Promote HPV Vaccination Research Articles

Educational and communication strategies to promote HPV vaccination: A Systematic Review

Abstract Background Despite the evidence supporting the value of vaccination, Cervical Cancer (CC) and HPV-related diseases still represents a public health challenge, requiring international efforts to address all barriers that can reduce vaccine acceptance and equitable uptake. In this context, implementing interventions aimed at enhancing knowledge levels within target populations emerges as a crucial approach to improve vaccination coverage. Thus, this study conducted within the PERCH project (PartnERship to Contrast HPV), aimed to explore all educational interventions/communication strategies adopted at the international level to improve HPV vaccine uptake. Methods A systematic literature review was conducted by querying three databases from July 1, 2006 (the time of the first HPV vaccine licensure) to January 30, 2024. It included studies focused on educational interventions/communication strategies adopted by healthcare providers (HCPs) targeting the World Health Organization (WHO)-recommended population for HPV vaccination, as well as parents, caregivers, teachers, and other influential individuals involved in vaccination decision-making. Results Overall, 16 studies were considered, with 68.7% (11/16) focusing on educational initiatives and 50% (8/16) on communication strategies. Regarding the target population, 19% (3/16) involved parents/caregivers, 25% (4/16) included both parents and adolescents, and the remaining 56% (9/16) targeted adolescents/young adults. Videos were the most commonly used channel for both types of interventions (54%), followed by informative materials (31%), person-to-person solicitation (17%), social media (15%) and slide presentations (23%). Conclusions Understanding the strengths and weaknesses in HPV knowledge and communication is crucial for developing effective, tailored strategies to disseminate reliable information and promote evidence-based knowledge, thereby implementing high-value healthcare. Key messages • Effective communication of vaccination’s value to stakeholders is essential for informing health policies, guiding best practices, and countering misinformation. • Further research is needed to develop interventions that effectively increase HPV vaccine acceptance, aligning with the WHO’s goals to eliminate CC and HPV-related diseases.

Abstract A066: Unmasking differences in adolescent HPV vaccine uptake in six Asian American subgroups: data from the national immunization survey-teen (2015-2019)

Abstract Introduction: The HPV vaccination rates among Asian American adolescents were found to be below optimal levels. Understanding the high-risk demographics and the various factors influencing HPV vaccine acceptance is essential for addressing disparities and enhancing vaccination rates in this population. This study aimed to investigate HPV vaccine uptake in adolescents aged 13 to 17 across six major Asian American ethnic groups using nationally representative data. Methods: The study analyzed data from the National Immunization Survey- Teen (2015-2019), comprising 3,968 Asian American adolescents from Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese backgrounds. Provider and practice characteristics were examined alongside HPV vaccine initiation and completion rates within each subgroup. Results: Findings revealed that while the overall initiation rate among Asian American adolescents was 66.65%, significant variations existed among subgroups, ranging from 57.3% in Asian Indians to 71.22% in Chinese adolescents. Similarly, completion rates ranged from 30.89% in Asian Indians to 48.14% in Chinese adolescents, with an aggregated completion rate of 40.37% for the total Asian American sample. Household survey data generally showed lower initiation and completion rates compared to provider-reported data but still reflected subgroup disparities. Conclusion: Across all ethnic groups, a common barrier to HPV vaccination was the lack of physician recommendation. However, slight variations in this barrier were observed among subgroups. These findings underscore the importance of considering socioeconomic, cultural, and acculturation-related factors in designing effective public health and clinical interventions to promote HPV vaccination among Asian American adolescents. Citation Format: Lin Zhu, Elaine Z. Liu, Philip Siu, Chun Pan, Grace X. Ma. Unmasking differences in adolescent HPV vaccine uptake in six Asian American subgroups: data from the national immunization survey-teen (2015-2019) [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A066.

Influential factors and willingness to advocate for HPV vaccination among male nursing interns in China

BackgroundHuman papillomavirus (HPV) infection significantly contributes to the global cancer burden. Understanding the factors influencing male clinical interns’ willingness to promote HPV vaccination is crucial for developing effective public health strategies in China.MethodsThis study employed a stratified random sampling method to select 1,980 male clinical interns from five provinces in China between January and March 2024. Data were collected on participants’ demographic characteristics, HPV-related clinical experience, and knowledge. The Theory of Planned Behavior framework, encompassing attitudes, subjective norms, and perceived behavioral control, was used to examine factors influencing the willingness to promote the HPV vaccine. Logistic regression analyses were conducted to identify factors associated with the willingness to promote the HPV vaccine.ResultsAmong the respondents, 72.29% were willing to encourage others to receive the HPV vaccine. Significant factors influencing this willingness included older age (OR = 3.065, P ≤ 0.001), higher monthly household income (OR = 1.449, P = 0.025), participation in the diagnosis and treatment of HPV-related diseases (OR = 3.458, P ≤ 0.001), positive attitude towards the vaccine (OR = 13.503, P = 0.004), and strong perceived behavioral control (OR = 2.364, P = 0.006).ConclusionThis study highlights the critical role of practical experience and targeted education in promoting HPV vaccination among male clinical interns in China. Enhancing the training and education of this group is essential for improving HPV vaccine advocacy and supporting public health efforts to reduce HPV-related diseases.

Promoting HPV vaccination: effectiveness of mobile short videos for shaping attitudes and influencing behaviors

The explosive growth and attractive features of mobile short videos (MSVs) have made it become an effective tool for disseminating health-related information. This study aims to examine the potential informational and technical factors of MSVs, which contribute to the persuasive effects on people’s decision-making process toward HPV vaccination. An experiment with a 2 (information quality: high vs. low) × 2 (source credibility: high vs. low) × 2 (media richness: high vs. low) between-subject factorial design was conducted among 248 Chinese female students. Findings revealed significant persuasive impacts of three factors, i.e., information quality, source credibility, and media richness, on participants’ HPV vaccination intent, via the mediation effect of attitude toward HPV vaccine information. Significant two-way interaction effects indicated that the persuasive effects of media richness varied across different levels of information quality and source credibility. This research not only applied the theoretical lens of the elaboration likelihood model and media richness theory to understand the influencing mechanism within short-form videos but also offered valuable guidelines regarding how professionals best adopt emerging media to maximize health outcomes.

HPV Vaccination Information Access, Needs, and Preferences Among Black and Hispanic Mothers

HPV-associated cancer disparities disproportionately affect Black/African American and Hispanic individuals in the U.S. HPV vaccination, which can prevent many HPV-associated cancers, should be clearly recommended by pediatricians to parents of adolescents aged 9–12, yet uptake and completion remain lower than other adolescent vaccinations. We used the Structural Influence Model of Health Communication to explore communication inequalities from interviews with 19 Black and Hispanic mothers of adolescents. We identified HPV vaccination information seeking behaviors, media use, and preferred channels to address information needs. This study provides insights into how mothers’ nativity and ethno-racial identity influenced how they accessed and processed information from various sources. Preferences for digital and community-based strategies to address information gaps and hesitancy concerns are also presented. Findings suggest future prevention strategies must increase access to accurate information that resonates with NH-Black and Hispanic communities’ needs and is disseminated via preferred communication channels to maximize the effects of multi-level interventions promoting HPV vaccination among communities experiencing disparities.

Unveiling the potency of FDA-approved oxidopamine HBr for cervical cancer regulation and replication proteins.

Cervical Cancer remains a women's health concern worldwide and ranks among the most prevalent cancers, particularly in developing countries. Many women are diagnosed with cervical cancer, with a substantial number succumbing to the disease even after the availability of vaccines and drugs. The tumour microenvironment often exhibits immune evasion, including suppression of T-cell activity and altered cytokine, impacting the efficacy of therapeutic interventions and highlighting the need for treatments to modulate the immune response. Despite efforts to promote HPV vaccination and regular screenings, it causes many deaths, underscoring the urgent need for continued research, healthcare access, and rapid drug development or repurposing. In this study, we identified various proteins involved in cervical cancer cell cycle regulation and DNA replication proteins, performed the multitargeted docking with an FDA-approved library, and identified Oxidopamine HBr as a multitargeted drug. Studies extended with pharmacokinetics and compared with the standard values followed by DFT, which supported the compound as a multitargeted inhibitor. Further, the docked complexes were taken for the interaction fingerprints, and it was identified that there are many 9 polar, 5 hydrophobic, 2 aromatic, and 2 basic residues. We extended our studies for 100ns MD Simulation in water, and the computations explored the deviation and fluctuations under 2Å and many intermolecular interactions; the same trajectory files were used for the MM\GBSA studies. All the studies have supported the Oxidopamine HBr as a cervical cancer multitargeted inhibitor-however, experimental studies are needed before human use.

Burden of cervical cancer in India: estimates of years of life lost, years lived with disability and disability adjusted life years at national and subnational levels using the National Cancer Registry Programme data

BackgroundCervical cancer is ranked as the second most common cancer in India. This study aims to assess the cervical cancer burden at the national and subnational level in India, projecting it for the year 2025 in terms of years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs).MethodsTwenty-eight population based cancer registries within the National Cancer Registry Programme network contributed cancer incidence and mortality data for this analysis. The DisMod-II tool, WHO lifetables, disability weights, mortality to incidence ratio, sample registration system, and census data were used to estimate the burden of cervical cancer. The projection estimates for 2025 were performed using a negative binomial regression model.ResultsIn 2016, the cervical cancer burden in India was 223.8 DALYs per 100,000 women. The highest age-standardised DALYs were found in the northeast region (290.1 DALYs per 100,000 women) and the lowest in the eastern region (156.1 DALYs per 100,000 women). The states of Mizoram, Arunachal Pradesh, Karnataka, and Nagaland had a higher cervical cancer burden with DALYs exceeding 300 per 100,000 women. The projected cervical cancer burden for India in 2025 was estimated to be 1.5 million DALYs.ConclusionsThe study has found a significant cervical cancer burden across the regions of India, providing a baseline for monitoring impact of actions. Enhancing awareness of cervical cancer, advocating for the significance of screening, and promoting HPV vaccination among adolescents, families, and communities through informative communication campaigns are essential steps in managing and ultimately eliminating cervical cancer in India.

Use of concept mapping to inform a participatory engagement approach for implementation of evidence-based HPV vaccination strategies in safety-net clinics

BackgroundMultiple evidence-based strategies (EBS) for promoting HPV vaccination exist. However, adolescent HPV vaccination rates remain below target levels in communities at high risk for HPV-associated cancers and served by safety-net clinics. Participatory engaged approaches are needed to leverage the expertise of community and clinical partners in selecting EBS relevant to their local context. We engaged concept mapping as a method to inform the adoption and adaptation of EBS that seeks to empower implementation partners to prioritize, select, and ultimately implement context-relevant EBS for HPV vaccination.MethodsUsing 38 EBS statements generated from qualitative interviews and national HPV vaccine advocacy sources, we conducted a modified concept mapping activity with partners internal to safety-net clinics and external community members in two study sites of a larger implementation study (Greater Los Angeles and New Jersey), to sort EBS into clusters and rate each EBS by importance and feasibility for increasing HPV vaccination within safety-net clinics. Concept mapping findings (EBS statement ratings, ladder graphs and go-zones) were shared with leaders from a large federally qualified health center (FQHC) system (focusing on three clinic sites), to select and implement EBS over 12 months.ResultsConcept mapping participants (n=23) sorted and rated statements, resulting in an eight-cluster solution: 1) Community education and outreach; 2) Advocacy and policy; 3) Data access/quality improvement monitoring; 4) Provider tracking/audit and feedback; 5) Provider recommendation/communication; 6) Expanding vaccine access; 7) Reducing missed opportunities; and 8) Nurse/staff workflow and training. The FQHC partner then selected to intervene on eight of 17 EBS statements in the “go-zone” for action, with three from “reducing missed opportunities,” two from “nurse/staff workflow and training,” and one each from “provider tracking/audit and feedback,” “provider recommendation/communication,” and “expanding vaccine access,” which the research team addressed through the implementation of three multi-level intervention strategies (e.g., physician communication training, staff training and workflow assessment, audit and feedback of clinic processes).ConclusionsConcept mapping provided a powerful participatory approach to identify multilevel EBS for HPV vaccination relevant to the local safety-net clinic context, particularly when several strategies exist, and prioritization is necessary. This study demonstrates how a clinic system benefited directly from the ratings and prioritization of EBS by multilevel clinic and community partners within the broader safety-net clinic context to identify and adapt prioritized solutions needed to advance HPV vaccine equity.

A multilevel intervention to promote HPV vaccination among young adults in Texas: protocol for a randomized controlled trial

BackgroundHuman papillomavirus (HPV) infections can cause cancers of the cervix, vagina, vulva, penis, anus, and oropharynx. The most recently approved HPV vaccine, Gardasil-9, protects against HPV infection and can prevent HPV-associated invasive cancers. However, Gardasil-9 is one of the most underused vaccines in the US today. Young adults are at risk for HPV infection, but many are not vaccinated. This study uses a randomized controlled trial (RCT) to test an innovative multilevel intervention to increase HPV vaccination rates among young adults. In this paper, we describe the research protocol.MethodsThe study uses a two by three factorial design. A total of 1200 young adults in Texas, age 18–26 years, who have not been previously fully vaccinated against HPV will be randomly assigned to one of six conditions to receive: (1) standard CDC information about HPV vaccination (control); (2) video narratives about HPV vaccination; (3) written narratives about HPV vaccination; or (4–6) enhanced access to HPV vaccine combined with (4) standard CDC information, (5) video narratives, or (6) written narratives. The two primary outcomes are the rate of HPV vaccination initiation by 3-month follow-up and rate of HPV vaccination completion by 9-month follow-ups. We will determine the impact of the individual level intervention (i.e., persuasive narratives through video or written format), the systemic level intervention (i.e., enhanced access to HPV vaccines), and the combination of both levels, on HPV vaccination initiation and completion. We will also use purposive sampling to select participants to take part in semi-structured interviews/focus groups to better understand the mechanisms of the intervention.DiscussionRecruitment and data collection began in March 2022. We expect to complete data collection by March 2026. We expect that narratives, enhanced access, and the combination of both will improve HPV vaccination initiation and completion rates among young adults. If proven successful, these individual- and system-level interventions can be easily disseminated in regions with low HPV vaccination rates to improve HPV vaccination, and ultimately decrease HPV-related cancer burden.Trial RegistrationNCT05057312.

Assessing a Continuing Education Course for Dental Hygienists to Improve HPV and HPV Vaccine Knowledge and Self-efficacy.

Human papillomavirus is the most common sexually transmitted infection and causes anogenital and oropharyngeal cancers. Although HPV-related cancers can be prevented through vaccination, HPV vaccination rates are low compared to other vaccines. One of the strongest indicators for vaccination is provider recommendation, and dental health providers are well positioned to promote HPV vaccination among their patients. The purpose of this study was to determine if a continuing education (CE) course could improve dental hygienists' HPV-related knowledge and self-efficacy related to HPV vaccination recommendations. Data were collected from a sample of participants (n = 202) at a large dental hygiene conference in the southern US. A pre- and post-tests were administered with the CE course and differences in HPV vaccine knowledge and self-efficacy in counseling, recommending, and referring for the HPV vaccine were analyzed using SAS. HPV vaccine knowledge overall significantly increased post-CE (p < .001) and improvement was seen among several specific knowledge areas. However, knowledge regarding the common sites of HPV-related oral and oropharyngeal cancers remained moderate (82% correct) even after the CE intervention. There was no significant change from pre-test to post-test in participants' self-efficacy related to counseling patients about the HPV vaccine, recommending the HPV vaccine to patients, or referring patients for the vaccine. This study demonstrates that continuing education can improve dental hygienists' HPV-related knowledge. Since dental providers may play an important role in HPV-related cancer prevention, future work should develop continuing education tools that can motivate changes in self-efficacy and ultimately improve practice behaviors.

Knowledge, Awareness, and Perception Towards Human Papilloma Virus Vaccination Among the General Population in Makkah, Saudi Arabia: A Cross-Sectional Study

Background and aim: This cross-sectional study sought to assess knowledge, awareness, and perceptions about HPV vaccination among the general population in Makkah, Saudi Arabia, and identify factors influencing HPV vaccination decisions. Materials and Methods: From May to April 2023 in Makkah, a descriptive cross-sectional study was carried out using random sampling techniques to select 501 participants for this research project. An online survey was distributed through social media platforms to collect the necessary data using structured questionnaires. Descriptive statistics and logistic regression models were then employed for data analysis. Results: Most participants were female (78.1%), Saudi nationals (95.6%) and married (51.3%). Only 41.3% were familiar with HPV, and their awareness varied regarding its association with cervical cancer and genital warts. Among those informed about HPV, 72.0% were aware of the HPV vaccine, and about two-thirds believed it could prevent cervical cancer. Concerns regarding potential side effects were prevalent among participants. Factors associated with knowledge about HPV included employment in a health-related sector, pursuing a health specialty degree, and higher family income. Conversely, being married and older was associated with lower levels of awareness. Conclusion: This study highlights a lack of knowledge and awareness regarding HPV infection and the HPV vaccine among the general population in Makkah, Saudi Arabia. Efforts should be made to improve education and awareness programs to increase knowledge about HPV and promote HPV vaccination. Targeted interventions addressing misconceptions and concerns about the vaccine could enhance vaccine acceptance and uptake among the population.

Implicit theories of health predict HPV vaccination intention among young adult Chinese women: The mediating effect of consideration of future consequences and future self-continuity.

This study investigated the predicting effect of implicit theories of health on HPV vaccination intention among young adult Chinese women and its underlying mechanisms. Four-hundred and eighty-three young Chinese women adults (18-26 years old) participated this study by completing measures on implicit theories of health, consideration of future consequences, future self-continuity, and reported their HPV vaccination intention. The results demonstrated that age, whether they knew someone being diagnosed with cancer, implicit (incremental) theories of health, consideration of future consequences (CFC-Future), and future self-continuity significantly predicted young adult Chinese women's HPV vaccination intention. The predicting effect of implicit theories of health was mediated by consideration of future consequences and future self-continuity. Implications of the current research for promoting HPV vaccination among young adult women and directions for future research are discussed.

Using an extended information-motivation-behavioral skills model to explain HPV vaccination intention among men who have sex with men only and men who have sex with men and women

ABSTRACT Men who have sex with men and women (MSMW) have been reported to differ in psychosocial and sexual behavior patterns from men who have sex with men only (MSMO). However, results regarding the differences in HPV vaccination intention/behavior were inconclusive. We compared HPV vaccination intention between MSMO and MSMW and analyzed the differences in potentially associated factors in China. MSM participants were recruited online using a snowball sampling method. Cross-sectional data were collected via a questionnaire based on the extended information-motivation-behavioral skills model. Structural equation modeling was conducted to examine the relationship between the variables, followed by multi-group analysis to test differences between groups. Of 914 MSM, 77.68% were MSMO and 22.32% were MSMW. MSMW had a higher rate of reluctance to vaccinate than MSMO (23.53% vs. 16.20%, p = .016). Differences between the two groups were statistically significant in risky sexual behavior, behavioral skills, and promotional attitude. In both groups, promotional attitude was the most significant predictor of vaccination intention. Vaccination intention was directly influenced by motivation and indirectly by risky sexual behavior in MSMO, but not significantly in MSMW. Additionally, the direct effect of information on behavioral skills in MSMW was significantly greater than that in MSMO, but we did not find any effect of behavioral skills on vaccination intention. MSMW had lower vaccination intention than MSMO. MSMO may be influenced by risky sexual behavior and motivation, positively impacting their vaccination intention, unlike MSMW. Targeted strategies could help promote HPV vaccination, especially in MSMW.

KNOWLEDGE, ATTITUDES, PRACTICES, and INFLUENCING FACTORS of HUMAN PAPILLOMAVIRUS (HPV) and HPV-RELATED DISEASES among YOUNG PEOPLE Aged 15-26 YEARS

This study aimed to assess the knowledge, attitudes, and practices of HPV and HPV-related diseases as well as associated influencing factors among young Chinese people aged 15-26 years. Participants aged 15-26 years living in mainland China were recruited between September 2022 and March 2023 by convenience sampling. Demographic characteristics and the knowledge, attitudes, and practices of HPV and HPV-related diseases were assessed in questionnaires. The data collection process of this cross-sectional study was executed online. Data analysis used descriptive statistical analysis, chi-squared (χ2) test, and binary logistic regression analysis. In this study, 1005 valid questionnaires were collected. 910 had heard of HPV, 835 had a high level of HPV knowledge, 778 had a high level of HPV-related diseases knowledge, and the HPV vaccination rate was 23.10%. The logistic regression analysis showed that aged 19-22 years (OR=2.330, p=0.001), aged 23-26 years (OR=3.216, p=0.005), female (OR=3.020, p&lt;0.001), majoring in medicine (OR=2.109, p&lt;0.001), having relatives engaged in medical work (OR=2.234, p&lt;0.001), and using condoms at sexual intercourse (OR=2.322, p=0.009) were the influencing factors of HPV knowledge. Furthermore, the result showed that aged 19-22 years (OR=1.925, p=0.003) and aged 23-26 years (OR=2.484, p=0.009), majoring in medicine (OR=2.799, p&lt;0.001) and using condoms at sexual intercourse (OR=3.262, p&lt;0.001) were the influencing factors of HPV-related diseases knowledge. The findings revealed that young people aged 15-26 years had a high level of HPV and HPV-related diseases knowledge, but they still did not have enough in-depth understanding. Besides, the HPV vaccination rate was low, but the vaccination intention was high. In the future, it is necessary further to strengthen health education on HPV and HPV-related diseases, optimize HPV vaccination policy, and promote HPV vaccination.

Cervical cancer in the Autonomous Province of Vojvodina, Serbia, 2016-2021

Background: Cervical cancer is a major global health problem, and one of the most common causes of cancer in women. This descriptive epidemiological study aimed to provide an overview of the cervical cancer incidence and mortality in Vojvodina. Methods: The data from the Serbian Cancer Registry regarding the cervical cancer incidence and mortality for the period 2016?2021 were analyzed. Results: During the observed 6-year period, the average age-standardized incidence rates of cervical cancer in Vojvodina and Serbia were 20.4 and 19.1 per 100,000 women, respectively. The average age-standardized incidence rates by the district of Vojvodina ranged from 16.8 to 30.2/100,000. The average age-standardized cervical cancer mortality rate in Vojvodina and Serbia was 7.0 and 6.6/100,000, respectively. The average mortality rates by the district of Vojvodina ranged between 5.6/100,000 and 9.9/100,000. Conclusion: The cervical cancer incidence and mortality rates in Vojvodina exhibited significant variation across different districts and observed years, with their average values surpassing the national average. To improve the epidemiological situation of cervical cancer in Vojvodina, it is imperative to enhance the implementation of organized screening at the district level, coupled with intensified efforts to promote HPV vaccination throughout Vojvodina. Additionally, more research on screening coverage and vaccination rates and improved reporting cervical cancer cases and deaths are needed.

Building knowledge using a novel web-based intervention to promote HPV vaccination in a diverse, low-income population

ObjectivesHPV vaccination rates remain suboptimal despite proven efficacy. Data suggest misconceptions or lack of knowledge are leading barriers. Our study aimed to develop and pilot a novel interactive education resource designed to educate parents and patients about HPV vaccines. MethodsThis is a prospective pilot study conducted in an urban teaching hospital pediatric clinic. The Patient Activated Learning System (PALS) intervention included 3 web-based videos with HPV vaccine-related educational content. Participants were parents of adolescent patients, aged 11–17 years, and young adult patients, aged 18–26 years. Enrolled participants completed an HPV vaccine knowledge survey before and after watching PALS; paired scores were evaluated. Acceptability and participant-reported impact of PALS modules were measured via Likert-scale surveys. Results132 individuals were approached; 101 (76%) enrolled and completed the study. Participants self-identified as Hispanic (50%), non-Hispanic Black (23%), non-Hispanic White (7%), Asian (6%), American/Alaskan/Hawaiian Native or Pacific Islander (5%). Half reported earning ≤$40,000 annually; 57% had only a high school education. Post-intervention knowledge scores were increased compared to baseline (9.87/27 points vs 17.53/27 points, p < 0.01). PALS modules were reported as enjoyable to use and understandable (89% and 93%, respectively), and improved participants' understanding of the importance of HPV vaccination (90%). Of the 18 patients unvaccinated at baseline, 39% received 1 shot of the HPV vaccine within one month. ConclusionThe PALS HPV vaccine educational intervention was feasible, acceptable, and improved knowledge among a diverse, underserved population. Our intervention may positively influence HPV vaccination rates, with potential to overcome HPV vaccine hesitancy.

Perspectives of HPV vaccination among young adults: a qualitative systematic review and evidence synthesis protocol

IntroductionHuman papillomavirus (HPV) is the causative agent of nearly all cervical cancers. Despite the proven safety and efficacy of HPV vaccines in preventing HPV-related cancers, the global vaccine coverage rate...

Abstract C099: Take CARE: An implementation science initiative to reduce the cervical cancer burden in Appalachia

Abstract Appalachia has a higher burden of cervical cancer than other regions of the United States. Cervical cancer risk factors and causes are largely known, so evidence-based interventions in health systems addressing those factors and causes can improve cervical cancer incidence and mortality rates. Take CARE (Clinical Avenues to Reach Health Equity) is designed to address three factors strongly associated with cervical cancer and is made up of three evidence-based complementary initiatives focused on HPV vaccination, smoking cessation, and cervical cancer screening: I Vaccinate, Break Free, and The HOME Initiative, respectively. The overall goal is to use implementation science designs to provide an integrated approach to reduce cervical cancer risk among patients of 39 health centers from ten participating systems. The project was implemented in two phases: formative and trial. In the formative phase, community profiles were developed to better understand the cancer burden and resources available. Community members and clinic staff were interviewed about barriers to cervical cancer screening and HPV vaccination and norms about screening, vaccination, and tobacco cessation. Findings informed study materials. Clinic champions were identified, and implementation teams were formed to support the champion role. Details were gathered about facility processes, staffing, patient load, and existing cervical cancer-related activities. Waiting room seating, availability of digital displays, number of exam rooms, and locations for promotional materials and staff trainings were documented through environmental scans. The trial phase was introduced as a delayed group implementation design in ten health systems located in Appalachian counties of Kentucky, Ohio, Virginia, and West Virginia from October 2020 to June 2022. Five systems were assigned to an Early Group and five to a Late Group that would receive the intervention 12 months after Early systems. I Vaccinate was first to be implemented, promoting HPV vaccination in 9–45-year-olds. Health systems receive education materials and providers select strategies and set goals to improve vaccination rates. Break Free was introduced six to eight weeks later and identifies eligible smokers who want to quit in the next six months, providing free smoking cessation counseling and medication to patients. Systems received education on the Ask, Advise, Refer model and could select staff to be trained as Tobacco Treatment Specialists. HOME was the final initiative introduced and focuses on improving cervical cancer screening in underscreened female patients via a mail-based HPV self-sampling program. One year after the first initiative launched, health systems were taught to bundle the initiatives as one program, Take CARE. After this, the Early systems entered a sustainability phase for two years. The process will occur similarly for Delayed health systems but with only one year of sustainability. Analyses will focus on changes in HPV vaccination, smoking cessation, and cervical cancer screening over time. Citation Format: Ryan D. Baltic, Roger Anderson, Mark B. Dignan, Amy K. Ferketich, Mira L. Katz, Stephenie Kennedy, Paul L. Reiter, Electra D. Paskett. Take CARE: An implementation science initiative to reduce the cervical cancer burden in Appalachia [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C099.

Public perception of the resumption of HPV vaccine recommendation in Japan: Twitter content analysis.

On 12 November 2021, after a stagnation of 8.5 years, Japan decided to resume proactive recommendations for HPV vaccines. However, it is not known how the public reacted to the resumption of proactive recommendations for HPV vaccines, which are key elements in health communication that promote HPV vaccination. This study aimed to capture discussions on HPV vaccination on Twitter and to identify user characteristics, sentiments, discussed themes and their potential reach before and after 12 November 2021, when the Ministry of Health, Labour, and Welfare's decision to resume proactive recommendation for HPV vaccines was first reported by the media in Japan. This study conducted a content analysis of tweets related to HPV vaccines posted on 11 November and 12 November 2021. Tweets were coded in terms of user characteristics, sentiments (i.e. positive, negative and neutral) and themes. Reach was measured by the number of retweets, likes and followers. A total of 3623 tweets were identified. The results showed that approximately 50% of health professionals and researchers tweeted neutral content about HPV vaccines. The most frequently discussed theme was the safety and side effects of HPV vaccines, which was accompanied by mainly negative sentiments. Although health professionals and researchers are influential on Twitter, half of them tweeted neutrally about HPV vaccines. Influential professionals, such as health professionals and researchers, are expected to disseminate accurate information to correct misinformation and recommend HPV vaccination on Twitter to overcome the HPV vaccination crisis, which is characterized by the low vaccination rates.

Factors Influencing HPV Vaccine Intentions in Malaysian Men Who Have Sex with Men: A Cross-Sectional Study in Malaysia.

In the landscape of healthcare disparities and the marginalized status of men who have sex with men (MSM) in Malaysia, understanding the dynamics surrounding HPV vaccination is of paramount importance. The purpose of this study is to examine the knowledge and attitudes of MSM regarding HPV vaccination and to identify factors that may hinder or facilitate its uptake. The findings will contribute to the development of targeted interventions to promote HPV vaccination and reduce the burden of HPV-related health issues among Malaysian MSM. Between May 2019 and September 2022, an online cross-sectional survey was conducted to collect data through popular social media platforms targeting MSM in Malaysia. A multivariable logistic regression model was employed to investigate the associations between HPV vaccination intention and various influencing factors. Out of the total 411 respondents in the study, 266 (60.3%) indicated an intent to receive the HPV vaccination, falling under the categories of "certain to happen", "very likely", and "likely". The average knowledge score for participants was 6.82 (SD = 3.93, range 0-13) out of a total possible score of 13. In the multivariate logistic model, participants who identified themselves as bisexual (OR 6.93, 95% CI 2.35-20.41) and gay/homosexual (OR 4.36, 95% CI 1.66-11.42) showed a greater inclination to receive the HPV vaccine compared to heterosexual participants. High intent to be vaccinated for HPV infection was positively and significantly associated with a high level of knowledge (OR 1.79, 95% CI 1.09-2.95). In the multivariable model, there was no significant association between all variables of attitudes towards HPV infection and HPV vaccinations and the intention to receive HPV vaccination. Study participants reported a low level of susceptibility to HPV infection despite their perception that HPV infection is severe. Two-thirds of participants expected to encounter stigma in healthcare settings during future implementation of HPV vaccination programs. This study underscores the importance of improving HPV vaccine acceptance among Malaysian MSM due to the moderate acceptance level observed. In Malaysia, promoting HPV awareness, enhancing risk perception, and addressing stigma and sensitivity surrounding HPV vaccination may be beneficial in increasing the vaccination willingness among MSM.