Predictors of Initial Uptake of Human Papillomavirus Vaccine Uptake Among Rural Appalachian Young Women

Abstract

Women in Appalachian Kentucky experience a high burden of cervical cancer and have low rates of human papillomavirus (HPV) vaccination. The purpose of this study was to identify normative influences predicting initial HPV vaccine uptake among a sample of young women in southeastern Kentucky. Women (N = 495), ages 18 through 26 years, were recruited from clinics and community colleges. After completing a questionnaire, women received a free voucher for HPV vaccination. Whether women redeemed the voucher for Dose 1 served as the primary outcome variable. Hierarchical logistic regression was used to estimate the influence of healthcare providers, friends, mothers, and fathers on vaccine uptake. One-quarter of the total sample (25.9 %) received Dose 1. Uptake was higher in the clinic sample (45.1 %) than in the college sample (6.9 %). On multivariate analysis, women indicating that their healthcare provider suggested the vaccine, that their friends would "definitely" want them to be vaccinated, and that their fathers would "definitely" want them to receive the vaccine all were 1.6 times more likely to receive Dose 1. Interaction effects occurred between recruitment site (clinic vs. community college) and all three of the normative influences retaining multivariate significance, indicating that the associations only applied to the clinic sample. HPV vaccine interventions may benefit from highlighting paternal endorsement, healthcare provider recommendation, and peer support.

Incentivizing health care behaviors in emerging adults: a systematic review

“…Three of the 29 articles were companion reports 21 – 23 of two primary publications. 15 , 16 We report on the 26 primary publications ( Figure 1 ).…”

“…Fourteen articles reported the results of randomized controlled trials, 14 , 16 , 17 , 19 , 24 – 33 two reported the results of controlled clinical trials, 34 , 35 one reported the results of a crossover clinical trial, 36 two reported the results of cohort studies, 6 , 37 and seven reported the results of uncontrolled before–after studies. 15 , 38 – 43 Eleven of the 26 trials described the effects of behavioral interventions when conducted along with cointerventions, including motivational enhancement therapy, 14 , 16 , 26 , 28 , 33 relaxation-control treatment, 14 cognitive behavioral therapy, 16 , 31 , 38 drug counseling, 16 multidisciplinary adherence support, 39 motivational interviewing, 39 and instructional materials or information. 32 , 40 , 41…”

“…This was a study of HPV-vaccine uptake in young women, where vouchers were provided to enable participants to receive all three doses of the HPV vaccine at no cost. 15 Thirteen studies described an escalation and reset strategy for the incentive, 14 , 16 , 17 , 24 , 26 , 28 , 29 , 31 – 34 , 36 , 38 one study reported a reset scheme only, 37 and 12 studies incorporated neither an escalating strategy nor a reset. 6 , 15 , 19 , 25 , 27 , 30 , 35 , 39 – 43 One article reported the use of a disincentive where participants could receive a “payment reduction” from their study compensation for decreased ability to complete four cognitive/psychomotor tasks following a 3-hour ad libitum drinking period.…”

Fatalistic Beliefs and Completion of the HPV Vaccination Series Among a Sample of Young Appalachian Kentucky Women

“…1 Two vaccines (HPV4, Gardasil R ; HPV2, Cervarix R ) are now widely available for the primary prevention of HPV infection and cervical cancer. 2 The Centers for Disease Control and Prevention (CDC) recommends routine HPV vaccination for females ages 11-12 and catch-up vaccination for females ages [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Current CDC guidelines recommend that the second dose of the HPV vaccine series be administed 1-2 months after the first injection; the third dose is administered 6 months after the first dose.…”

“…Other noted barriers to HPV vaccination among Appalachian women include lack of transportation, limited parental/peer/health care provider support, cultural views, and lack of knowledge regarding cervical cancer prevention and HPV. 13,[15][16][17] There is an additional barrier to preventive cancer behavior, however, that has received limited attention as it relates to HPV vaccination, and that is the concept of fatalism. Fatalism has been examined as a potential determinant for engaging in preventive cancer strategies, including cancer information seeking, screening (eg, colorectal cancer screening, Papanicolaou [Pap] testing, mammography) and preventive behaviors (eg, diet, exercise, smoking).…”