Uptake of Free HPV Vaccination Among Young Women: A Comparison of Rural Versus Urban Rates

Crosby, Richard A.; Casey, Baretta R.; Vanderpool, Robin C.; Collins, Tom; Moore, Gregory R.

doi:10.1111/j.1748-0361.2010.00354.x

Cited by 48 publications

(50 citation statements)

References 16 publications

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“…Adherence to doses two and three was extremely low, limiting subsequent analysis; results have been presented elsewhere. 6 Table 2 displays the significant bivariate findings. After examining the data for interaction by study site, three variables were found to have interaction at the bivariate level: condom use and hormonal and intrauterine birth control use.…”

Section: Discussionmentioning

confidence: 99%

“…36 As posited by the Diffusion of Innovations Theory, knowledge of new innovations, such as the HPV vaccine, is often lower in populations that have limited formal education and lower socioeconomic status (SES) and are less urban. 37 Kentucky as a whole has lower adolescent HPV vaccination rates compared to the United States (40% at least dose one), 4 and Crosby et al 6 found higher vaccination rates among young adult women in urban Kentucky compared to rural Kentucky. Therefore, it is reasonable to extrapolate that our study targeted a population that was clearly undervaccinated compared to national and state data.…”

Section: Study Samplementioning

confidence: 99%

“…5 Additional community-based research suggests there may also be localized, geographic disparities in HPV vaccine uptake, with rural women having lower rates than their urban counterparts. 6 Much of the early HPV vaccine-related research focused on a hypothetical vaccination scenario and emphasized intent and barriers to vaccinate from the perspective of parents of adolescents and healthcare providers. [7][8][9][10][11][12][13][14][15][16][17] More recently, several researchers have reported varying predictors of actual HPV vaccine uptake; however, many of the predictors are clinical variables commonly found in medical record reviews, including previous obstetric history, characteristics of providers, and healthcare system use.…”

Section: Introductionmentioning

confidence: 99%

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Sexually Related Behaviors as Predictors of HPV Vaccination Among Young Rural Women

Mills

Vanderpool²,

Crosby³

2011

Journal of Women's Health

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Purpose-To explore whether sexually related behaviors predict refusal of the human papillomavirus (HPV) vaccine among a sample of women aged 18-26 in Appalachian Kentucky.Methods-Using a convenience sample, young women attending health clinics and a community college in southeastern Kentucky were recruited to participate in a Women's Health Study. After completing a questionnaire, women received a free voucher for the three-dose HPV vaccine series. Completion of dose one served as the outcome variable.Results-Women with a history of an abnormal Pap test were almost two times more likely to decline the HPV vaccine (adjusted odds ratio [AOR] 1.91, 95% confidence interval [CI] 1.14-3.20, p = 0.015), and women who reported they had never had a Pap test were four times more likely to decline the vaccine (AOR 4.02, 95% CI 1.13-14.32, p = 0.032). Women engaging in mutual masturbation were nearly two times more likely to decline the free vaccine (AOR 1.91, 95% CI 1.17-3.10, p = 0.009). Use of hormonal birth control showed a protective effect against refusal of the free HPV vaccine (AOR 0.593, 95% CI 0.44-0.80, p = 0.001).Conclusions-Among this sample of Appalachian women, those engaging in behaviors that increase their risk for HPV infection were more likely to refuse the vaccine. Conversely, those women engaging in protective health behaviors were more likely to accept the vaccine. These findings suggest that those women not being vaccinated may be the very group most likely to benefit from vaccination. Cervical cancer prevention programs need to be creative in efforts to reach young women most in need of the vaccine based on a higher profile of sexually related behaviors and the proxy measure of this risk (having an abnormal Pap test result).

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Section: Discussionmentioning

confidence: 99%

Section: Study Samplementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sexually Related Behaviors as Predictors of HPV Vaccination Among Young Rural Women

Mills

Vanderpool²,

Crosby³

2011

Journal of Women's Health

Self Cite

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“…33 Other studies have also reported differences by demographic characteristics. 34,[37][38][39][40][41] Using data from the main NIS-Teen phone interview, 35 we focused our analysis on predictor variables that included household (census region, urbanicity, and poverty [compared to 100% of the federal poverty level]), parent (maternal education and preferred language to complete the survey), and adolescent characteristics (race/ethnicity, age at the time of the interview, and private health insurance status).…”

Section: Methodsmentioning

confidence: 99%

Disparities in collaborative patient-provider communication about human papillomavirus (HPV) vaccination

Moss

Gilkey

Rimer

et al. 2016

Human Vaccines & Immunotherapeutics

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Background. Healthcare providers may vary their communications with different patients, which could give rise to differences in vaccination coverage. We examined demographic disparities in parental report of collaborative provider communication and implications for human papillomavirus (HPV) vaccination. Methods. Participants were 4,124 parents who completed the National Immunization Survey-Teen about daughters ages 13-17. We analyzed disparities in collaborative communication (mutual information exchange, deliberation, and decision) and whether they mediated the relationship between demographic characteristics and HPV vaccine initiation. Results. Half of parents (53%) in the survey reported collaborative communication. Poor, less educated, Spanish-speaking, Southern, and rural parents, and parents of non-privately insured and Hispanic adolescents, were least likely to report collaborative communication (all p<.05). These disparities in communication accounted for geographic variation in HPV vaccination, specifically, the higher rates of uptake in the Northeast versus the South (mediation zD2.31, p<.01) and in urban/suburban vs. rural areas (mediation zD2.87, p<.01). These disparities were also associated with vaccination among subgroups with relatively high coverage, minimizing what could have been even higher uptake among Hispanic compared to non-Hispanic white adolescents (mediation zD¡3.04, p<.01) and non-privately versus privately insured adolescents (mediation zD¡3.67, p<.001). Controlling for provider recommendation attenuated some of these associations (but all p<.10). Conclusions. Collaborative communication showed widespread disparities, being least common among underserved groups. Collaborative communication helped account for differences-and lack of differences-in HPV vaccination among some subgroups of adolescent girls. Leveraging patient-provider communication, especially for underserved demographic groups, could improve HPV vaccination coverage.

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“…86 An HPV vaccine uptake study conducted in the US found lower uptake of free vaccines in rural college clinics as compared with urban college clinics. 87 Age-appropriate vaccination rates were also lower among rural children as compared with urban children in Nonsan City in South Korea. 88 Complementary and alternative medicine.…”

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confidence: 96%

The effect of social determinants on immunization programs

Glatman‐Freedman

Nichols

2012

Human Vaccines & Immunotherapeutics

113

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Uptake of Free HPV Vaccination Among Young Women: A Comparison of Rural Versus Urban Rates

Abstract: Initial uptake of free HPV vaccination among young rural college women may be problematic. Moreover, uptake of subsequent free doses among rural women may be problematic regardless of whether contact is made in a clinic or through college recruitment.

Cited by 48 publications

References 16 publications

Sexually Related Behaviors as Predictors of HPV Vaccination Among Young Rural Women

Sexually Related Behaviors as Predictors of HPV Vaccination Among Young Rural Women

Disparities in collaborative patient-provider communication about human papillomavirus (HPV) vaccination

The effect of social determinants on immunization programs

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