Background
South Texas Latinas experience higher cervical cancer incidence and mortality compared to Latinas nationwide. Despite the availability of effective human papillomavirus vaccines, South Texas Latino/a adolescents sub-optimally complete the series. Research shows provider recommendation strongly predicts vaccine uptake, but minority adolescents are less likely to report that their provider recommended the vaccine and series completion. There is also scant information on the HPV vaccine administration process in clinic practices providing vaccination services to Latino adolescents with limited access to healthcare resources. The purpose of the study was to describe providers’ experience with administering the HPV vaccine to Latino/a patients in their practices.
Methods
The study used qualitative description to describe the experience of 15 South Texas healthcare providers (doctors and nurses) with the process of HPV vaccine administration in their practices. We conducted open ended, audio-recorded interviews, which were subsequently transcribed verbatim and uploaded into Atlas.(ti) 7.0 for analysis. The interviews yielded detailed descriptions of barriers and facilitators that could potentially impact HPV vaccine uptake.
Results
Providers identified parental exposure to provider recommendation as enhancing HPV acceptance and existing policies and implementation of evidence-based practices as facilitators of HPV vaccine uptake. Barriers ranged from parental fears of adolescent sexual activity and potential vaccine side effects to lack of transportation and the cost of the vaccine.
Conclusion
These findings reflect barriers and facilitators to administering the HPV vaccine previously identified and also highlight issues unique to the situation among Latinos in South Texas. Implications include the need to design and implement efforts to improve provider-parent communication and enhance parental and adolescent patients’ understanding of and confidence in the HPV vaccine. Furthermore, policy changes are needed to rectify organizational/structural challenges to HPV vaccine administration.
This study investigated romantic partners’ undermining of weight management (i.e. hindrance of weight loss efforts) and how perceived motivations behind undermining were associated with weight loss progress. Data from 241 overweight individuals currently cohabiting with a romantic partner and trying to lose weight revealed two overarching undermining factors (i.e. verbal criticism/complaint, behavioral interference) and six perceived motivations (e.g. partner believed weight loss was unnecessary, partner relational fears, weight loss was an imposition on partner). Path modeling showed both undermining behaviors were negatively associated with weight management. Yet, only certain motivations (e.g. imposition on partner, weight loss was unnecessary) were linked to weight management, either directly or indirectly, through undermining. Specifically, whereas criticism/complaint mediated the associations between these motivations and weight management, interference only mediated the association between imposition and weight management. Findings are discussed in terms of the theoretical and practical value of distinguishing undermining behaviors and their underlying motivations.
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