Abstract
Background: Although human papilloma virus (HPV) vaccination has been available for seven years, uptake remains low, and evidence suggests disparities exist in vaccination completion. Perceptions about the HPV vaccine may be contributing to these trends. The purpose of this study was to examine perceptions about the HPV vaccine by socio-demographic characteristics and the extent to which perceptions are associated with provider communication, health information seeking, and cancer beliefs.
Methods: The study used data from the National Cancer Institute's Health Information National Trends Survey (HINTS) that were collected in 2012-2013 (HINTS 4, Cycle 2). The sample was comprised of respondents for whom the HPV vaccine was relevant. Respondents were considered “HPV vaccine-relevant” if they or someone in their immediate family was ages 9-27 years old. Of the 3,551 adults in the HINTS survey population, 1,417 (52%) were HPV vaccine-relevant. Variables of interest were socio-demographic characteristics (age, gender, race/ethnicity, health insurance status, income, education), perceptions about the HPV vaccine, and variables related to provider communication, health information seeking, and cancer beliefs. Bivariate analyses were used to examine socio-demographic differences in perceptions about the vaccine. Binomial logistic regression was used to examine the influence of provider communication, health information seeking, and cancer beliefs on perceptions. Jackknife replicate weights were incorporated to assess standard errors and 95% confidence intervals.
Results: Among vaccine-relevant individuals, 25% (n = 348) reported talking with a healthcare provider about the HPV vaccine. Talking with a healthcare provider varied by education level (p=0.03); for example, 34% of college graduates reported talking with a provider compared to only 21% of individuals with less than a high school education. Non-Hispanic Black respondents reported the lowest levels of confidence in the HPV vaccine's effectiveness (18.6%). Overall, 70% (n = 980) of respondents reported not knowing how successful the HPV vaccine is at preventing cervical cancer, with non-Hispanic Black respondents reporting the highest levels of uncertainty (78%). However, the only socio-demographic characteristics statistically significantly associated with uncertainty were education (p=0.002) and gender (p=0.04). Uncertainty about HPV vaccine effectiveness was significantly higher among individuals who had not talked with a provider about the vaccine, had not sought cancer information from any source, had not sought cancer information on the Internet in the past 12 months, agreed that there's not much one can to do lower his/her chances of getting cancer, and agreed that there are so many recommendations about cancer prevention that it's hard to know which to follow. In a logistic regression model adjusting for socio-demographic characteristics, vaccine-relevant respondents who had never talked with a provider about the HPV vaccine were nearly four times more likely to not know about its effectiveness (aOR 3.89; 95% CI 2.31-6.55); those who had not sought cancer information on the Internet in the past 12 months were twice as likely to not know about the HPV vaccine's effectiveness (aOR 2.10; 95% CI 1.21-3.65).
Conclusions: Uncertainty about HPV vaccine effectiveness remains high and may be a factor contributing to low uptake and disparities in vaccination. Findings suggest HPV communication and messages need refinement to clearly highlight vaccine efficacy, and targeted strategies may be needed to reach non-Hispanic Blacks and individuals with lower levels of education.
This abstract is also presented as Poster A7.
Citation Format: Kassandra I. Alcaraz, Lauren D. Arnold, Alicia L. Best, Vetta L. Sanders Thompson. Examining perceptions about the HPV vaccine by sociodemographic characteristics and factors associated with perceptions: Findings from the 2012 Health Information National Trends Survey (HINTS). [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr PR2. doi:10.1158/1538-7755.DISP13-PR2