“for The Safety Of Our Health”: A Qualitative Analysis Of Pre-Exposure Prophylaxis (prep) Acceptability Among Female Sex Workers In Malaysia

Female sex workers (FSW) in Malaysia are at substantially increased risk of acquiring HIV compared to the general female population. Daily oral pre-exposure prophylaxis (PrEP) offers a novel way to prevent HIV transmission in this population. This research aims to inform culturally relevant implementation of PrEP through a qualitative exploration of the factors that determine FSW willingness to use PrEP. In-depth, semi-structured interviews (n=30) were conducted with FSW in English, Malay, or Tamil. Transcribed and translated interviews were analyzed using a grounded theory approach. FSW expressed positive interest in PrEP but preferred it as a supplement to condoms, not a replacement. Perceived challenges to PrEP use included cost, adherence, side effects, and disinterest. FSW experiences with HIV and condoms support these reactions. This research bolsters prior work on the inapplicability of behavioral disinhibition to FSW and supports PrEP implementation in combination with condom promotion

Engaging health plans to prioritize HPV vaccination and initiate at age 9

Health plans can influence pediatric and primary care providers and patients to understand HPV vaccination coverage and increase HPV vaccination uptake. By initiating vaccination at age nine, health plans can lay the groundwork for on-time HPV cancer prevention by age 13. In 2022, the American Cancer Society engaged 28 health plans in a 12-month HPV vaccination learning collaborative in which plans set their own quality improvement targets, implemented multi-pronged interventions, and joined quarterly best-practice sharing calls. Twenty-five of the 28 plans reported including a focus on ages 9 to 10. Preliminary pre-intervention data illustrate that vaccination rates from participating plans follow national trends and reaffirm existing gaps for HPV vaccination. Health plan interventions to address HPV vaccination are consistent with best practices but could be maximized to target initiation at ages 9–10 by using provider and patient reminders, targeted provider education, and dose-specific provider pay for performance and patient incentive programs. Health plans should explore future capacity to analyze non-HEDIS required data, including HPV initiation and HPV vaccination data for adolescents below age 13

“That Was an Eye Opener for Me”: Mixed-Methods Outcomes Educating Texas Community Health Workers on HPV Vaccination Using Project ECHO^®

Human papillomavirus (HPV) is known to cause six different types of cancer. HPV vaccination can prevent over 90% of these cancers. Community health workers (CHWs) have the potential to drive HPV vaccination demand through education and navigation by addressing vaccine hesitancy and dis/misinformation and by reaching non-English speaking, vulnerable, or rural populations. Despite their possible reach, there is limited research on HPV vaccination education programs for CHWs. In 2020–2021, the American Cancer Society (ACS) HPV Cancer Free Texas (HPVCFT) Project implemented the eight-session Mission: HPVCFT Vaccination ECHO–CHW Program ten times. This manuscript details the program’s implementation processes and outcomes. The program used the Project ECHO model and was offered in both English and Spanish. One hundred and forty-six Texan CHWs completed pre- and post-training surveys. The participants demonstrated significant HPV vaccination knowledge increases and desirable shifts in their foundational HPV vaccination beliefs, including the belief that the HPV vaccine is for cancer prevention. The participants also reported increased confidence in communicating about the HPV vaccine in the community. Improving knowledge, beliefs, and confidence in HPV vaccination is the first step in addressing concerns and increasing uptake. Future research and interventions are needed to better understand how CHWs can be more systematically linked to vaccination opportunities or provided with clearer paths for directing patients to providers that vaccinate

Age nine is possible: Improving age 9 HPV initiation through a national quality improvement initiative during the COVID-19 pandemic

ABSTRACTThe American Cancer Society collaborated with a range of healthcare partners in 2020–2022 to implement quality improvement clinical interventions with the goal of improving HPV vaccination rates among adolescents’ ages 9–13. 2020 was the first cohort for which partners had been asked to submit HPV rate data for patients’ ages 9–12. At least 80% of the partners across all reported project years were able and willing to report HPV rates for these ages. Partners submitted HPV initiation rates at the beginning and end of the 12-month project year along with project activities, including evidence-based interventions (EBIs) implemented. Mean initiation rates for ages 9–10 significantly increased 4.1% during 2020 compared to non-significant rate increases of 2.6% and 2.0% for ages 11–12 and age 13, respectively. In 2021, ages 9–10 initiation saw a non-significant increase of 2.2%, whereas ages 11–12 and age 13 decreased non-significantly by 0.3% and 0.1%, respectively. The 2022 cohort saw significant initiation rate increases of at least 4% across all ages, potentially a promising result of the myriad back on track HPV vaccination campaigns designed to reverse the damage of the COVID-19 pandemic on adolescent immunizations. These findings demonstrate an effective adaptation of quality improvement in increasing HPV vaccination coverage among younger ages even during a national pandemic

Age nine is possible: Improving age 9 HPV initiation through a national quality improvement initiative during the COVID-19 pandemic

The American Cancer Society collaborated with a range of healthcare partners in 2020–2022 to implement quality improvement clinical interventions with the goal of improving HPV vaccination rates among adolescents’ ages 9–13. 2020 was the first cohort for which partners had been asked to submit HPV rate data for patients’ ages 9–12. At least 80% of the partners across all reported project years were able and willing to report HPV rates for these ages. Partners submitted HPV initiation rates at the beginning and end of the 12-month project year along with project activities, including evidence-based interventions (EBIs) implemented. Mean initiation rates for ages 9–10 significantly increased 4.1% during 2020 compared to non-significant rate increases of 2.6% and 2.0% for ages 11–12 and age 13, respectively. In 2021, ages 9–10 initiation saw a non-significant increase of 2.2%, whereas ages 11–12 and age 13 decreased non-significantly by 0.3% and 0.1%, respectively. The 2022 cohort saw significant initiation rate increases of at least 4% across all ages, potentially a promising result of the myriad back on track HPV vaccination campaigns designed to reverse the damage of the COVID-19 pandemic on adolescent immunizations. These findings demonstrate an effective adaptation of quality improvement in increasing HPV vaccination coverage among younger ages even during a national pandemic.</p

Evaluating the Impact of Common Ground High School, Urban Farm, and Environmental Education Center on Student Health Behaviors and Outcomes

Discusses how the curriculum and other factors of Common Ground High School affect the health behaviors of students attending the high school.https://elischolar.library.yale.edu/ysph_pbchrr/1011/thumbnail.jp