A Narrative Engagement Framework to Understand HPV Vaccination Among Latina and Vietnamese Women in a Planned Parenthood Setting

Abstract

Disparities in cervical cancer and human papillomavirus (HPV) vaccination persist among Vietnamese and Latina women. Through a partnership with Planned Parenthood of Orange and San Bernardino Counties (PPOSBC) in Southern California, we conducted in-depth interviews with young adult Latina (n = 24) and Vietnamese (n = 24) women, and PPOSBC staff (n = 2). We purposively sampled vaccinated women to elicit HPV vaccine decision narratives to uncover rich data on motivators, cultural values, and implicit vaccine attitudes. Unvaccinated women were interviewed to identify barriers. Women were also asked to discuss their observations of men’s HPV vaccine attitudes. Narrative engagement theory guided the study privileging the meaning women ascribed to their experiences and conversations related to vaccine decision making. Vaccine decision narratives included (a) mother–daughter narratives, (b) practitioner recommendation of HPV vaccination, (c) independence narratives among Vietnamese women, (d) HPV (un)awareness narratives, and (d) school exposure to HPV knowledge. Barriers to vaccinating included trust in partner HPV status, and family silence and stigma about sexual health. Participants conveyed the importance of including messages aimed at reaching men. Practitioners described insurance barriers to offering same day vaccination at PPOSBC health center visits. Narrative communication theory and methodology address health equity by privileging how Vietnamese and Latina women ascribe meaning to their lived experiences and conversations about HPV vaccination. Identifying authentic and relatable vaccine decision narratives will be necessary to effectively engage Vietnamese and Latina women. These findings will guide the process of adapting an existing National Cancer Institute research-tested HPV vaccine intervention.

Evaluating a Technology-Mediated HPV Vaccination Awareness Intervention: A Controlled, Quasi-Experimental, Mixed Methods Study

“…Campaign messages emphasized college students pursuing their interests and dreams with the time they gained from preventing HPV and HPV-related cancer. This approach aligns with current research that successful narrative messages depend on the perceived relevance of the storyline to the audience [ 31 , 48 ].…”

Knowledge, Attitudes and Perceptions of Immigrant Parents Towards Human Papillomavirus (HPV) Vaccination: A Systematic Review

“…Twelve studies were conducted in the USA, three in the UK, one in the Netherlands, one in Denmark, one in Sweden, and one in Puerto Rico. Six studies were conducted in community organizations including faith-based centres like churches and mosques [21][22][23][24][25][26], eight in health and social service agencies [27][28][29][30][31][32][33][34], two in schools and/or community groups [35,36], another two in social clubs [37,38], and one in a household [39].…”

“…Five studies revealed that some participants had not heard of HPV disease or HPV vaccine [27,33,35,39]. There were four studies that reported participants had no prior knowledge of HPV as a sexually transmitted disease or as a cause of cancer [25,30,32]. In four studies, participants described a lack of information and knowledge about the purpose of HPV vaccination, and HPV transmission [21,29,37].…”

Health Information Source Characteristics Matter: Adapting the Dissemination of an HPV Vaccine Intervention to Reach Latina and Vietnamese Women

“…To effectively reach young Latina and Vietnamese women with HPV vaccine prevention messages, source preferences should be considered (Hopfer, et al, 2017a(Hopfer, et al, , 2017b. Findings suggest that the use of many sources by Latina and Vietnamese women should inform dissemination strategies for the NCI EBCCP HPV Vaccine Decision Narratives.…”

“…The intervention was originally developed to reach college women, and in the context of a randomized controlled trial the decision story messages nearly doubled vaccinations in the intervention relative to the control group (Hopfer, 2012). The EBCCP has since been adapted to reach many audiences, including women who seek care at safety-net clinics like Planned Parenthood (Hecht et al, 2021;Hopfer, Garcia, et al, 2017a;Hopfer Ray et al, 2017b).…”