Examining Differences in HPV Awareness and Knowledge and HPV Vaccine Awareness and Acceptability between U.S. Hispanic and Island Puerto Rican women

Background: In 2015, only 42% of Puerto Rican (PR) girls aged 13-17 and 44% of U.S. Hispanic girls aged 13-17 were vaccinated with all three Human Papillomavirus (HPV) vaccine doses. These percentages were far lower than the Healthy People 2020 goal of 80% of girls aged 13-15 completing the vaccine series. The purpose of this study was to examine potential differences in HPV awareness and knowledge and HPV vaccine awareness and acceptability between a population-based sample of U.S. Hispanic and island Puerto Rican women. Methods: We restricted our analyses to female respondents from the Health Information National Trends Survey (HINTS) 2007 (n=375; U.S. Hispanic) and HINTS Puerto Rico 2009 (n=417; PR). Using the Wald chi-square test, we assessed if there were significant differences in HPV awareness and knowledge and HPV vaccine awareness and acceptability between U.S. Hispanic and island PR women. We then utilized logistic or multinomial regression to control for covariates on significant outcomes. Results: Both groups of Hispanic women were highly knowledgeable that HPV causes cancer (89.2% in both samples) and that HPV is a sexually transmitted infection (78.1% [U.S. Hispanics] and 84.7% [PR]). Less than 10% of both groups recognized that HPV can clear on its own without treatment. Island PR women had significantly higher HPV vaccine awareness (66.9% vs. 61.0%; Wald X2 F(1, 97) = 16.03, p \u3c .001) and were more accepting of the HPV vaccine for a real or hypothetical daughter, compared to U.S. Hispanic women (74.8% vs. 56.1%; Wald X2 F(2, 96) = 7.18, p \u3c .001). However, after controlling for sociodemographic variables and survey group, there was no longer a difference between the two groups of women and HPV vaccine awareness (AOR = .53; 95% CI = .23, 1.24). Moreover, after controlled analysis, island PR women were significantly less likely to have their hypothetical daughter get the HPV vaccine, compared to U.S. Hispanic women (AOR = 0.26; 95% CI = .08, .81). Conclusions: Future research focused on factors contributing to differences and similarities in HPV knowledge and awareness and HPV vaccine awareness and acceptability between these two groups of Hispanic women is warranted. Findings may assist in developing health education programs and media to promote HPV vaccination among both groups

Mixed-methods assessment of barriers to physical activity for middle school Latina girls

Meeting physical activity guidelines is associated with positive mental, physical, and social health. However, most adolescent girls do not meet the recommended level of physical activity, with Latina girls even less likely than white girls to do so. Partnership for Girls (PG) sought to improve physical activity (PA) and reduce sedentary behaviors to prevent obesity and obesity-related health disparities among low-income Latina adolescent girls attending Westside San Antonio schools. This study utilizes mixed-methods data—qualitative formative assessments with parents of adolescent girls to gain further insight on the PA needs of Latina girls, and standard quantitative survey assessments to examine barriers and facilitators to PA from the perspective of the Latina girls. Results from the parent focus groups identify safety, cost, and neighborhood structure, such as traffic, as salient barriers to physical activity. In alignment with the focus groups, the feasibility study found that the middle school Latinas’ neighborhood environment was a major barrier to physical activity. Policymakers and planners must address the structural obstacles, such as neighborhood structure and safety concerns, to address physical activity disparities among Latina middle school girls

Cervical cancer, human papillomavirus (HPV), and HPV vaccination: Exploring gendered perspectives, knowledge, attitudes, and cultural taboos among Mexican American adults

Background: Gendered perspectives may be particularly important in shaping norms and values around HPV and HPV vaccination, as previous research suggests that sexuality taboos (e.g. promiscuity) may contribute to low perceived risk among adolescent and young adult Hispanic females. However, research to date focuses primarily on Hispanic mothers, adolescent females, and women of HPV vaccine-eligible age. Hispanic father\u27s perspectives are relatively unknown despite father\u27s important role in shaping norms for their female children. Objective: To close this gap, this study examines gendered perspectives in knowledge, beliefs, and attitudes about HPV and HPV vaccination from Hispanic parents (mothers and fathers), women of vaccine-eligible age (18-26 years old), and women eligible for Pap Test screening (\u3e26 years old) living in two counties along the Texas-Mexico border. Design: We conducted eight focus groups. Research staff transcribed audio recordings verbatim and uploaded them into Atlas(ti) 5.0 for analysis. The research team analyzed the data for content, meaning, patterns and themes using the constant comparison approach. Results: Perspectives were highly gendered. Women\u27s (all groups combined) beliefs focused on misconceptions around how the HPV virus is contracted (e.g. toilet surfaces). Women also linked HPV-related sexual risk to adultery and indiscretion of male partners. Fathers (men) were more likely to link risk to female promiscuity. Fathers also worried that HPV vaccination might increase promiscuity. All groups believe that HPV vaccination is a way to protect Hispanic females in the face of beliefs around sexual behavior and risk of contracting HPV. Conclusion: Results suggest gendered differences in risk beliefs concerning HPV among Hispanics living along the Texas-Mexico border. Researchers can use these findings to address barriers to HPV vaccination, as well as to create culturally appropriate prevention messages that may help reduce disparities in HPV among Hispanic women

Engaging Latino Adolescent Girls in Physical Activity Intervention Planning in a Low-income, Urban Environment

Purpose: Latino adolescent girls are less physically active than the general adolescent population, which puts them at increased risk for obesity and chronic disease. The Physical Activity Partnership for Girls (PG) uses a community-based participatory research approach to assess community needs and priorities related to physical activity (PA) behaviors of middle school girls living in low-income, urban sectors of San Antonio, Texas. Input was sought from girls, parents, and youth-serving agencies serving the community to inform the development of an innovative PA intervention utilizing low-cost, mobile technology (texting) and social media that will be delivered through Girl Scout troops. We will describe the results of two strategies used to elicit the perspectives of girls about their PA and technology use: 1) participatory photomapping (PPM), and 2) self-administered survey. Methods: Girl Scouts facilitated the participation of 40 girls (11-14years) in PPM activities to guide girls in assessing their active living experience in the community. PPM integrates traditional photovoice strategy with geographic information systems technology, connecting qualitative data to specific locations on a map. In addition, girls (n=102) completed a self-administered survey to assess access to and use of technology, including mobile phones, computer, television, internet, social networking, and PA. Results: The PPM process took place over 12 weeks and involved multiple photo walks, guided group discussions, and the development of an advocacy presentation for a community retreat. Of the 40 participants enrolled, 10 completed the process. The resulting photomap, presented to community stakeholders, revealed key themes about environmental barriers to PA for girls, including animal control, built environment, and safety concerns. Survey results indicated cell phone ownership and use varied by age: 76% of 14-year-olds owned a cell phone compared to 43% of 11-year-olds; 14-year-olds reported using cell phone 49 hours/week compared to 9 hours/week for 11-year-olds. Cell phone ownership was significantly associated with higher levels of PA (P≤0.05) and personal contentment (P=0.006). Conclusions: Use of cell phones and social networking holds promise as an effective strategy for engaging girls in improving individual PA behaviors. However, interventions should also address environmental concerns girl identified through PPM in order to maximize potential benefit

Acculturation, Body Mass Index, Waist Circumference, and Physical Activity in Mexican Origin Women

Purpose: Longer time in the United States (US) is associated with increased risk of obesity in Hispanic immigrants, particularly for women. Although previous research has established an association between nutrition and acculturation, little attention has focused on physical activity. In this study, we examine the associations between acculturation on Mexican origin women’s body mass index (BMI), waist circumference (WC), and report of moderate to vigorous physical activity (MVPA). Method: Mexican origin women ≥18 years (n=120) from South Carolina (n=60) and Texas Lower Rio Grande Valley (n=60) completed a survey and anthropometric measures. Participants reported MVPA in hours per week, country of birth, age at migration (\u3c16\u3eyears, 16-25 years, and ≥26 years), and language use. Using these latter two as indicators of acculturation, we evaluated associations between acculturation and BMI, WC, and MVPA. Results: Age standardized means for BMI indicated lowest BMI and waist circumference measures among women either with middle-range English language proficiency or who had immigrated to the US between the ages of 16-25; however, the relationship with BMI was more robust. Age standardized means for MVPA show that women who migrated at younger ages (\u3c16\u3eyears) had the lowest MVPA levels, followed by those migrating as younger adults (16-25 years), then adults (≥26 years). Similarly, women with lowest English proficiency levels had the lowest reported MVPA and those with highest English proficiency had highest reported MVPA. Conclusions: The relationship between acculturation and obesity and MVPA is multifaceted. While the relationship between MVPA and the two indicators of acculturation appear to be linear, the direction of association varied by acculturation indicator. Moreover, the association with acculturation indicators and measures of obesity was not linear. The findings from this study have implications in how researchers interpret the relationship between acculturation, obesity and obesity risk factors

Parenting practices, acculturation and Hispanic youth\u27s sexual health

This dissertation examined the impact of acculturation and the influence of the family (specifically parenting practices) on Hispanic youth\u27s sexual behavior and reproductive health and is presented in the form of three papers. In the first paper, we assessed the reliability and validity of the Bicultural Acculturation Scale/Language Proficiency (BAS/LP) subscale for use among Hispanic middle school-aged youth. The purpose of the second paper was to examine the associations between initiation of vaginal intercourse, parental monitoring, and parent-child communication while controlling for acculturation and other recognized covariates. Finally, the purpose of the third dissertation paper was to examine HPV vaccine knowledge, attitudes, and acceptability among Hispanic mothers and girls using strategic focus groups. The three papers will jointly extend the knowledge about Hispanic youth and their parents regarding both sexual initiation and uptake of the HPV vaccine. In addition, findings from the papers can inform the development of interventions for Hispanic youth and their parents to delay sexual initiation and increase HPV vaccine uptake

Hispanic Mothers' and High School Girls' Perceptions of Cervical Cancer, Human Papilloma Virus, and the Human Papilloma Virus Vaccine

AbstractPurposeCervical cancer incidence and mortality are higher for Hispanic women than for women in other population groups. However, the incidence could be reduced if teenaged Hispanic girls received the human papillomavirus (HPV) vaccine before they become sexually active. Unfortunately, few Hispanic girls receive this vaccine, which prevents cervical cancer. This study assessed Hispanic mothers' and girls' perceptions about cervical cancer, HPV, and the HPV vaccine. Results show factors that affect whether Hispanic high school girls receive the vaccine.MethodsTwenty-four Hispanic mothers and 28 Hispanic girls from an urban school district in southeast Texas each participated in one of eight focus groups. Bilingual moderators facilitated the mothers' groups in English and Spanish and the girls' groups in English. We analyzed transcripts of the discussions and identified themes using the grounded theory approach.ResultsOur analysis found several themes that affect whether Hispanic girls get the HPV vaccine: gaps in knowledge; fears and concerns about the vaccine; sociocultural communication practices; and decision-making about HPV vaccination. Both mothers and girls had limited knowledge about cervical cancer, HPV, and the vaccine. Some girls who received the vaccine said they wished their mothers had involved them in making the decision.ConclusionsFindings may help in developing school or community-based educational programs for Hispanic families. Such programs should provide information on the HPV vaccine and the link between HPV and cervical cancer, and they should assist mothers and girls in communicating to make informed decisions about the vaccine