The Influence of Affect on HPV Vaccine Decision Making in an HPV Vaccine Naïve College Student Population

The HPV vaccine is recommended for all adolescents starting at age 11, but coverage is low, especially in the young adult population. The CDC is prioritizing catch-up vaccination and has expanded recommendations for all young adults to age 26. College students may be ideal targets for HPV vaccine interventions as they typically have on-site clinics that offer prevention services and students are in the position to make decisions about their own healthcare. We examined the risk perceptions of 101 HPV vaccine-naïve college students, both in terms of risk cognition (beliefs about susceptibility to HPV-related cancers and genital warts) and affect (worry and fear regarding HPV-related health outcomes) as they relate to HPV vaccine intentions. Participants completed an online survey, reporting absolute and comparative risk perceptions for HPV-related cancers/genital warts, fear and worry related to getting HPV-related cancer and/or genital warts, desire for positive emotions, affective associations with the HPV vaccine, and intentions to get the HPV vaccine. More fear/worry about vaccination was directly associated with increased vaccine intentions. The perceived risk to intentions relation included an indirect effect via fear/worry. Desire for positive affect strengthened this relation. Positive affective associations with the HPV vaccine were also related to increased vaccine intentions. Given the public health impact of increasing HPV vaccine coverage for young adults, educational strategies framing the HPV vaccine positively while decreasing fear/worry related to negative health outcomes might increase interest in on-campus catch-up vaccination

Examining parents' assessments of objective and subjective social status in families of children with cancer.

INTRODUCTION: Understanding the social determinants of child health is a prominent area of research. This paper examines the measurement of socioeconomic position in a sample of families of children with cancer. Socioeconomic position is difficult to measure in pediatric health research due to sensitivity of asking about finances when research is conducted in health care delivery settings, financial volatility associated with periods of pediatric illness, and difficulty recruiting fathers to research. METHODS: Caregivers of children with cancer (n=76) completed a questionnaire that included the MacArthur Scale of Subjective Social Status (SSS). SSS was measured using two 10-rung ladders with differing referent groups: the US and respondents' communities. Respondents placed themselves on each ladder by placing an X on the rung that represented their social position in relation to the two referent groups. Individuals' SSS ratings and discrepancies in SSS ratings within couples were examined, and associations with objective social status measures were evaluated using Pearson correlations or t-tests. RESULTS: Parents' placement on the US and community ladders was positively associated with their income, education, wealth, household savings, and household savings minus debt. On average, respondents placed themselves higher on the US ladder compared to the community ladder. There was an average intra-couple discrepancy of 1.25 rungs in partner's placements on the US ladder and a 1.56 rung difference for the community ladder. This intra-couple discrepancy was not associated with gender. DISCUSSION: Results offer insight into the use of subjective social status measures to capture a more holistic assessment of socioeconomic position and the measurement of socioeconomic position in two-parent families

Demographic Characteristics of Sample.

<p><i>Note.</i> Differences in demographics between subsample of two-parent families and non-two-parent families are noted, <i>*p</i><.05, **<i>p</i><.01. ^aMarital status was dichotomized as “married” vs. “not married” for comparison of subsamples; ^bEducational attainment was dichotomized as “less than bachelor’s degree” vs. “bachelor’s degree or greater” for comparison of subsamples; <b>^c</b>1&2 are high subjective social status categories, 9&10 are low.</p

Within-couple differences in reporting of objective and subjective measures of social status.

<p><i>Note.</i> N = 26 couples.</p

Child Characteristics.

<p>Child Characteristics.</p

Factors influencing patient pathways for receipt of cancer care at an NCI-designated comprehensive cancer center.

BACKGROUND:Within the field of oncology, increasing access to high quality care has been identified as a priority to reduce cancer disparities. Previous research reveals that the facilities where patients receive their cancer care have implications for cancer outcomes. However, there is little understanding of how patients decide where to seek cancer care. This study examined the factors that shape patients' pathways to seek their cancer care at a National Cancer Institute-designated comprehensive cancer center (NCI-CCC), and differences in these factors by race, income and education. METHODS:In-depth interviews and survey questionnaires were administered to a random sample of 124 patients at one NCI-CCC in the Northeast US. In-depth interview data was first analyzed qualitatively to identify themes and patterns in patients' pathways to receive their cancer care at an NCI-CCC. Logistic Regression was used to examine if these pathways varied by patient race, income, and education. RESULTS:Two themes emerged: following the recommendation of a physician and following advice from social network members. Quantitative data analysis shows that patient pathways to care at an NCI-CCC varied by education and income. Patients with lower income and education most commonly sought their cancer care at an NCI-CCC due to the recommendation of a physician. Patients with higher income and education most commonly cited referral by a specialist physician or the advice of a social network member. There were no statistically significant differences in pathways to care by race. CONCLUSIONS:Our findings show that most patients relied on physician recommendations or advice from a social network member in deciding to seek their cancer care at an NCI-CCC. Due to the role of physicians in shaping patients' pathways to the NCI-CCC, initiatives that strengthen partnerships between NCI-CCCs and community physicians who serve underserved communities may improve access to NCI-CCCs

Coding of Factors Motivating Cancer Care Seeking at a NCI-Designated Comprehensive Cancer Center.

<p>Coding of Factors Motivating Cancer Care Seeking at a NCI-Designated Comprehensive Cancer Center.</p

Factors Motivating Cancer Care Seeking at a NCI-Designated Comprehensive Cancer Center by Race, Education, and Income.

<p>Factors Motivating Cancer Care Seeking at a NCI-Designated Comprehensive Cancer Center by Race, Education, and Income.</p

Sample Characteristics.

<p>Abbreviations: NS, Not Significant. P values based on Pearson Chi-Square test results.</p><p>Some Columns do not equal 100% due to rounding.</p><p>Sample Characteristics.</p