Policy opportunities to increase HPV vaccination in rural communities

Abstract

Rural communities experience health disparities, including elevated incidence and mortality of human papillomavirus (HPV)-associated cancers and correspondingly low HPV vaccination rates. There are numerous policy strategies that are available at multiple levelspatient, provider, clinic, community, state, and nationalto address geographic, clinical, and communication barriers to HPV vaccination across rural America. Examples include policy development, implementation, and evaluation of healthcare provider and clinic-based assessment and education initiatives; school entry requirements; school, pharmacy, and community-based vaccination programs; evidence-based, community-driven communication efforts; and increased interventional research in rural communities. Strategically implemented policy measures will contribute to reduction in the incidence and mortality from HPV-related cancers through increased access to HPV vaccination in our rural communities.

A multi-site case study of community-clinical linkages for promoting HPV vaccination

“…[30][31][32][33] Five of the nine clinical sites were FQHCs, an indicator of the commitment among clinical and community sites to providing preventive care to economically disadvantaged populations and a common site for research and quality improvement projects focused on HPV vaccination across the country. 34,35 The profiled linkages included urban and rural settings; inclusion of rural communities is particularly important given the disparities in HPV-related cancers in rural areas of the U.S. 11 Each CCL had unique characteristics, but several common themes emerged from these profiles.…”

“…9 In addition, interventions aimed at expanding access to and community awareness of the HPV vaccine have occurred in pharmacy, mobile clinic, and dental settings, and through the use of strategic health communication campaigns. 11,12 Despite previous HPV vaccination interventions, uptake, and completion of the HPV vaccine series remains a public health challenge. [13][14][15] Innovative and coordinated partnerships between vested stakeholders and implementation of evidence-based prevention strategies in clinical and community settings offers a way to connect these settings.…”

Epidemiology and Implementation of Cancer Prevention in Disparate Populations and Settings

“…Previous research suggests that rural communities experience an undue burden of HPVrelated cancers, 36 including Kentucky, which leads the nation in the incidence of HPVrelated cancers. 37 Moreover, national data suggest that adolescents from rural communities are less likely to receive the HPV vaccine.…”

There’s Much Yet to be Done: Diverse Perspectives on HPV Vaccination

“…21 A second paper points to the lower vaccination rates in rural areas of the U.S. and suggests policy strategies to improve vaccine uptake in these areas. 22 A third paper examines, in detail, policy challenges and issues with the introduction of vaccines in China. 6 Another paper addresses the challenges associated with implementing effective HPV vaccination programs for men who have sex with men, 23 and a final paper reviews the arguments for and against the implementation of policies to vaccinate female sex workers.…”