Barriers to Cervical Cancer Screening and Prevention in Young Korean Immigrant Women: Implications for Intervention Development

This study aimed to identify major barriers to Papanicolaou (Pap) test uptake and human papillomavirus (HPV) vaccine acceptability. Three focus groups with 16 young Korean immigrant women residing in a community in the Midwest were conducted. Braun and Clarke’s six phases of thematic analysis were used to develop themes. Three major themes emerged as barriers: (a) limited knowledge about cervical cancer and preventive behaviors, (b) culture-specific barriers, and (c) low accessibility to health care services. These themes were multifactorial and interrelated barriers to Pap test uptake and HPV vaccine acceptability among young Korean immigrant women. These findings indicate that culturally tailored cervical cancer education is needed to promote Pap test uptake and HPV vaccination in this underserved population.

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Introduction of HPV vaccination in Kenya

Afrika Focus ◽

10.21825/af.v29i2.4851 ◽

2016 ◽

Vol 29 (2) ◽

Author(s):

Heleen Vermandere

Keyword(s):

Cervical Cancer ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Organizational Factors ◽

Personal Control ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Open Communication ◽

Vaccine Acceptability ◽

Hpv Vaccine Acceptability

HPV vaccination prevents cervical cancer, the fourth most common cancer among women worldwide. Measured HPV vaccine acceptability is often high but does it also lead to high uptake? Methodology: A cohort was set up assessing HPV vaccine acceptability and other health behav- iour constructs before, and vaccine uptake after an HPV vaccination programme in Eldoret, Kenya. Focus groups shed light on the motivation for vaccine uptake or refusal. Results: Acceptability was high but was no strong predictor of uptake, and neither were the constructs of the Health Belief Model. Lack of information and fear of side effects were major barriers. Feeling uncomfortable to discuss cervical cancer hampered open communication. Discussion: Distrust towards new vaccines and the health system blocked translation from willingness-to-vaccinate to actual uptake, as did organizational factors such as poor promotion. Conclusion: Future research should include broader concepts such as vaccine hesitancy and factors beyond personal control in order to predict vaccine uptake. Key words: HPV vaccination, acceptability, uptake, longitudinal study, Kenya

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Introduction of HPV vaccination in Kenya

Afrika Focus ◽

10.1163/2031356x-02902010 ◽

2016 ◽

Vol 29 (2) ◽

pp. 117-121

Author(s):

Heleen Vermandere

Keyword(s):

Cervical Cancer ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Organizational Factors ◽

Personal Control ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Open Communication ◽

Vaccine Acceptability ◽

Hpv Vaccine Acceptability

Introduction: HPV vaccination prevents cervical cancer, the fourth most common cancer among women worldwide. Measured HPV vaccine acceptability is often high but does it also lead to high uptake? Methodology: A cohort was set up assessing HPV vaccine acceptability and other health behaviour constructs before, and vaccine uptake after an HPV vaccination programme in Eldoret, Kenya. Focus groups shed light on the motivation for vaccine uptake or refusal. Results: Acceptability was high but was no strong predictor of uptake, and neither were the constructs of the Health Belief Model. Lack of information and fear of side effects were major barriers. Feeling uncomfortable to discuss cervical cancer hampered open communication. Discussion: Distrust towards new vaccines and the health system blocked translation from willingness- to-vaccinate to actual uptake, as did organizational factors such as poor promotion. Conclusion: Future research should include broader concepts such as vaccine hesitancy and factors beyond personal control in order to predict vaccine uptake.

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Improvement of Parent’s awareness, knowledge, perception, and acceptability of human papillomavirus vaccination after a structured-educational intervention

BMC Public Health ◽

10.1186/s12889-020-09962-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mei Neni Sitaresmi ◽

Nisrina Maulida Rozanti ◽

Lamria Besty Simangunsong ◽

Abdul Wahab

Keyword(s):

Educational Intervention ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Hpv Infection ◽

Primary School Students ◽

School Students ◽

Demonstration Program ◽

Vaccine Acceptability ◽

Parental Awareness ◽

Hpv Vaccine Acceptability

Abstract Background Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11–13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability. Methods We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. Results A total of 506 parents participated. Before receiving the structured-educational intervention, parents’ awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p < 0.001). HPV vaccine’s acceptability increased from 74.3 to 87.4% (p < 0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r = 0.32 to 0.53, p < 0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine’s acceptability with OR 1.90 (95%CI:1.40–2.57) and OR 1.31(95%CI,1.05–1.63), respectively. Conclusions A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability.

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Cervical cancer screening and HPV vaccine acceptability among rural and urban women in Kilimanjaro Region, Tanzania

BMJ Open ◽

10.1136/bmjopen-2014-005828 ◽

2015 ◽

Vol 5 (3) ◽

pp. e005828-e005828 ◽

Cited By ~ 39

Author(s):

M. S. Cunningham ◽

E. Skrastins ◽

R. Fitzpatrick ◽

P. Jindal ◽

O. Oneko ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Hpv Vaccine ◽

Urban Women ◽

Vaccine Acceptability ◽

Rural And Urban ◽

Kilimanjaro Region ◽

Hpv Vaccine Acceptability

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Improvement of Parent’s Awareness, Knowledge, Perception, and Acceptability of HPV Vaccination After a Structured-educational Intervention

10.21203/rs.3.rs-30161/v5 ◽

2020 ◽

Author(s):

Mei Neni Sitaresmi ◽

Nisrina Maulida Rozanti ◽

Lamria Besty Simangunsong ◽

Abdul Wahab

Keyword(s):

Educational Intervention ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Hpv Infection ◽

Primary School Students ◽

School Students ◽

Demonstration Program ◽

Vaccine Acceptability ◽

Parental Awareness ◽

Hpv Vaccine Acceptability

Abstract Background: Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5 th and 6 th grades (11-13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability. Methods: We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5 th and 6 th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. Results: A total of 506 parents participated. Before receiving the structured-educational intervention, parents' awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p <0.001). HPV vaccine's acceptability increased from 74.3% to 87.4% ( p <0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r=0.32 to 0.53, p <0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine's acceptability with OR 1.90 (95%CI:1.40-2.57) and OR 1.31(95%CI:1.05-1.63), respectively. Conclusions: A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability .

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Improvement of Parent’s Awareness, Knowledge, Perception, and Acceptability of HPV Vaccination After a Structured-educational Intervention

10.21203/rs.3.rs-30161/v4 ◽

2020 ◽

Author(s):

Mei Neni Sitaresmi ◽

Nisrina Maulida Rozanti ◽

Lamria Besty Simangunsong ◽

Abdul Wahab

Keyword(s):

Educational Intervention ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Hpv Infection ◽

Primary School Students ◽

School Students ◽

Demonstration Program ◽

Vaccine Acceptability ◽

Parental Awareness ◽

Hpv Vaccine Acceptability

Abstract Background: Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11-13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability.Methods: We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. Results: A total of 506 parents participated. Before receiving the structured-educational intervention, parents' awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p<0.001). HPV vaccine's acceptability increased from 74.3% to 87.4% (p<0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r=0.32 to 0.53, p<0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine's acceptability with OR 1.90 (95%CI:1.40-2.57) and OR 1.31(95%CI:1.05-1.63), respectively. Conclusions: A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability.

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Cervical Cancer Prevention Education Program for Rural Korean Immigrant Women

Western Journal of Nursing Research ◽

10.1177/01939459211014111 ◽

2021 ◽

pp. 019394592110141

Author(s):

Jung A. Choi ◽

Oksoo Kim

Keyword(s):

Cervical Cancer ◽

Cancer Prevention ◽

Education Program ◽

Immigrant Women ◽

Primary Care Providers ◽

Cervical Cancer Prevention ◽

Korean Immigrant ◽

Prevention Education ◽

Korean Immigrant Women ◽

Experimental Group

The study aimed to evaluate the effectiveness of a cervical cancer prevention education program for rural Korean immigrant women. A total of 46 Korean immigrant women who had not been screened in the past three years participated. The experimental group participated in the intervention program once a week for four weeks and completed a post-program survey in week 12. Compared to the control group, significant increases were detected in level of knowledge of cervical cancer prevention ( p = .001), behavioral attitude toward cervical cancer prevention ( p = .029) and behavioral intention regarding cervical cancer prevention ( p = .005) in the experimental group. Pap screening rate of the experimental group was significantly increased ( p = .029), but the rate of change in the selection of primary care providers was not significant. The results suggest the need for a multilevel approach to address cultural and systemic barriers to Korean immigrant women in promotion of cervical cancer prevention behavior.

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The Role of Hospitals in Cervical Cancer Prevention

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v2i1.371 ◽

2014 ◽

pp. 3-9

Author(s):

Susie Susilawati ◽

Dwiana Ocviyanti

Keyword(s):

Health Care ◽

Cervical Cancer ◽

Primary Prevention ◽

Cancer Prevention ◽

Health Care Professionals ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Pap Test ◽

Cervical Cancer Prevention

Objective: To evaluate the role of hospitals in DKI Jakarta on primary and secondary cervical cancer prevention. Method: This was a survey conducted to 25 hospitals, chosen with simple random sampling from 109 hospitals in DKI Jakarta. Questionnaire used for interview contained statements regarding knowledge, attitude and behavior of 117 health care professionals along with identification of facility preparedness for cervical cancer prevention within those 25 hospitals. Result: The assessment of knowledge shows that all health care professionals (100%) knew that HPV vaccination is used as a primary prevention for cervical cancer. About 98.3% respondent knew HPV vaccine injected intramuscularly. As much as 91.5% of the respondent knew HPV vaccine is given three times either at month 0, 1, 6 or at month 0, 2, 6. About 71.8% respondent knew deltoid as site for vaccine injection. Most of health care professionals (99.1%) knew VIA (visual inspection with acetic acid) can be used for early detection of cervical cancer. About 76.9% respondent knew how to interpret positive VIA results and 60.7% respondent knew how to do VIA test. As much as 93.2% health care professional knew the purpose of Pap test and about 82.1% knew how to do it. From attitude aspect, most of health care professionals (96.6%) agreed in giving HPV vaccination. About 94% of them agreed to do VIA test and about 98.3% agreed in conducting Pap test. From behavioral aspect, most of the respondent (76.9%) offered HPV vaccination to their clients/patients and 62.4% respondent did HPV vaccination. VIA test was offered and conducted by 52.1% and 30.8% of them, respectively. About 86.3% respondent offered Pap test and 71.8% did the Pap test. As many as 75% of female health care professionals who meet the qualification already had a Pap test for themselves, but only 32.5% ever been vaccinated for HPV. From facility aspect, twenty hospitals (80%) in DKI Jakarta offered HPV vaccination with Pap test can be done in all of them. VIA test and colposcopy were only available in eleven (44%) and ten (40%) hospitals respectively. Conclusion: Most hospitals in DKI Jakarta have health care professionals with good knowledge and attitude in cervical cancer prevention. However, not many have shown expected behavior in the primary prevention. Most hospitals in DKI Jakarta provide facilities for HPV vaccination and Pap test, but only few have VIA facilities and colposcopy. Keywords: cervical cancer prevention, health care professional, hospital

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