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• W2494562603 abstract "This study examined parental acceptability of the Human Papilloma Virus (HPV) vaccination among Latino parents. The role that acculturation may play in Latino parents‟ acceptability of the vaccine was also examined. A survey conceptualized using the Health Belief Model and two acculturation measures were administered to participants (N = 130). Approximately 70% of parents endorsed that they would vaccinate their daughters with the HPV vaccine. A regression analysis revealed that perception of susceptibility, perception of seriousness, perception of benefit, and cues to action significantly predicted parental acceptability, with 57% of the variance accounted by these variables. Acculturation was not a significant predictor of parental acceptability. These results indicate that a large proportion of Latino parents are likely to accept the HPV vaccine and that certain Health Belief Model constructs may predict acceptability in this population. It is important for healthcare providers to understand what factors may predict Latino parents‟ acceptability to the HPV vaccine given the high rates of cervical cancer among Latina women. Recommendations for future research in this area are provided. Running head: Latino Parental Acceptability 8 CHAPTER I: STATEMENT OF THE PROBLEM Human Papilloma Virus (HPV) infection is the most common sexually transmitted disease (CDC, 2008). HPV infection is also one of the leading causes of both genital warts and cervical cancer. In the United States, HPV is known to cause 90% of genital warts and is responsible for 70% of cervical cancers (Reichman, 2008). According to the CDC (2008), 20 million Americans are currently infected with HPV and at least 50% of sexually active men and women will acquire the HPV infection. Not every individual who acquires HPV will develop genital warts or cervical cancer. In 90% of cases, the body‟s immune system clears the HPV infection naturally within two years (CDC, 2008). It is still unknown how the body can resist the HPV infection. Today, HPV is one of the leading causes of cervical cancer. Specifically, HPV types 16, 18, 31, 33, and 45 are linked to cervical cancer. In the U.S., cervical cancer was once the leading cause of cancer deaths in women, but over the past 40 years, the mortality rate has decreased by 50% due to the implementation of Pap tests. Although cervical cancer rates have significantly dropped in the U.S., it continues to cause a large portion of cancer deaths in women. When compared by ethnicity, Latina women had the highest incidence rate of any race with a 13.2 per 100,000 rate of cervical cancer (Ward, 2004). In addition, higher prevalence rates of cervical cancer have also been found among immigrants (Ward, 2004). In June of 2008, the United States Food and Drug Administration approved Merck‟s HPV vaccine, Gardasil, for females 9 to 26 years of age, for the purpose of reducing rates of HPV infection (FDA, 2008). Although research on parental acceptability towards the HPV vaccine began several years before the vaccine was approved, still little Running head: Latino Parental Acceptability 9 is known on what influences parental acceptability towards the HPV vaccine. Overall, the research has supported that parents are accepting of the HPV vaccine and intend to have their daughters vaccinated against HPV. Research has primarily focused on identifying the predictors to acceptability and intention to vaccinate. Mays, Sturm, & Zimet (2005) recruited 24 Caucasian and 10 African American parents and found that, when they compared urban clinic patients to suburban clinic patients, they found that urban clinic patients had less education and a higher HPV vaccine acceptance rate. This study did not find a significant difference between HPV vaccine acceptance and ethnicity. Another larger study that recruited 56% Caucasian, 40% African American and less than 2% Latino parents found that parents who did not have private insurance (66%) and were recruited from urban clinics (66%) were more likely to accept sexually transmitted infection (STI) vaccines (Zimet, et al., 2005). Olshen et al. (2005) who conducted a small nonrandom focus group concluded that higher rates of parental acceptability of the HPV vaccine depended on physician recommendation and if their child was at risk of infection. Other investigators have found that parental beliefs and attitudes, rather than knowledge, were stronger predictors of the HPV vaccine acceptability (Dempsey, Zimet, Davis, & Koutsky, 2006). Findings highlighted that those individuals with less education and less access to healthcare were more likely to accept the vaccine. These results may also generalize to the lower income Latino community. Ogilvie et al. (2007) identified predictors to parental intention to vaccinate throughout Canada using random digit dialing and a telephone interview. The strongest predictors in this study included the parents‟ attitude towards vaccines in general, attitude Running head: Latino Parental Acceptability 10 towards the HPV vaccine, recommendations from health care providers, family and friends, parents‟ ages, and if parents believed that the vaccine would negatively impact their daughters‟ sexual behavior. In a quantitative study, Constantine & Jerman (2007) found that Latino parents (84%) were more likely to accept the HPV vaccine for girls before age 13 than Caucasian, African American and Asian American parents. They also concluded that Asian Americans (60%) and African Americans (61%) were least likely to accept the HPV vaccine for girls before age 13. The parents who were more likely to accept the HPV vaccine had a high school degree or less. Those more likely to accept the HPV vaccine also identified as Catholic, less religious and politically liberal. These results may indicate that Latinos who identify themselves as less religious, Catholic and who are politically liberal are more likely to accept the HPV vaccine. Out of 75% of parents who endorsed the HPV vaccine, 40% attributed their acceptance to health and safety concerns and 25% of acceptances were because parents believed it was a practical prevention technique. A study also found that women‟s willingness to have their children vaccinated was associated with whether their child had received all of the recommended vaccinations and if they accepted the vaccine for themselves (Slomovitz et al., 2006). Finally, research has also highlighted that parents who do not accept the HPV vaccine have concerns that it will promote sexual behaviors, promote unprotected sexual activity, and may cause adverse effects (Ogilvie et al., 2007). While some studies focused on Latino parents or included Latino parents in their samples, most research has focused on other groups. Therefore knowledge about Latino parents‟ acceptability towards the HPV vaccine remains limited. The current study will Running head: Latino Parental Acceptability 11 address Latino parents‟ acceptability towards the HPV vaccine for their daughters. This research intends to identify predictors to the acceptability towards the vaccine such as the perception of threat, perception of response effectiveness, cues to action, acculturation and access to healthcare. CHAPTER II: REVIEW OF THE LITERATURE Human Papillomavirus (HPV) HPV is a virus, which causes a viral infection known to be associated with cervical cancer and genital warts. It is classified as a deoxyribonucleic acid (DNA) virus because it has the ability to replicate in genetic material such as a cell‟s nucleus (Wang & Kieff, 2008). HPV inhibits a protein that suppresses tumor growth and, as a result, promotes abnormal cell growth. HPV can be found on the skin as well as the body‟s internal skin walls known as mucus membranes. Mucus membranes can be found in the genitals, anus, mouth, and airways. HPV is transmitted through direct contact with the skin of an infected person. More than 40 HPV types are recognized to affect the genital area, and individual types are associated with their specific clinical manifestations (CDC, 2008) HPV is transmitted through genital contact and usually is passed through vaginal, oral and anal sex (CDC, 2008). According to the Center for Disease Control (2008), 20 million Americans are currently infected with HPV and at least 50% of sexually active men and women will acquire the HPV infection. Some of the more common HPV types are categorized into either high or low risk categories, depending on their association with cervical cancer or genital warts (CDC, 2004). For example, HPV types 6 and 11 are considered low risk and can produce genital warts, whereas types 16, 18, 31, 33, and 45 are considered high risk and are linked to cervical cancer. Running head: Latino Parental Acceptability 12 In the United States, HPV is known to cause 90% of genital warts and is responsible for 70% of cervical cancers (Reichman, 2008). The CDC (2008) estimated that 1% of sexually active adults in the U.S. will have genital warts at one time in their lives. Moreover, in 2008 the American Cancer Society estimated that during that year alone approximately, 12,200 women in the U.S. would be diagnosed with cervical cancer (CDC, 2010). Not every individual who acquires HPV will develop genital warts or cervical cancer. In 90% of cases, the body‟s immune system clears the HPV infection naturally within two years (CDC, 2008). It is still unknown how the body can resist the HPV infection. While much remains unclear about HPV infection, it is clear that HPV can present in many varieties including symptomless genital warts or be associated with a variety of benign tumors and malignant cancers (Reichman, 2008). Consequences and Prevalence of HPV" @default.
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• W2494562603 title "Latino parental acceptability towards the Human Papilloma Virus vaccine" @default.
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