Abstract A35: Knowledge and attitudes concerning the human papillomavirus, cervical cancer, and the human papillomavirus vaccine in rural Appalachia

Despite introduction of the quadrivalent Human Papillomavirus (HPV) vaccine Gardasil that prevents 70% of cervical cancer in immunized women, cervical cancer mortality rates in rural areas of Appalachia have remained significantly higher than the overall US cervical cancer death rate. The purpose of this study was to determine the knowledge level concerning cervical cancer and HPV among people in three communities in eastern Tennessee and Kentucky, and to identify barriers against receiving the HPV vaccine. A two-page survey was developed which addressed: 1) knowledge about cervical cancer, HPV, and the vaccine, and 2) attitudes towards children receiving the vaccine, including questions addressing barriers to receiving the vaccine. The survey was written at a 4th-grade reading level and was administered in written and oral form in the three Community Health Clinics run by Dayspring Family Health Center. If administered in written form, nurses in the clinics handed out the survey after triage; if administered orally, the principle investigator read the questions to the participant. Data analysis is currently ongoing, but initial results indicate that the populations had less-than-ideal knowledge about HPV and the vaccine. While 63% of those surveyed had heard of HPV, only 37% of participants answered 7 or more of the 10 knowledge questions correctly, and only 42% believed that the vaccine could prevent cervical cancer. It also appears that the people attending the most rural clinic had the least knowledge about HPV and the vaccine. Fifty-five percent of those surveyed thought that children of the correct age and gender should get the HPV vaccine. The most common reason against getting the vaccine for children cited by survey participants lack of information about the vaccine, but participants overwhelmingly indicated that their doctor was the only person who could convince them to obtain the vaccine for their children. The regression analysis showed that gender and age of the participant as well as their attitude towards children receiving the HPV shot have a statistically significant affect on their knowledge of HPV and the vaccine. The type of survey administration was not significant when adjusting for other predictors. In conclusion, current analysis indicates that levels of knowledge about HPV and the HPV vaccine are low in these rural Appalachian populations, and that people overwhelmingly want to learn more about the vaccine from their doctor before deciding to get the shot for their children. In light of the high rates of cervical cancer in this area, these results indicate that further information distribution about HPV, its link to cervical cancer, and the preventive affects of the vaccine by doctors is necessary in this area.