Human Papillomavirus and Oropharyngeal Cancer Among Indigenous Australians: Protocol for a Prevalence Study of Oral-Related Human Papillomavirus and Cost-Effectiveness of Prevention

Jamieson, Lisa; Garvey, Gail; Hedges, Joanne; Mitchell, Amanda; Dunbar, Terry; Leane, Cathy; Hill, Isaac; Warren, Kate; Brown, Alex; Ju, Xiangqun; Roder, David; Logan, Richard M.; Johnson, Newell W.; Smith, Megan A.; Antonsson, Annika; Canfell, Karen

doi:10.2196/10503

Cited by 21 publications

(27 citation statements)

References 51 publications

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“…This qualitative project is a nested sub-study of a larger study examining oral human papilloma virus (HPV) infection among Indigenous South Australians [ 11 ]. Ethical approval for the nested qualitative sub-study was provided by the University of Adelaide’s Human Research Ethics Committee (HREC-2016-246) and Aboriginal Health Research Ethics Committee (AHREC 14-18-865).…”

Section: Methodsmentioning

confidence: 99%

‘There’s a Wall There—And That Wall Is Higher from Our Side’: Drawing on Qualitative Interviews to Improve Indigenous Australians’ Experiences of Dental Health Services

Krichauff

Hedges

Jamieson

2020

IJERPH

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Indigenous Australians experience high levels of untreated dental disease compared to non-Indigenous Australians. We sought to gain insight into barriers that prevent Indigenous Australians from seeking timely and preventive dental care. A qualitative study design was implemented, using face-to-face interviews conducted December 2019 to February 2020. Participants were 20 Indigenous Australians (10 women and 10 men) representing six South Australian Indigenous groups; Ngarrindjeri, Narungga, Kaurna, Ngadjuri, Wiramu, and Adnyamathanha. Age range was middle-aged to elderly. The setting was participants’ homes or workplaces. The main outcome measures were barriers and enablers to accessing timely and appropriate dental care. The findings were broadly grouped into eight domains: (1) fear of dentists; (2) confusion regarding availability of dental services; (3) difficulties making dental appointments; (4) waiting times; (5) attitudes and empathy of dental health service staff; (6) cultural friendliness of dental health service space; (7) availability of public transport and parking costs; and (8) ease of access to dental clinic. The findings indicate that many of the barriers to Indigenous people accessing timely and appropriate dental care may be easily remedied. Cultural competency training enables barriers to timely access and provision of dental care to Indigenous Australians to be addressed. The findings provide important context to better enable health providers and policy makers to put in place appropriate measures to improve Indigenous people’s oral health, and the Indigenous oral health workforce in Australia.

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Section: Methodsmentioning

confidence: 99%

‘There’s a Wall There—And That Wall Is Higher from Our Side’: Drawing on Qualitative Interviews to Improve Indigenous Australians’ Experiences of Dental Health Services

Krichauff

Hedges

Jamieson

2020

IJERPH

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“…We used a large convenience sample (n = 1011) of adults aged 18 years or older who identified as being Indigenous in the Australian state of South Australia. Data were collected between February 2018 and January 2019 as part of a broader study investigating HPV and OPSCC among Indigenous Australians 25 and were analyzed from October 2018 to July 2019. The study was governed by an Indigenous Reference Group, with data collected by trained Indigenous research officers.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Prevalence of Oral Human Papillomavirus Infection Among Australian Indigenous Adults

et al. 2020

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IMPORTANCE Human papillomavirus (HPV) infection is associated with oropharyngeal squamous cell carcinoma. International estimates suggest overall oral HPV prevalence is 7.5%, with prevalence of oral HPV types 16 and 18 being 1.6%; prior Australian estimates suggest oral HPV prevalence is 2.3%, with HPV-16 and HPV-18 being 1.3%. OBJECTIVES To estimate the prevalence of oral HPV infection among Indigenous Australians and to report the prevalence of factors associated with high-risk HPV types (ie, HPV-16 and HPV-18) and HPV types linked with Heck disease (ie, HPV-13 and HPV-32). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study analyzed HPV screening results from saliva samples collected from 1011 Indigenous Australians between February 2018 and January 2019. Data were analyzed from May 2018 to May 2019. Recruitment occurred through Aboriginal Community Controlled Health Organisations in South Australia. Eligibility included identifying as Indigenous, residing in South Australia, and being aged 18 years or older. MAIN OUTCOMES AND MEASURES Saliva samples were collected, with microbial DNA for genotyping extracted. Sociodemographic parameters, health-related behaviors, and sexual history data were collected. Analyses were stratified by sex as well as by HPV types 13 and 32 (Heck disease) and 16 and 18 (high risk of oropharyngeal squamous cell carcinoma). Multivariable analyses were conducted to obtain adjusted odds ratios (ORs). RESULTS Data were obtained for 910 participants (median [interquartile range] age, 37 [27-51] years); 595 participants (65%) were female and 572 (63%) resided in nonmetropolitan locations. In all, 321 saliva samples (35.3%; 95% CI, 32.2%-38.4%) were positive for oral HPV (106 [33.7%] men; 215 [36.1%] women). The highest prevalence was found for HPV types 13 and 32 (207 [22.7%] total; 60 [19.0%] men; 147 [24.7%] women) followed by HPV types 16 and 18 (30 [3.3%] total; 9 [2.9%] men; 21 [3.5%] women). After multivariable analysis, risk factors associated with HPV types 13 and 32 included nonmetropolitan residential status (OR, 2.06; 95% CI, 1.10-3.88) and not having had a tonsillectomy (OR, 2.74; 95% CI, 1.05-7.16). Among women, having obtained a high school education or less was associated with lower odds of HPV-16 and HPV-18 infection (OR, 0.16; 95% CI, 0.03-0.97). CONCLUSIONS AND RELEVANCE Prevalence of oral HPV infection in a large sample of Indigenous Australians was high, with one-third testing positive. The most prevalent HPV types were those associated with Heck disease. The prevalence of HPV types associated with oropharyngeal squamous cell carcinoma exceeded both Australian and international population-level estimates.

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“…This included Indigenous community members, councillors and health workers, and was chaired by an Indigenous health manager. A protocol of the study was subsequently published [9].…”

Section: Community Consultationmentioning

confidence: 99%

Engaging with Indigenous Australian communities for a human papilloma virus and oropharyngeal cancer project; use of the CONSIDER statement

Hedges

Garvey

Dodd³

et al. 2020

BMC Med Res Methodol

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Background: The prevalence of oral HPV infection and HPV-related oropharyngeal squamous cell carcinoma (OPSCC) among Indigenous Australians is unknown. This paper outlines the engagement, consultation and recruitment strategies for a study involving investigation of HPV and OPSCC among Indigenous South Australians, based on the consolidated criteria for strengthening the reporting of health research involving Indigenous Peoples (CONSIDER) statement. Methods: Initial consultations with all interested Aboriginal Community Controlled Health Organisations (ACCHOs) were done throughout 2014 and 2015. This resulted in a funding application submitted that reflected Indigenous community views and inputs in study design and methodology, and which included nine Indigenous investigators. Once funding was received, community consultation was again undertaken, with six ACCHOs providing structures, strategies and recommendations for how recruitment for participants taking part in the study should be undertaken. Staff were hired (n = 6), with non-Indigenous staff (n = 3) undertaking extensive cultural competency training. An Indigenous Reference Group was established to provide oversight and cultural guidance. Recruitment of Indigenous participants by trained field officers occurred between Feb 2018 and Dec 2018, with n = 1011 recruited. Qualitative records summarising research staff contact with ACCHOs and participants were documented. These records, together with field trip notes, key ACCHO stakeholder reflections and research staff comments, were reviewed to summarise the culturally sensitive strategies that appeared to work most successfully to facilitate ACCHO and participant buy-in.

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Human Papillomavirus and Oropharyngeal Cancer Among Indigenous Australians: Protocol for a Prevalence Study of Oral-Related Human Papillomavirus and Cost-Effectiveness of Prevention

Cited by 21 publications

References 51 publications

‘There’s a Wall There—And That Wall Is Higher from Our Side’: Drawing on Qualitative Interviews to Improve Indigenous Australians’ Experiences of Dental Health Services

‘There’s a Wall There—And That Wall Is Higher from Our Side’: Drawing on Qualitative Interviews to Improve Indigenous Australians’ Experiences of Dental Health Services

Prevalence of Oral Human Papillomavirus Infection Among Australian Indigenous Adults

Engaging with Indigenous Australian communities for a human papilloma virus and oropharyngeal cancer project; use of the CONSIDER statement

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