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Objectives We conducted a longitudinal study to examine human papillomavirus (HPV) vaccine uptake among male adolescents and to identify vaccination predictors. Methods In fall 2010 and 2011, a national sample of parents with sons aged 11 to 17 years (n = 327) and their sons (n = 228) completed online surveys. We used logistic regression to identify predictors of HPV vaccination that occurred between baseline and follow-up. Results Only 2% of sons had received any doses of HPV vaccine at baseline, with an increase to 8% by follow-up. About 55% of parents who had ever received a doctor's recommendation to get their sons HPV vaccine did vaccinate between baseline and follow-up, compared with only 1% of parents without a recommendation. Fathers (odds ratio = 0.29; 95% confidence interval = 0.09, 0.80) and non-Hispanic White parents (odds ratio = 0.29; 95% confidence interval = 0.11, 0.76) were less likely to have vaccinated sons. Willingness to get sons HPV vaccine decreased from baseline to follow-up among parents (P < .001) and sons (P = .003). Conclusions Vaccination against HPV remained low in our study and willingness to vaccinate may be decreasing. Physician recommendation and education about HPV vaccine for males may be key strategies for improving vaccination.

Objective Whether human papillomavirus (HPV) self-testing can expand access to cervical cancer screening will depend on making the test accessible and acceptable to higher-risk women. To evaluate a novel delivery mode, we mailed HPV self-test kits to low-income, under-screened women and assessed their perceptions of self-testing and cervical cancer prevention. Materials and Methods We conducted a telephone survey of 199 women in North Carolina. Eligibility criteria included not having had a Pap test in 4 years and reporting 1 or more indicators of economic hardship, such as being uninsured. Results Over half (55%) of women in the diverse sample were non-Hispanic black, and almost three-quarters (74%) reported annual household incomes of $20,000 or less. Trust in HPV self-testing was moderate to high, with almost all women (98%) agreeing the mailed test was safe. A few women (6%) preferred HPV self-testing to Pap testing for protecting health, but most (75%) had no preference. Trust in or preference for mailed self-testing did not vary by race or income. However, compared to white women, black women had lower HPV-related knowledge (OR=0.46, 95% CI, 0.23–0.92) and perceived lower cervical cancer risk in the absence of screening (OR=0.44, 95% CI, 0.22–0.86). We found similar patterns of disparities for women with very low (<$10,000) versus relatively higher incomes. Conclusions Our findings suggest that, across racial and economic subgroups, under-screened women generally trust HPV self-tests delivered by mail. To succeed, programs for HPV self-testing must overcome disparities in knowledge and perceptions related to cervical cancer screening.

Purpose To determine whether psychosocial factors predict depression among older African American cancer patients. Design/Methods A descriptive correlational study. Setting Outpatient oncology clinic of NCI designated Cancer Center in Southeastern U.S. Sample African American cancer patients aged 50 and over. Methods Fisher’s Exact and Wilcoxon Rank Sum tests were used to evaluate differences between patients who were possibly depressed (Geriatric Depression Scale) or not. Multivariate linear regression statistics were used to identify the psychosocial factors that predicted higher depression scores. Education and gender were included as covariates. Main Variables Religiosity, emotional support, collectivism, perceived stigma and depression. Findings African American cancer patients (n=77) were on average a median age of 58 years (IQR = 55–65), a majority were well-educated, insured, religiously affiliated, and currently in treatment. Participants in the lowest income category, not married, and male gender had higher depression scores. The multivariable model consisting of organized religion, emotional support, collectivism, education, and gender explained 52% (adjusted R2) of the variation in depression scores. Stigma became insignificant in the multivariable model. Conclusions Psychosocial factors are important predictors of depression. For these participants, emotional support and organized religious activities may represent protective factors against depression, while collectivism may increase their risk. Implications Nurses need to be especially aware of the potential psychological strain for patients with collectivist values, experienced stigma, disruptions in church attendance and lack of emotional support. Further, these treatment plans for these patients should ensure that family members are knowledgeable about cancer, its treatment and side effects so they are empowered to meet the needs for support of the African American cancer patient.

Among African-Americans, religion impacts health-seeking behaviors. This qualitative study used criterion purposeful sampling and thematic analysis in analysis of data from 31 African-American cancer patients to understand the influence of religion on the utilization of cancer care services. Our findings suggest that religious beliefs and practices positively influenced attitudes toward their illness and ability to endure treatment. God's ability to heal and cure, God's control over survival, God's will over their lives, and God's promise for health and prosperity were examples of survivor's religious beliefs. Religious practices such as prayer promoted a trusting relationship with healthcare providers and were a source of strength and encouragement.