This descriptive qualitative study explored Latinx mothers’ acceptance of the human papillomavirus (HPV) vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analyzed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Twenty-two ( n = 22), mostly foreign-born, Latinx mothers of male and female adolescents participated in the study. Three main themes and nine subthemes emerged from the analyses. Findings identified the need for increased efforts to raise awareness and knowledge among Latinx mothers of the direct benefits of the HPV vaccine for sons, including stressing prevention of HPV-associated cancers in males. Findings also underscore the need for improved health care providers’ communication and recommendation of the HPV vaccine for Latinx adolescent males. Future research should intervene upon the study’s findings to address barriers that remain and affect Latinx mothers’ acceptance and uptake of the HPV vaccine for their children, in particular their sons.
Purpose: To evaluate and quantify potential sociodemographic disparities in breast cancer screening, diagnosis, and treatment due to the COVID-19 pandemic, and the use of telemedicine. Methods: We fielded a 52-item web-based questionnaire from 14 May 2020 to 1 July 2020 in partnership with several U.S.-based breast cancer advocacy groups. Individuals aged 18 or older were eligible for this study if they: (1) received routine breast cancer screening; OR (2) were undergoing diagnostic evaluation for breast cancer; OR (3) had ever been diagnosed with breast cancer. We used descriptive statistics to understand the extent of cancer care delay and telemedicine adoption and used multivariable logistic regression models to estimate the association of sociodemographic factors with odds of COVID-19-related delays in care and telemedicine use. Results: Of 554 eligible survey participants, 493 provided complete data on demographic and socioeconomic factors and were included in the analysis. Approximately half (n = 248, 50.3%) had a personal history of breast cancer. Overall, 188 (38.1%) participants had experienced any COVID-19-related delay in care including screening, diagnosis, or treatment, and 339 (68.8) reported having at least one virtual appointment during the study period. Compared to other insurance types, participants with Medicaid insurance were 2.58 times more likely to report a COVID-19-related delay in care (OR 2.58, 95% Cl: 1.05, 6.32; p = 0.039). Compared to participants with a household income of less than USD 50,000, those with a household income of USD 150,000 or more were 2.38 (OR 2.38, 95% Cl: 1.09, 5.17; p = 0.029) times more likely to adopt virtual appointments. Self-insured participants were 70% less likely to use virtual appointment compared to those in other insurance categories (OR 0.28, 95% Cl: 0.11, 0.73; p = 0.009). Conclusions: The COVID-19 pandemic has had a significant impact on breast cancer screening, diagnosis, and treatment, and accelerated the delivery of virtual care. Lower-income groups and patients with certain insurance categories such as Medicaid or self-insured could be more likely to experience care delay or less likely to use telemedicine. Careful attention must be paid to vulnerable groups to insure equity in breast cancer-related service utilization and telemedicine access during and beyond the COVID-19 pandemic.
Introduction: The COVID-19 pandemic has altered the health care delivery system. The purpose of this study was to determine the impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment. Methods: Potential survey respondents were identified through partnerships with breast cancer organizations including Dr. Susan Love Foundation for Breast Cancer Research, SHARE, Survivingbreastcancer.org, Sisters Network Inc., the African American Breast Cancer Alliance, and through ResearchMatch.org. Study information was shared via social media, websites, or email. Individuals were eligible for this study if they: 1) receive routine breast cancer screening, or 2) are undergoing diagnostic evaluation for breast cancer, or 3) had ever been diagnosed with breast cancer. Participants accessed and completed the 10-15-minute REDCap survey either by emailing the research team and receiving a private survey link or by clicking a public link. The survey collected information on respondent demographics; breast cancer screening and diagnosis; the extent to which screening, diagnosis, or treatment had been changed, delayed, or canceled because of COVID-19; personal protective practices; extent of worry about financial and health implications of COVID-19; and use of telemedicine. We used descriptive statistical analyses to better understand the impact of the COVID-19 pandemic on respondents. Results: There are currently 415 survey respondents, 404 of whom agreed to participate in the study. 46.8% (N=189) of respondents were white, 26.7% (N=108) Black, 6.7% (N=27) Asian, and 5.5% Hispanic or Latino (N=22). Most respondents were between the ages of 50 and 69 years (52.2%, N=211). 43.3% (N=175) of respondents had been diagnosed with breast cancer and, of those, 36% (N=63) were in active treatment. More than a quarter of participants (26.5%, N=107) reported delayed or canceled breast cancer care due to COVID-19; the most frequently affected care was screening mammogram, ultrasound, or MRI (97.2%, N=104). 20.6% (N=13) of women in active treatment reported delayed or canceled surgery, chemotherapy, or radiation visits. 22.3% (N=90) of respondents reported that an in-person visit was changed to a phone call or videoconference, and 39.1% (N=158) said they had discussed COVID-19 with a health care provider. 29.1% (N=51) of those with breast cancer were worried or very worried that the COVID-19 pandemic would make it harder for them to get cancer care; among those without breast cancer, 34.9% (N=80) were worried that COVID-19 would make it harder to obtain health care, including breast cancer screening and diagnosis. Conclusions: The COVID-19 pandemic continues to disrupt breast cancer-related care, primarily screening. Planning and coordination are necessary to ensure the timely return of these patients to care. Most participants agreed to be contacted for follow-up, allowing us to investigate the long-term effects of delayed breast cancer screening, diagnostic evaluation, and treatment on health outcomes. Citation Format: Erica T. Warner, Emily Restrepo, Christine Benjamin, Ricki Fairley, Laura Roudebush, Leah Eshraghi, Crystal Hertz, Simo Du, Laura Carfang. Patient-reported impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment: A national survey [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S11-02.
Purpose: Parents play a critical decision-making role in vaccinating their children against HPV, and mothers, in particular, are key stakeholders as they are often the parent taking their children to healthcare visits. Given the importance of the HPV vaccination as a cancer prevention strategy, this study was designed to explore Latinx mothers’ suggested strategies to promote vaccine uptake among Latinx parents. Setting and Participants: Community-based in Massachusetts, United States, and Latinx mothers. Design and Methods: Descriptive qualitative research employing individual semi-structured interviews. Data were analyzed using a hybrid method of thematic analysis incorporating deductive and inductive approaches. Results: Twenty-two, majority foreign-born (91%) Latinx mothers of adolescent girls (∼60%) and boys (∼40%) aged 11–19 years participated. Mothers suggested several strategies to promote uptake of the HPV vaccine among Latinx families including healthcare providers’ increased communication and anticipatory guidance addressing factors influencing parents’ HPV vaccination hesitancy, and improved community-wide dissemination of culturally and linguistically relevant information targeting not only parents of age-eligible participants but the broader community. Finally, mothers suggested the use of social media using personal narratives and an enhanced active role of schools in providing accurate information to raise awareness and educate adolescents and parents about the importance of HPV vaccination. Conclusion: Findings are relevant to the development of tailored interventions to meet the needs of Latinx populations, and ultimately increase Latinx children’s HPV vaccination rates.
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