Emergency Medicine Physician Attitudes toward HPV vaccine uptake in an Emergency Department Setting

Hill, Mandy J.; Okugo, Glory

doi:10.4161/hv.29634

Cited by 4 publications

(2 citation statements)

References 41 publications

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“…[28][29][30][31] However, as Hill and Okugo demonstrated when assessing EP attitudes toward proposed HPV vaccine initiation in the ED, perceived barriers to HPV education and vaccine initiation in the ED setting do exist, including concerns regarding time requirements and reimbursement. 32 Likewise, it is anticipated that some EPs may not embrace a preventative medicine role, a wheelhouse that traditionally has belonged to primary care physicians.…”

Section: Discussionmentioning

confidence: 99%

Human Papillomavirus Awareness, Vaccine Status, and Risk Factors in Female Emergency Patients

Walter

Leader

Galbraith

2020

WestJEM

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Introduction: A vaccine targeting high-risk human papillomavirus (HPV) strains can effectively prevent HPV-associated cervical cancer risk. However, many girls and women do not receive the vaccine, more often those impacted by health disparities associated with race and/or socioeconomic status. This same disparate population has also been shown to be at higher risk for cervical cancer. Many of these women also rely on the emergency department (ED) as a safety net for their healthcare. This study sought to gather information pertaining to HPV and cervical cancer risk factors, awareness of HPV and the vaccine, as well as HPV vaccine uptake in female patients presenting to an ED. Methods: We obtained 81 surveys completed by female ED patients. Demographics included age, race, income, insurance status, primary care provider status, and known cervical-cancer risk factors. Subsequent survey questions explored respondents’ knowledge, familiarity, and attitudes regarding HPV, cervical cancer, and the HPV vaccine, including vaccination uptake rates. We analyzed data using descriptive statistics and Fisher’s exact test. Results: Approximately one in seven respondents (14.8%) had never previously heard of HPV and 32.1% were unaware of the existence of a HPV vaccine. Minority patients, including those who were Black and Hispanic patients, low income patients, and uninsured and publicly insured patients were less likely to be aware of HPV and the vaccine and likewise were less likely to be offered and receive the vaccine. More than 60% of all respondents (61.3%) had never previously been offered the vaccine, and only 24.7% of all respondents had completed the vaccine series. Conclusion: Female ED patients may represent an at-risk cohort with relatively low HPV awareness and low HPV vaccine uptake. The ED could represent a novel opportunity to access and engage high-risk HPV populations.

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Section: Discussionmentioning

confidence: 99%

Human Papillomavirus Awareness, Vaccine Status, and Risk Factors in Female Emergency Patients

Walter

Leader

Galbraith

2020

WestJEM

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“…Using a conservative estimate of recruiting two participants a week, Monday - Friday, the recruitment aspect of this study is estimated to last approximately five months. We established the feasibility of obtaining a sufficient sample of cisgender Black women with this recruitment approach from the ED [ [24] , [25] , [26] , [27] , [28] ] in prior studies; we achieved 100% of our planned accrual of cisgender women at both EDs. Thus, we estimate that recruitment of 40 cisgender Black women over a 12-month recruitment period is feasible.…”

Section: Methods and Proceduresmentioning

confidence: 99%

Pilot testing the effectiveness of whether a survey-driven tablet-based intervention increased willingness of Black women to attend to an initial PrEP clinic visit: The protocol for the pilot randomized controlled trial design and methods

Hill¹,

Heads²,

Green³

et al. 2022

Contemporary Clinical Trials Communications

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A survey with interventional components delivered on tablet devices versus usual care to increase pre-exposure prophylaxis uptake among cisgender Black women: a pilot randomized controlled trial

et al. 2023

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Background Cisgender (cis) Black women in the USA are more likely to become HIV positive during their lifetime than other women. We developed and implemented a behavioral intervention, Increasing PrEP (iPrEP), the first pilot randomized controlled trial (RCT) aimed at motivating cis Black women to be willing to use PrEP for HIV prevention and attend an initial PrEP clinic visit following an emergency department visit. Methods Eligible participants were Black cisgender women ages 18–55 years who acknowledged recent condomless sex and substance use. Participants were randomized to iPrEP or usual care (UC). iPrEP is a survey-based intervention designed to raise awareness and knowledge about PrEP. Participants completed an assessment of knowledge of and willingness to use PrEP before and after the intervention, then received a warm-hand off with referral to a local PrEP clinic. Enrolled participants were followed for 6 months. Results Forty enrolled participants were ages 18–54 years. Education levels varied evenly between some high school education and graduate education. Most participants were single (n = 25) or married (n = 7). Twenty-two participants were employed full-time. Pre-test results indicated that 21 of 40 participants had heard of PrEP. All participants identified PrEP as a daily HIV prevention medication. For those randomized to iPrEP, the odds of knowing about PrEP at post-test, when controlling for baseline, were higher relative to UC (OR = 5.22, 95%CrI = 0.50, 94.1]. iPrEP did not have any effect on willingness relative to UC. The estimate for iPrEP on willingness is marginally higher (4.16 vs. 4.04; i.e., 0.12 points higher); however, the posterior probability of 67.9% does not suggest a strong degree of evidence in favor of an effect. During the post-test, those receiving iPrEP were less ready to take PrEP than those receiving UC. Conclusions Findings suggest that iPrEP increased knowledge about the PrEP medication but had a negative impact on readiness to take PrEP relative to UC. It is imperative that future research among cisgender Black women carefully considers the content provided in interventions designed to increase PrEP use, balancing the benefits of PrEP with the side effects and daily pill burden. Trial registration: clinicaltrial.gov Identifier: NCT03930654, 29/04/2019.

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Emergency Medicine Physician Attitudes toward HPV vaccine uptake in an Emergency Department Setting

Cited by 4 publications

References 41 publications

Human Papillomavirus Awareness, Vaccine Status, and Risk Factors in Female Emergency Patients

Human Papillomavirus Awareness, Vaccine Status, and Risk Factors in Female Emergency Patients

Pilot testing the effectiveness of whether a survey-driven tablet-based intervention increased willingness of Black women to attend to an initial PrEP clinic visit: The protocol for the pilot randomized controlled trial design and methods

A survey with interventional components delivered on tablet devices versus usual care to increase pre-exposure prophylaxis uptake among cisgender Black women: a pilot randomized controlled trial

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