic factors that may predict human papillomavirus vaccination. MethodsUsing the Civil Registration System, we identified all boys and men aged 9–26 years in 2006–2013 and their mothers. By linkage to Statistics Denmark and the National Prescription Registry, we obtained information on socioeconomic variables and human papillomavirus vaccination during the study period. Using Cox regression, we examined the associations between socioeconomic variables and human papillomavirus vaccination. ResultsBetween 2006 and 2013, 6253 (0.8%) males aged 9–26 years were vaccinated against human papillomavirus. The strongest predictor identified was ethnicity. Males who were immigrants (hazard ratio, 0.12; 95% confidence interval, 0.08–0.180) or sons of immigrant parents (hazard ratio, 0.13; 95% confidence interval, 0.10–0.17) were less likely to be vaccinated than Danish males. Additionally, sons of mothers who were unemployed, unmarried, had a low income, and basic education initiated human papillomavirus vaccination less frequently. Finally, sons of mothers who were physicians or nurses were more likely to be vaccinated than sons of other highly educated mothers. ConclusionWe found low uptake, with social disparities in human papillomavirus vaccination of boys and young men in Denmark.

Predictors of Human Papillomavirus Vaccination Among Young Men Who Have Sex With Men.

Human papillomavirus (HPV) is a common sexually transmitted infection that causes anal, penile, and oropharyngeal cancers in men. Men who have sex with men (MSM) are at particularly high risk for HPV infection and HPV-related disease. Human papillomavirus vaccination is currently recommended for all MSM in the United States through age 26 years, yet little is known about HPV vaccine uptake in this population. The purpose of this study was to identify predictors of HPV vaccine uptake and barriers and facilitators to HPV vaccination that may be unique to young MSM. Men aged 18 to 26 years (n = 336) were recruited via advertisements placed on a geospatial smartphone dating application designed for MSM. Participants completed an online survey. Correlates of vaccine uptake and provider recommendation for HPV vaccine were identified using logistic regression. In total, 21% of participants had received at least 1 dose of HPV vaccine. Provider recommendation was the strongest predictor of uptake such that MSM with a recommendation were more than 40 times more likely to have been vaccinated. Additional predictors of uptake included age and HPV vaccine attitudes. Predictors of provider recommendation included sexual identity, race/ethnicity, condomless anal sex, and HIV status. Psychosocial correlates and barriers and facilitators to HPV vaccination among unvaccinated men were also identified. Findings highlight potential disparities in HPV vaccine uptake, as well as disparities in provider recommendation practices for HPV vaccination. Future interventions should aim to clarify misconceptions, modify psychosocial beliefs, and address barriers and facilitators to HPV vaccine uptake specific to young MSM.

Identification of potential missed opportunities for human papillomavirus (HPV) vaccination in women referred to an academic colposcopy clinic for evaluation of abnormal cervical cytology

abstractObjective: To identify possible predictors of missed opportunities for human papillomavirus (HPV) counseling and vaccination prior to presentation at an academic colposcopy clinic. Materials and Methods: We examined the characteristics of 638 vaccinated and 1,024 unvaccinated age-eligible patients using data from a patient registry of women presenting for colposcopic evaluation between 2/26/2007 and 3/10/2014 who were aged 26 or less at presentation. Demographics, smoking history, pregnancy history, sexually transmitted infections (STIs), sexual history, contraception use, immunosuppression, and medical problems were compared between HPV vaccinated and unvaccinated women. Multivariable logistic regression models included age, race, language, marital status, insurance type, lifetime number of sexual partners, other medical illnesses, number of pregnancies, contraception use, history of STIs, and smoking history to determine predictors of HPV vaccination. Results: In multivariable analysis, race, marital status, and language were not significantly associated with HPV vaccination. Women with fewer pregnancies were more likely to be vaccinated (p-trend <0 .0001). Vaccinated women were more likely to have other medical illnesses (OR=1.44, 95% CI=1.13–1.83) and be aware of their HPV status (OR=1.75, 95% CI= 1.40–2.18). Conclusions: In this study, greater number of pregnancies was associated with lower vaccination rates as compared to women who had never been pregnant. Reproductive health visits, such as postpartum and family planning visits, represent an ideal opportunity to educate women about HPV and the importance of vaccination, and should be an area of focus to improve current HPV vaccination rates.

Predictors of Human Papillomavirus Vaccination in a Large Clinical Population of Males Aged 11 to 26 years in Maryland, 2012-2013.

Despite the recommendation for routine human papillomavirus (HPV) vaccination in males, coverage estimates remain low. We sought to identify predictors of receiving each HPV vaccine dose among a large clinical population of males. We conducted a cross-sectional analysis of electronic medical records for 14,688 males ages 11 to 26 years attending 26 outpatient clinics (January 2012-April 2013) in Maryland to identify predictors of each HPV vaccine dose using multivariate logistic regression models with generalized estimating equations. All analyses were stratified in accordance with vaccine age recommendations: 11 to 12 years, 13 to 21 years, and 22 to 26 years. Analyses of predictors of receipt of subsequent HPV doses were also stratified by the number of clinic visits (≤3 and >3). Approximately 15% of males initiated the HPV vaccine. Less than half of males eligible received the second and third doses, 49% and 47%, respectively. Non-Hispanic black males (vs. non-Hispanic white) ages 11 to 12 and 13 to 21 years and males with public insurance (vs. private) ages 13 to 21 years had significantly greater odds of vaccine initiation, but significantly decreased odds of receiving subsequent doses, respectively. Attendance to >3 clinic visits attenuated the inverse association between public insurance and receipt of subsequent doses. Overall, rates of HPV vaccine initiation and of subsequent doses were low. While non-Hispanic black and publicly insured males were more likely to initiate the HPV vaccine, they were less likely to receive subsequent doses. Tailoring different intervention strategies for increasing HPV vaccine initiation versus increasing rates of subsequent doses among males may be warranted.

Human papillomavirus vaccination among adolescents in Georgia

Human papillomavirus (HPV) vaccination coverage for adolescent females and males remains low in the United States. We conducted a 3-arm randomized controlled trial (RCT) conducted in middle and high schools in eastern Georgia from 2011–2013 to determine the effect of 2 educational interventions used to increase adolescent vaccination coverage for the 4 recommended adolescent vaccines: Tdap, MCV4, HPV and influenza. As part of this RCT, this article focuses on: 1) describing initiation and completion of HPV vaccine series among a diverse population of male and female adolescents; 2) assessing parental attitudes toward HPV vaccine; and 3) examining correlates of HPV vaccine series initiation and completion. Parental attitude score was the strongest predictor of HPV vaccine initiation among adolescents (adjusted odds ratio (aOR): 2.08; 95% confidence interval (CI): 1.80, 2.39). Other correlates that significantly predicted HPV series initiation were gender, study year, and intervention arm. Parental attitudes remained a significant predictor of receipt of 3 doses of HPV vaccine along with gender, race, school type and insurance type. This study demonstrates that positive parental attitudes are important predictors of HPV vaccination and critical to increasing coverage rates. Our findings suggest that more research is needed to understand how parental attitudes are developed and evolve over time.

Socioeconomic Predictors of Human Papillomavirus Vaccination Among Girls in the Danish Childhood Immunization Program

PurposeIn 2009, human papillomavirus (HPV) vaccination was introduced in the Danish national childhood immunization program targeting all 12-year-old girls. Previous findings suggest that 10%–13% of girls born in 1996–1997 have not initiated vaccination despite free access. This study aims to identify socioeconomic predictors of initiation and completion of HPV vaccination. MethodsGirls born in 1996–1997 and their guardians were identified through the Danish Civil Registration System. Information on socioeconomic variables and HPV vaccination status was obtained by linkage to Statistics Denmark and the Danish National Health Insurance Service Register. Through logistic regression, we examined associations between socioeconomic variables and HPV vaccine initiation (N = 65,926) and completion (N = 61,162). ResultsGirls with immigrant ethnicity (odds ratio [OR] = .49; 95% confidence interval [CI], .42–.57) had lower HPV vaccine initiation than Danish girls. Girls of mothers with basic education (OR = .75; 95% CI, .69–.82) or low disposable income (OR = .67; 95% CI, .61–.73) had decreased initiation compared with girls of mothers with higher education/income. Girls of unemployed mothers (OR = .75; 95% CI, .69–.82) or mothers being unmarried (OR = .70; 95% CI, .65–.76) had lower initiation than girls of employed or married mothers. Finally, vaccine initiation varied depending on place of residence. The predictors of HPV vaccine completion were similar to those of initiation. ConclusionsWe found social inequality in the initiation and completion of HPV vaccination despite free access. As socioeconomic risk factors identified for cervical cancer also are associated with decreased HPV vaccination, social inequalities in cervical cancer have the potential to increase.

Young Hispanic Men and Human Papillomavirus Vaccination Choices.

This exploratory descriptive study examined perceived vulnerabilities to human papillomavirus (HPV) and the correlation to factors influencing vaccine beliefs and vaccine decision making in young Hispanic males attending a large public urban university. Only 24% of participants believed that the HPV vaccine could prevent future problems, and 53% said they would not be vaccinated. The best predictors of HPV vaccination in young Hispanic men were agreement with doctor recommendations and belief in the vaccine's efficacy. Machismo cultural norms influence young Hispanic men's HPV-related decision making, their perceptions of the vaccine, and how they attitudinally act on what little HPV information they have access to. This study provides culturally relevant information for the development of targeted health education strategies aimed at increasing HPV vaccination in young Hispanic men.

Predictors of Human Papillomavirus Vaccination Among Daughters of Low-Income Latina Mothers: The Role of Acculturation

Human papillomavirus (HPV) vaccination is a safe and effective primary prevention strategy for cervical cancer. Little is known about correlates of HPV vaccination among Hispanic adolescents living in the United States. The purpose of this study was to (1) examine relationships between both U.S./American and Latina acculturation and variables typically associated with HPV vaccine uptake (e.g., physician recommendation); and (2) identify predictors of HPV vaccine uptake among daughters of Latina mothers. Latina mothers (N = 200) recruited from a Federally Qualified Health Center serving low-income families in Florida completed a semistructured interview that assessed awareness of and knowledge about HPV and HPV-vaccines, vaccination beliefs, whether their daughter's physician had recommended the HPV vaccine, health history, U.S./American and Latina acculturation, mother and daughter demographics, and daughter's HPV vaccination status. Only 18% of daughters had received at least one dose of the vaccine. Higher levels of U.S./American acculturation were associated with greater odds of vaccine uptake and other common predictors of HPV vaccination (e.g., physician recommendation, vaccine awareness). A multivariate logistic regression analysis identified three independent predictors of vaccine uptake: physician recommendation, daughter's age, and low worry about how to pay for the vaccine. Despite generally favorable views of HPV vaccination, observed rates of vaccine uptake in this sample were substantially lower than national estimates. Latina mothers who are more integrated into U.S. society may be more likely to vaccinate their daughters against HPV. Findings provide promising directions for future HPV vaccination interventions with Hispanic adolescents.

Ethnic Differences in Predictors of HPV Vaccination: Comparisons of Predictors for Latina and Non-Latina White Women

The purpose of this study was to examine how social and behavioral factors such as age of first intercourse, mother–daughter communication, and perceived norms are associated with human papillomavirus (HPV) vaccination behaviors, and whether ethnicity moderates those associations (non-Latina White versus Latina participants). From June through December 2009, we surveyed a community sample of 309 White and Latina women, ages 15 to 30. We recruited participants from local health care clinics in Des Moines, Iowa. Vaccination status was not significantly different for Whites versus Latinas. The effects of age at first intercourse, mother–daughter communication about values related to sex, and descriptive norms of HPV vaccine uptake were all significantly moderated by ethnicity. The current findings reveal that sociocultural and behavioral factors that affect HPV vaccine uptake do not affect White and Latina women in the same fashion. In the future, public health campaigns about HPV and the HPV vaccine may be more effective if their messages are sensitive to these differences.

Prevalence and predictors of human papillomavirus vaccination in adolescent girls

ObjectivesTo determine the prevalence and predictors of human papillomavirus (HPV) vaccination in adolescent girls who were recommended to receive the vaccine by their health care providers. DesignCross-sectional study. SettingUnited States in 2007–08. ParticipantsParents or guardians most knowledgeable about health and health care of adolescent girls aged 12 to 17 years participating in the 2007 National Survey of Children's Health (NSCH). InterventionNCSH was a population-based telephone survey using a complex probability sampling design. Main outcome measuresPrevalence of HPV vaccination in adolescent girls who were recommended to receive the HPV vaccine and predisposing, enabling, and need factors associated with HPV vaccination. ResultsOf 12.38 million adolescent girls aged 12 to 17 years, 3.69 million (29.76%) were recommended to receive the HPV vaccine by their health care provider. The majority who received the HPV vaccine recommendation were 13 to 17 years of age (83%), were white (71%), and had one or more preventive visits (94%). Among those for whom the HPV vaccine was recommended, 48.75% (95% CI 45.37–52.13) received the vaccine. Multivariate logistic regression analysis of those who were recommended revealed that enabling and predisposing factors were significantly associated with the HPV vaccination. Children living at 101% to 200% of the Federal Poverty Level (odds ratio 0.54 [95% CI 0.30–0.98]) and children in households with two or more adults (0.51 [0.33–0.80]) were negatively associated with HPV vaccination, whereas children with any preventive medical care visit(s) (2.28 [1.36–3.84]) in the previous year were positively associated with HPV vaccination. ConclusionNearly one-half of adolescent girls received the HPV vaccine among those who were recommended by their health care provider. The study finding emphasizes the importance of predisposing and enabling factors for HPV vaccination. Policy and education efforts can focus on these factors to improve HPV vaccination rates.

Sexually related behaviors as predictors of HPV vaccination among young rural women.

To explore whether sexually related behaviors predict refusal of the human papillomavirus (HPV) vaccine among a sample of women aged 18-26 in Appalachian Kentucky. Using a convenience sample, young women attending health clinics and a community college in southeastern Kentucky were recruited to participate in a Women's Health Study. After completing a questionnaire, women received a free voucher for the three-dose HPV vaccine series. Completion of dose one served as the outcome variable. Women with a history of an abnormal Pap test were almost two times more likely to decline the HPV vaccine (adjusted odds ratio [AOR] 1.91, 95% confidence interval [CI] 1.14-3.20, p=0.015), and women who reported they had never had a Pap test were four times more likely to decline the vaccine (AOR 4.02, 95% CI 1.13-14.32, p=0.032). Women engaging in mutual masturbation were nearly two times more likely to decline the free vaccine (AOR 1.91, 95% CI 1.17-3.10, p=0.009). Use of hormonal birth control showed a protective effect against refusal of the free HPV vaccine (AOR 0.593, 95% CI 0.44-0.80, p=0.001). Among this sample of Appalachian women, those engaging in behaviors that increase their risk for HPV infection were more likely to refuse the vaccine. Conversely, those women engaging in protective health behaviors were more likely to accept the vaccine. These findings suggest that those women not being vaccinated may be the very group most likely to benefit from vaccination. Cervical cancer prevention programs need to be creative in efforts to reach young women most in need of the vaccine based on a higher profile of sexually related behaviors and the proxy measure of this risk (having an abnormal Pap test result).

Predictors of Human Papillomavirus Vaccination in Female University Students.

The purpose of this study was to identify predictors of HPV (Human papillomavirus) vaccination among female university students. The participants in this study were 1,486 female university students. Data were collected using self-administered questionnaire from september 1, 2010 to June 30, 2011. Data were analysed using descriptive statistics, t-test, chi2-test and logistic regression. The rate of HPV vaccination was 7.2%. Factors that influence HPV vaccination included residential region, smoking experience, family history of cervical cancer, experience having heard about the HPV vaccination, awareness that HPV is a sexual disease, HPV knowledge, perceived seriousness, perceived benefit and perceived barrier in health beliefs. The results suggest a need to increase HPV vaccination campaigns to increase awareness of HPV vaccination. University and health care facilities should provide health education emphasizing perceived seriousness and perceived benefits. Also, the national health insurance corporation should consider addressing cost issues as a barrier to HPV vaccination.