Acceptability of HPV Vaccine for Males and Preferences for Future Education Programs Among Appalachian Residents

Abstract

Appalachia is a geographic region with several disparities related to human papillomavirus (HPV) infection, yet little is known about acceptability of HPV vaccine for males among Appalachian residents. HPV vaccine acceptability and preferences for future HPV vaccine education programs were examined among residents of Appalachian Ohio. Focus groups and in-depth interviews were conducted with Appalachian Ohio residents between July and October 2011. Participants (n = 102 from 24 focus groups and 5 in-depth interviews) included four key stakeholder groups: health care providers, community leaders, parents with adolescent sons, and young adult men ages 18 to 26 years. Support for vaccinating males against HPV was high among participants, despite low awareness and knowledge about HPV vaccine for males. Participants reported three categories of potential barriers to vaccinating males against HPV: concerns about vaccine safety and side effects, access to care and vaccination logistics, and gender and cultural issues. Participants reported that HPV vaccine was viewed as being only for females in their communities and that receiving the vaccine may be emasculating or embarrassing to males. Participants suggested that future HPV vaccine education programs mainly target parents, include basic information about HPV-related diseases and HPV vaccine (e.g., number of doses, cost), and present the vaccine as having the potential to prevent cancer (as opposed to preventing genital warts). Acceptability of HPV vaccine for males was high among residents of Appalachian Ohio. Future HPV vaccine education programs in Appalachia should address common potential barriers to vaccination and help destigmatize vaccination among males.

Parents’ perceptions of provider communication regarding adolescent vaccines

“…With clinical visits typically lasting between 15-20 minutes, a large amount of time spent on the vaccine discussion means less time for other important topics to be covered, and can also lead to provider burn-out for convincing parents to get vaccinated. 18,19 However, based on this and other studies, [20][21][22][23][24] parents appear to be open to receiving other types of HPV vaccine-related communication such as decision-making tools, pictures of vaccine-preventable diseases, and lists of frequently asked questions. Technology-based interventions such as websites that provide personalized educational information also show promise in this regard.…”

“…Technology-based interventions such as websites that provide personalized educational information also show promise in this regard. 21,[24][25][26][27][28] Our group is currently testing the impact of each of these strategies on the frequency with which providers strongly recommend HPV vaccines for their youngest (11-12 years) adolescent patients, and the impact on adolescent HPV vaccine utilization. An interesting finding from this study was the lack of difference in provider recommendation strength by any patient demographic factor.…”

Has Their Son Been Vaccinated? Beliefs About Other Parents Matter for Human Papillomavirus Vaccine

“…Concerns still persist among parents about potential, and sometimes undocumented, side effects (Berenson & Rahman, 2012;Reiter et al, 2013;Schuler, Hanley, & Coyne-Beasley, 2014). It is plausible that parents' concerns about side effects could be shaped, in part, by beliefs about social norms.…”

“…Normative beliefs are especially important to consider as they could plausibly be influenced by public messages, including promotional messages about HPV vaccine for boys, or even persistent messages about low vaccination rates. Beliefs about social norms may be relevant to parents' intention to vaccinate (Dempsey et al, 2011) and could plausibly be associated with degree of concern about vaccine side effects, still a concern among some parents (Berenson & Rahman, 2012;Reiter, Oldach, Randle, & Katz, 2013). Normative beliefs may also be relevant to knowledge of HPV, as identified in one prior study (de Visser & McDonnell, 2008).…”

The Process of Engaging Members From Two Underserved Populations in the Development of Interventions to Promote the Uptake of the HPV Vaccine

“…Small groups of caregivers and providers were used in both settings, and they may not reflect the viewpoints of all caregivers and providers from their communities. However, many of the issues about the HPV vaccine raised by the caregivers and health care providers in the initial focus groups have been raised by caregivers and providers in previous focus group studies (Katz et al, 2009; Reiter, Oldach, Randle, & Katz, 2014). Furthermore, some caregivers and providers did not participate in all intervention development and review sessions and that could also bias the findings.…”