Exploring attitudes of adolescents and caregivers towards community-based delivery of the HPV vaccine: a qualitative study

BMC Public Health

Constance Fontanet¹  Ingrid Katz²  Marina Teixeira³  Sitara Mahtani³  Shoba Ramanadhan⁴ 

[1] Brigham and Women’s Hospital, 75 Francis Street, 02115, Boston, MA, USA;Brigham and Women’s Hospital, 75 Francis Street, 02115, Boston, MA, USA;Harvard Global Health Institute, 42 Church St, 02138, Cambridge, MA, USA;Dana-Farber Cancer Institute, 450 Brookline Ave, 02215, Boston, MA, USA;Harvard T.H. Chan School of Public Health, 677 Longwood Avenue, Kresge 7th floor, 02115, Boston, MA, USA;

关键词: Human papillomavirus;    HPV;    Cancer prevention;    Racial and ethnic minorities;    Community-engaged research;    Adolescents;    Vaccination;    Community settings;   

DOI  :  10.1186/s12889-020-09632-2

来源: Springer

【 摘 要 】

BackgroundHuman Papillomavirus (HPV) vaccination among adolescents is an important strategy to prevent cervical and other cancers in adulthood. However, uptake remains far below the Healthy People 2020 targets for the US. Given the barriers to population-level vaccination policies and challenges to incorporating additional action items during clinical visits, we sought to explore alternative delivery mechanisms, specifically delivery of the vaccine in community settings.MethodsWe conducted six focus groups (three with adolescents aged 11–14 who had not received the HPV vaccine and three with caregivers of adolescents meeting those criteria) from Black, Latino, and Brazilian communities in Massachusetts. We utilized a framework analysis approach that involved a multi-stage coding process employing both prefigured and emergent codes. Initial interpretations were refined through consultation with an advisory board.ResultsAdolescents and caregivers expressed a range of concerns about the HPV vaccine and also described interest in learning more about the vaccine, emphasizing the importance of a relationship with a trusted provider as a facilitator of vaccine acceptance. Regarding community-based delivery of the vaccine, reactions were mainly negative. However, adolescents and caregivers noted that receiving information in community settings that could seed a conversation with a trusted provider would be welcome. Interestingly, the notion of a trusted provider seemed to extend broadly to practitioners linked to the trusted main provider.ConclusionsThe study highlights an opportunity for increasing HPV vaccination among some racial and ethnic minority populations by leveraging trusted community organizations to provide information and seed conversations with a potentially broad group of trusted providers. A task-shifting approach, or reliance on staff with fewer formal credentials, may offer opportunities to support vaccination in resource-constrained settings.

【 授权许可】

CC BY