9 research outputs found

    Evaluation of a Brief Intervention to Improve Human Papillomavirus-Related Awareness, Knowledge, and Attitudes Among Ethnically and Sexually Diverse College Students

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    Human papillomavirus (HPV) is a preventable infection responsible for anogenital and oropharyngeal cancers, as well as genital warts. Two safe and effective vaccines are recommended for adolescents and young adults to protect against HPV infection. Both are severely underutilized. Sexual and ethnic minorities are disproportionately affected by HPV infection and its sequelae. The goals of this study were to (1) assess baseline differences in HPV-related awareness, knowledge, and attitudes between men and women, and (2) evaluate the differential efficacy of a brief, educational HPV intervention among ethnically and sexually diverse college students. Students attending undergraduate courses from 2015 to 2017 participated in a brief, tailored, classroom intervention designed to improve HPV-related awareness, knowledge, and attitudes. These outcomes were assessed immediately before and following an evidence-based educational presentation about HPV risks, outcomes, treatments, and prevention. At baseline, 84% of participants (N=386) had heard of HPV; 28% of men and 55% of women reported receiving ≥1 dose of HPV vaccine. Vaccinated women were seven times more likely to report favorable attitudes than unvaccinated women (RR=7.1, CI[3.3-15.5]). Hispanic participants had more positive attitudes toward HPV vaccination (62% vs. 44%; P=0.009) and were more willing to become vaccinated (66% vs. 46%; p=0.02) than non-Hispanic participants at baseline. Gay and bisexual men (92%) were more likely than heterosexual men (68%) to have heard of HPV, to receive any doses of HPV vaccine (37% vs 19%), to view HPV vaccination positively (58% vs 39%), and more willing to be vaccinated (86% vs 39%;

    Associations between Health and Academic Success at a Florida University: An Exploratory Cross-sectional Study

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    The aims of the study were to explore the associations between college students’ perception of their overall physical and psychological health and four measures of academic performance. College students (N = 265) completed a 65-item Web-based survey in a university’s student health services building during the spring 2015 semester. Poorer psychological health was associated with seriously considering dropping out of college and missing more classes during the current school year “due to physical or psychological health reasons.” Poorer physical health was associated with enrollment in more credit hours. Students who reported a grade point average (GPA) below 2.0 missed more classes “because of physical or psychological reasons” during the current school year than those with a 2.0 or higher GPA. A longitudinal study is needed to clarify whether better health leads to more successful academic performance or vice versa and which specific health indicators play the largest role

    Adaptation and Formative Evaluation of Online Decision Support to Implement Evidence-Based Strategies to Increase HPV Vaccination Rates in Pediatric Clinics

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    Human papilloma virus (HPV) vaccination rates remain below national goals in the United States despite the availability of evidence-based strategies to increase rates. The Adolescent Vaccination Program (AVP) is a multi-component intervention demonstrated to increase HPV vaccination rates in pediatric clinics through the implementation of six evidence-based strategies. The purpose of this study, conducted in Houston, Texas, from 2019-2021, was to adapt the AVP into an online decision support implementation tool for standalone use and to evaluate its feasibility for use in community clinics. Phase 1 (Adaptation) comprised clinic interviews

    Parents\u27 Stigmatizing Beliefs About the HPV Vaccine and Their Association With Information Seeking Behavior and Vaccination Communication Behaviors

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    Parents\u27 stigmatizing beliefs about the HPV vaccine, such as beliefs that it promotes adolescent sexual activity, constitute a notable barrier to vaccine uptake. The purpose of this study is to describe the associations between parents\u27 stigmatizing beliefs about the HPV vaccine, psychosocial antecedents to vaccination, and parents\u27 intentions to vaccinate their children. Parents of vaccine-eligible children

    Increasing HPV Vaccination in a Network of Pediatric Clinics using a Multi-component Approach

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    Background: Despite continued public health efforts to increase human papillomavirus (HPV) vaccination among adolescents, initiation remains below the level needed to reach the Healthy People 2020 goal of 80% series completion by age 13. Methods: We developed, implemented, and evaluated a multi-component program that used evidence-based strategies to increase HPV vaccine initiation in a network of 51 pediatric clinics in Houston, Texas. Our target populations were the clinic network, healthcare providers, male and female patients ages 11-17, and their parents. The program, called the Adolescent Vaccination Program (AVP), was conducted from March 2016 through March 2019 and contained strategies to increase vaccination including: HPV immunization champions; provider assessment and feedback; provider continuing education; provider reminders; and patient reminders. We used a single group pre/post design with an external comparison – NIS-Teen. Our primary outcome was initiation of the HPV vaccine based on the electronic health record. We used interrupted time series analysis (ITSA) to measure change in initiation over time. We calculated monthly, quarterly, and annual rates of initiation for each physician, clinic, and the network. We examined patterns of initiation by patient age, sex, race/ethnicity, and type of insurance. Results: By the end of the project, the 51 clinics averaged 77.4% initiation. Rates increased annually from September 2015 through March 2019. ITSA analysis over 75 months showed an increase in vaccine initiation of 0.396% per month from the introduction of the program in March 2016. Average individual clinic improvement was 0.37% per month ranging from -0.04% to 0.68% through March 2019. Data for the 11-12 year olds, the target age group for initiating the vaccine, showed a greater percentage increase (54.2%) compared with the 13-17 year olds (29.6%). Hispanics and African Americans had the highest initiation rates in all years while non-Hispanic whites had the lowest. Families without insurance had the lowest rates while those with Medicaid/Medicare had the highest. Conclusions: We observed a secular trend upward in both the network and NIS-Teen data; however, the network showed a steeper increase. The AVP is a promising program of strategies to increase HPV vaccination in a clinic setting

    Improving Human Papillomavirus-Related Knowledge and Attitudes Among Ethnically Diverse Young Adults

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    Purpose: To make baseline comparisons and evaluate the efficacy of an intervention designed to improve human papillomavirus (HPV) and HPV vaccine awareness, knowledge, and attitudes among ethnically diverse participants. Methods: Design: Pre- and post-intervention surveys. Setting: An urban, Hispanic-Serving South Florida university. Subjects: Three hundred eighty-seven diverse college students attending a gender studies course. Intervention: Students received a brief educational message designed to improve HPV-related knowledge and attitudes. Baseline and follow-up survey data were collected. Measures: Outcome measures included baseline and follow-up awareness of HPV, perceived knowledge of HPV and HPV vaccination, measured knowledge score, vaccine attitudes, and doses of HPV vaccine received. Analysis: Chi-square, analysis of covariance (ANCOVA), and Wilcoxon rank-sum tests were used to compare baseline differences and evaluate the efficacy of the intervention. Results: Hispanic participants had more positive attitudes toward HPV vaccination (62% vs. 44%, p=0.009) and were more willing to become vaccinated (66% vs. 46%, p=0.02) than non-Hispanic participants at baseline. Hispanic women (48%) were more likely to have initiated HPV vaccination than Hispanic men (27%, p=0.006). At baseline, only 30% of participants scored ≥4/7 points in knowledge. Participants' HPV knowledge improved by 41% after the intervention, with no difference by ethnicity in the post-intervention score. Conclusion: The intervention was useful in improving HPV-related knowledge and attitudes among diverse college students. Future studies should examine barriers to vaccination among ethnic minorities

    Parents’ stigmatizing beliefs about the HPV vaccine and their association with information seeking behavior and vaccination communication behaviors

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    Parents’ stigmatizing beliefs about the HPV vaccine, such as beliefs that it promotes adolescent sexual activity, constitute a notable barrier to vaccine uptake. The purpose of this study is to describe the associations between parents’ stigmatizing beliefs about the HPV vaccine, psychosocial antecedents to vaccination, and parents’ intentions to vaccinate their children. Parents of vaccine-eligible children (n = 512) were surveyed in a large urban clinical network. Results indicate that two stigmatizing beliefs were significantly associated with self-efficacy in talking with a doctor about the HPV vaccine. Believing that the vaccine would make a child more likely to have sex was associated with citing social media as a source of information about the vaccine. Other stigmatizing beliefs were either associated with citing healthcare professionals as sources of information about the vaccine, or they were not significantly associated with any information source. This finding suggests that stigmatizing beliefs might discourage parents from seeking out information about the vaccine. This study is significant because it further highlights the importance of doctor recommendations to all patients at recommended ages; doctor visits may represent one of the few opportunities to normalize HPV vaccination and address parents’ stigmatizing beliefs about the HPV vaccine

    AVPCancerFree: Impact of a digital behavior change intervention on parental HPV vaccine –related perceptions and behaviors

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    Parent hesitancy contributes to reduced HPV vaccination rates. The HPVcancerfree app (HPVCF) was designed to assist parents in making evidence-based decisions regarding HPV vaccination. This study examined if parents of vaccine-eligible youth (11–12 yrs.) who use HPVCF in addition to usual care demonstrate significantly more positive intentions and attitudes toward HPV vaccination and greater HPV vaccination rates compared to those not using HPVCF. Clinics (n = 51) within a large urban pediatric network were randomly assigned to treatment (HPVCF + usual care) or comparison (usual care only) conditions in a RCT conducted between September 2017 and February 2019. Parents completed baseline and 5-month follow-up surveys. Participant-level analysis determined 1) change in HPV vaccination initiation behavior and related psychosocial determinants and 2) predictors of HPV vaccine initiation. Parents (n = 375) who completed baseline and 5-month follow-up surveys were female (95.2%), 40.8 (±5.8) yrs. married (83.7%), employed (68.3%), college educated (61.9%), and privately insured (76.5%). Between-group analysis of HPVCF efficacy demonstrated that parents assigned to receive HPVCF significantly increased knowledge about HPV and HPV vaccination (p < .05). Parents who accessed content within HPVCF significantly increased knowledge about HPV & HPV vaccine (p < .01) and perceived effectiveness of HPV vaccine (p < .05). Change in HPV vaccine initiation was not significant. A multivariate model to describe predictors of HPV vaccine initiation demonstrated an association with Tdap and MCV vaccination adoption, positive change in perceived effectiveness of the HPV vaccine, and reduction in perceived barriers against HPV vaccination. HPVCF appears to be a feasible adjunct to the education received in usual care visits and reinforces the value of apps to support the important persuasive voice of the health-care provider in overcoming parent HPV vaccine hesitancy
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