This systematic review provided synthesized evidence regarding the effectiveness of the interventions promoting the human papillomavirus (HPV) vaccination in college-aged population. The HPV infection is the most prevailing sexually transmitted disease. Despite the availability and effectiveness of the 9-Valent HPV vaccine, the vaccine coverage among young adults remained low. In witness to the increasing burden of HPV-related infections and cancers, research focused on the vaccination interventions should be conducted to determine the effectiveness of the vaccination strategy and address the gap. The search was conducted through PubMed, Cochrane, and CINAL. Studies were included if they (1) included vaccination programs, (2) target population was young adults aged 17–26, (3) examined factors associated with the intervention effectiveness, (4) were published in English, and (5) were published between February 2010 and February 2020. HPV-related knowledge and intentions toward HPV vaccination were all reported increased after the intervention. Increased HPV vaccination intentions were found associated with the increased vaccine initiation and completion. Among bisexual or homosexual individuals, females were found more likely to complete the HPV dose 2 and 3. The review findings suggested using vaccination interventions incorporated with educational components to promote vaccine uptake among young adults. Supportive interventions tailored to different populations and settings are crucial to address the suboptimal HPV-related knowledge and vaccination status among the young beneficiaries.

Background The high morbidity, mortality, and economic burden attributed to cancer-causing human papillomavirus (HPV) call for researchers to address this public health concern through HPV vaccination. Disparities of HPV-associated cancers in Vietnamese and Korean Americans exist, yet their vaccination rates remain low. Evidence points to the importance of developing culturally and linguistically congruent interventions to improve their HPV vaccination rates. We adopted digital storytelling (DST) that combines oral storytelling with computer-based technology (digital images, audio recording, and music) as a promising approach for facilitating the communication of culturally relevant health messages. Objective This study aimed to (1) assess the feasibility and acceptability of intervention development through DST workshops, (2) conduct an in-depth analysis of the cultural experience that shapes HPV attitudes, and (3) explore aspects of the DST workshop experience that could inform future formative and intervention work. Methods Through community partners, social media, and snowball sampling, we recruited 2 Vietnamese American and 6 Korean American mothers (mean age 41.4, SD 5.8 years) who had children vaccinated against HPV. Three virtual DST workshops were conducted between July 2021 and January 2022. Our team supported mothers to develop their own stories. Mothers completed web-based surveys before and after the workshop and provided feedback on each other’s story ideas and the workshop experience. We used descriptive statistics to summarize quantitative data and constant comparative analysis to analyze qualitative data collected in the workshop and field notes. Results Eight digital stories were developed in the DST workshops. They were well accepted, and the mothers showed overall satisfaction and relevant indicators (eg, would recommend it to others, would attend a similar workshop, it was worth their time; mean 4.2-5, range 1-5). Mothers found the process rewarding and appreciated the opportunity to share their stories in group settings and learn from each other. The 6 major themes that emerged from the data reflect the mothers’ rich personal experiences, attitudes, and perceptions about their child’s HPV vaccination, which included (1) showing parents’ love and responsibility; (2) HPV and related knowledge, awareness, and attitudes; (3) factors influencing vaccine decision-making; (4) source of information and information sharing; (5) response to children's being vaccinated; and (6) cultural perspectives on health care and HPV vaccination. Conclusions Our findings suggest that a virtual DST workshop is a highly feasible and acceptable approach to engaging Vietnamese American and Korean American immigrant mothers in developing culturally and linguistically congruent DST interventions. Further research is needed to test the efficacy and effectiveness of digital stories as an intervention for Vietnamese American and Korean American mothers of unvaccinated children. This process of developing an easy-to-deliver, culturally and linguistically aligned, and holistic web-based DST intervention can be implemented with other populations in other languages.

Introduction: Our research addressed double victimization among Asian Americans by COVID-19 and anti-Asian racial discrimination during the pandemic. Guided by the Vulnerable Populations framework that argues that health status reflects the dynamic interplay between resource availability and relative risk, we investigated time-sensitive questions that explored relative risk (perceived racial discrimination, fear of COVID-19), resources (COVID-19 prevention knowledge, resilience), and mental health status (post-traumatic stress disorder (PTSD), depression) in Asian American undergraduate and graduate students during the pandemic.Methods: A mixed-methods research was conducted to examine the relationships among the relative risk, resources, and mental health outcomes in this population. We adapted questions from valid and reliable measures to assess key variables. Descriptive and regression analyses along with content analysis were used to analyze the quantitative and qualitative data.Results: Our sample included 74 Asian American students (AA students) who participated in the online survey (53 complete cases were included in the statistical analysis) and an additional 10 AA students who were interviewed via Zoom. The results of hierarchical regression models confirmed a positive association between fear of COVID-19 and both mental health outcomes (PTSD and depression), and a negative association between COVID-19 prevention knowledge and mental health outcomes. Perceived racial discrimination was significantly and positively associated with PTSD and depression while controlling for sociodemographic variables. However, its association with outcomes diminished when fear of COVID-19 and COVID-19 prevention knowledge were added to the models. Our interview results supported the survey findings with more nuanced details not revealed in the survey.Conclusion: The findings of this research will help public health officials and universities identify practices useful for promoting culturally congruent safety and protection in response to pandemics and other health emergencies.

Objective The human papillomavirus (HPV) vaccine is effective in reducing HPV‐related disease. The 2‐, 4‐, and 9‐valent HPV vaccines have been approved by the Chinese FDA since 2016; however, factors associated with HPV vaccine acceptability and use in Chinese young adults remain unclear. Design and Sample We conducted a systematic review to analyze factors affecting HPV vaccine acceptability and use in Chinese young adults. A comprehensive search of databases (e.g., PubMed, CINAHL, and PsycINFO) was conducted, and articles between 2011 and 2020 were included. Results Seventeen studies were included in the final review, and eleven were conducted in mainland China and six in Hong Kong. All studies reported low level of HPV‐related knowledge. Better knowledge, more concerns about HPV‐associated diseases, and being female were found associated with higher vaccine acceptability. The vaccine cost and safety were the major concerns for vaccination. Conclusions Findings suggested a low level of HPV‐related knowledge and suboptimal vaccination rate in Chinese young adults. Theory‐based interventions addressing knowledge and other influencing factors and involving both males and females are urgently needed to increase vaccine acceptability and use in Chinese young adults.

Background Self-management behaviours can be crucial to improving disease symptoms and health outcomes in rheumatoid arthritis (RA) patients. Currently, the tools available for measuring self-management behaviours in RA patients are either generalized for patients with chronic diseases, which lack specificity or have poor reliability in the only specific scale—self-care behaviours scale (SCBS). The aim of this study was to develop a self-management behaviours scale for RA patients and evaluate its psychometric properties. Methods The study included two steps: scale development and the psychometric evaluation. The items were developed from a literature review, in-depth individual interviews, nominal group technique, Delphi expert consultation, and a pilot test. For the psychometric evaluation, a sample of 561 patients with RA was recruited. Item analysis, content validity, exploratory and confirmatory factor analysis, convergent and discriminant validity, and internal consistency reliability were conducted to examine the psychometric properties of the RA-SMBS. Results The final scale consists of 23 items with 4 dimensions, including medication management, exercise and joint protection, resource utilization and emotional management, and symptom management. The content validity index was 0.78. Exploratory factor analysis explained 61.89% of the total item variance. Confirmatory factor analysis indicated that the RA-SMBS fit well. Good internal consistency reliability was demonstrated (Cronbach's alpha = 0.908), and the test–retest reliability was found to be acceptable (ICC = 0.628, r = 0.780). Conclusions The scale has good content validity, construct validity, and internal consistency reliability. It can be used to assess the level of self-management behaviours in RA patients.

BACKGROUND The high morbidity, mortality, and economic burden attributed to cancer-causing HPV call for researchers to address this public health concern through human papillomavirus (HPV) vaccination. Despite disparities in HPV-associated cancers in Korean and Vietnamese Americans (KAs, VAs) their vaccination rates remain low. Evidence points to the importance of developing culturally and linguistically congruent interventions to improve HPV vaccination rates. Digital storytelling (DST; a specific form of cultural narrative) shows promise as an effective culture-centric health promotion strategy. OBJECTIVE Study aims were to assess the preliminary effects of an innovative remotely delivered culturally and linguistically congruent DST intervention consisting of stories of personal lived experiences on KA and VA mothers’ attitudes and intention in vaccinating their children against HPV. We also examined if the association between attitudes and intention differed by child’s sex (boy vs. girl) and by ethnicity (KA vs. KA). METHODS Participants were recruited from via multiple outlets (e.g., ethnic minority community organizations, social media, flyers posted in local Asian supermarkets and nail salons). Valid and reliable measures were administered online to collect data pre- and post-intervention. Statistical analysis including descriptive statistics, paired and independent sample t-tests, chi-square, and McNemar’s test were used to describe the distributions of variables and to examine differences between subgroups and changes in key variables over time. We estimated logistic regression models to examine associations between mother’s HPV- and vaccine-related attitudes and vaccination intention, and to explore if the association between attitudes and vaccination intention differed by the target child’s sex or ethnicity. RESULTS In our sample of 50 KA mothers (mean age = 42.8 years; SD = 4.8) and 114 VA mothers (mean age = 41.5 years; SD = 5.4), 36% of KA and 51% of VA mothers reported children receiving free or reduced-price lunch at school. Mother’s attitudes toward HPV and the vaccine (t [163] = 2.49, P = .014) and intention to vaccinate their children improved significantly (2 1 = 18.38, P < .001). The measure of mother’s positive attitudes toward HPV and the vaccine was significantly associated with the higher vaccination intention (OR = 0.246, p < .001), adjusting for background variables (sociodemographic characteristics) and other HPV-related variables (family cancer history, prior HPV education, HPV communication with healthcare providers). Findings did not suggest that child’s sex or ethnicity moderated association between attitudes and vaccination intention. CONCLUSIONS This brief intervention using digital stories was feasible and showed preliminary effects on promoting KA and VA mothers’ intention to vaccinate their children against HPV.

Background The high morbidity, mortality, and economic burden attributed to cancer-causing human papillomavirus (HPV) calls for researchers to address this public health concern through HPV vaccination. Despite disparities in HPV-associated cancers in Korean Americans and Vietnamese Americans, their vaccination rates remain low. Evidence points to the importance of developing culturally and linguistically congruent interventions to improve HPV vaccination rates. Digital storytelling (a specific form of cultural narrative) shows promise as an effective culture-centric health promotion strategy. Objective The aim of this quasi-experimental single-group study was to assess the feasibility, acceptability, and preliminary effects of a culturally and linguistically congruent digital storytelling intervention on Korean American and Vietnamese American mothers’ attitudes and intention in vaccinating their children against HPV. We also examined if the association between attitudes and intention differed by their child’s sex (boy vs girl) and by ethnicity (Korean American vs Vietnamese American). Methods Participants were recruited via multiple avenues (eg, ethnic minority community organizations, social media, and flyers posted in local Asian supermarkets and nail salons). Web-based, valid, and reliable measures were administered to collect data preintervention and postintervention. Descriptive statistics, paired and independent sample t tests, the chi-square test, and the McNemar test were used to describe the distributions of variables and to examine the differences between subgroups and changes in key variables over time. Logistic regression models were used to examine associations of mothers’ HPV- and vaccine-related attitudes with vaccination intention and to explore if the association between attitudes and vaccination intention differed by the target children’s sex or ethnicity. Results In our sample of 50 Korean American mothers (mean age 42.8, SD 4.8 years) and 114 Vietnamese American mothers (mean age 41.5, SD 5.4 years), 36% (18/50) of Korean American and 51% (58/114) of Vietnamese American mothers reported that their children received free or reduced-price lunches at school. After the intervention, mothers’ attitudes toward HPV and the vaccine (t163=2.49, P=.01) and intention to vaccinate their children improved significantly (X21=18.38, P<.001). The measure of mothers’ negative attitudes toward HPV and the vaccine was significantly associated with higher vaccination intention (odds ratio 0.27, 95% CI 0.14-0.51; P<.001), adjusting for background variables (sociodemographic characteristics) and other HPV-related variables (family cancer history, prior HPV education, and HPV communication with health care providers). Findings did not suggest that a child’s sex or ethnicity moderated the association between attitudes and vaccination intention. Conclusions This remotely delivered intervention using digital stories was feasible and acceptable, and showed preliminary effects on promoting Korean American and Vietnamese American mothers’ intention to vaccinate their children against HPV. Future research that uses a randomized controlled trial design with a larger and more diverse sample and includes children’s vaccination status will help understand the effect of the intervention.

BACKGROUND The global prevalence of human papillomavirus (HPV) and its associated cancers continue to be a significant concern. In the U.S., routine HPV vaccination at age 11 or 12 years has been recommended. However, despite HPV being the most common sexually transmitted infection and the proven effect of the vaccine, the vaccination rate among youth in the United States remains below the nationally recommended levels. mHealth interventions have demonstrated promise in improving health. Examining and synthesizing the current evidence about the impact of mHealth interventions on vaccination coverage in youth and intervention characteristics could guide future mHealth interventions aimed at mitigating the vaccination gap and disease burden. OBJECTIVE This study aimed to conduct a systematic review to assess the effectiveness of mHealth interventions on parental intent to vaccinate youth against HPV and youth’s vaccine uptake. METHODS We searched empirical papers through databases including Google Scholar, PubMed, CINAHL, PsycINFO, and Cochrane Library. The inclusion criteria were: (1) published between 2011 and December 2022; (2) using mHealth aimed to improve HPV vaccination rate; (3) targeted parents of unvaccinated youth or youth; (4) measured HPV-related knowledge, its vaccination intention or vaccine uptake. Three researchers screened and appraised the quality of the eligible papers using the Melnyk Levels of Evidence and the Cochrane Grading of Recommendations Assessment, Development, and Evaluation methodology. Disagreements in search results and result interpretation were discussed until reaching a consensus. RESULTS Seventeen studies that met the inclusion criteria were included in the final review. Most studies (n=14) were conducted in the United States, used randomized controlled trial design (n=12), and adopted behavioral change theories or a culture-centric approach (n=10). mHealth interventions used in the studies included text message reminders, motivational short message services, computer or tablet-tailored interventions, smartphone apps, web-based tailored interventions, social media (Facebook) campaigns, digital videos, and digital storytelling interventions. About 88% of the mHealth intervention demonstrated positive effects on knowledge, intention, and behaviors related to the HPV vaccination. Two studies reported limited or no impact of the intervention on vaccine uptake or vaccine series completion. Factors facilitating promising vaccine uptake were interventions developed based on behavioral change theories and culturally tailored information. CONCLUSIONS This systematic review identified the impact of mHealth interventions among unvaccinated youth and their parents, which showed improvement in HPV-related knowledge, vaccination intention, and/or vaccine initiation. The interventions incorporated theories and culture-centric approaches revealed the most promising results. Despite the positive outcomes of the interventions, future studies are needed to investigate factors associated with the effect of the intervention (e.g., text messaging and social media intervention). More research is also needed for a better understanding of the intervention elements that boost the responses of age and ethnic-specific populations.