“Is cancer contagious?”: Australian adolescent girls and their parents: Making the most of limited information about HPV and HPV vaccination
Introduction
Informed consumers are in a better position to make decisions about their health and well-being. Appropriate preventative health behaviours are dependent on one's understanding of the behaviour [1]. Unfortunately, in the case of HPV vaccination, decisions are often made without adequate information [2]. Various studies have documented low HPV knowledge levels of both girls and adults across different populations [3], [4], [5], [6]; even women diagnosed with HPV have low levels of comprehension [7], [8]. However, most of these studies were conducted before the HPV vaccine was widely advertised and available. One study, conducted after publicity about the vaccine by manufacturers in the US, showed that awareness had increased, but knowledge and understanding had not improved [9]. Prophylactic vaccination against HPV types 16, 18, 6, 11 (GARDASIL®) is now funded by the Australian government for Australian girls through school-based delivery. Since school-based vaccination is the method most likely to reach the highest percentage of adolescents [10], it is gaining popularity. Indeed, in the Australian HPV school program to date, rates of around 75% have been documented [11]. However, there are no published studies that fully explore and examine knowledge about HPV and HPV vaccine post-implementation of mass HPV vaccination in schools.
It is important to document vaccine recipients’ knowledge of HPV-related information as it may impact upon girls’ future health behaviours. Knowledge about the implications of vaccination may influence adolescents’ sexual behaviour, use of protective measures against other STIs, and future attendance at cervical screening. There is also an ethical responsibility to ensure that individuals are making a decision about vaccination with adequate understanding.
Section snippets
Background
Australia's National HPV Vaccination Program was implemented rapidly following its announcement on 29 November 2006, with commencement of school-based vaccination in April 2007. This created logistical challenges, including development of educational resources. Vaccine manufacturer materials were utilized by health professionals until other materials became available [12]. The Australian Department of Health and Ageing developed a communication strategy and materials for the national program,
Methods
Data was collected from participants within the same school year as their participation in the vaccination program. At the time of data collection, all participants had received information about HPV vaccination, made a decision about uptake of the vaccine, and received at least one dose if consent was procured. The time lapsed between receiving information and study participation ranged from 1 to 8 months, based on school availability for study participation.
Results
The core theme presented in this paper is lack of knowledge. See Fig. 1 for a pictorial representation of the supporting themes and their relationships. These themes were present across all groups of girls and parents, regardless of age, school type, date since receiving vaccination information, or vaccination status.
In each quote reference, the letter corresponds to a code for the school, and the number refers to either an adolescent focus group (FG), or parental interview (P).
Discussion and recommendations
This is the first study to examine knowledge and understanding of HPV and HPV vaccination among adolescent girls and their parents who have recently been involved in mass school-based HPV vaccination. Adolescents in particular had limited understanding about HPV and HPV vaccination and wanted this information. These findings have important implications for future cervical cancer prevention and safer sex behaviours among vaccinated adolescents and young women.
Adolescents were not provided
Acknowledgements
We would like to thank the NSW Department of Health for their cooperation with this study and their invaluable advice and feedback on the results. We would like to acknowledge CSL Limited Australia for partial funding of this research, in the form of an unrestricted research grant. We wish to acknowledge the invaluable input of the research participants: the parents, adolescents, teachers and nurses who participated in this study and each of the schools that allowed the research to be
References (36)
- et al.
Knowledge about infection with human papillomavirus: a systematic review
Preventive medicine
(2008) - et al.
Human papillomavirus, cervical cancer, and women's knowledge
Cancer Detection and Prevention
(2008) - et al.
Human papillomavirus and cervical cancer in Australasia and Oceania: risk-factors, epidemiology, and prevention
Vaccine
(2008) - et al.
Implementation of the Australian HPV vaccination program for adult women: qualitative key informant interviews
Vaccine
(2009) - et al.
Predictors of HPV vaccine acceptability: a theory-informed, systematic review
Preventive Medicine
(2007) - et al.
A cross-sectional survey to assess community attitudes to introduction of human papillomavirus vaccine
Australian & New Zealand Journal of Public Health
(2007) - et al.
Future acceptance of adolescent human papillomavirus vaccination: a survey of parental attitudes
Vaccine
(2006) - et al.
Predictors of STI vaccine acceptance among parents and their children
Journal of Adolescent Health
(2005) - et al.
Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative state-wide analysis
Journal of Adolescent Health
(2007) - et al.
Parental acceptance of the human papillomavirus vaccine
Journal of Adolescent Health
(2005)
Challenges to accepting a human papilloma virus (HPV) vaccine: a qualitative study of Australian women
Women & Health
Education about human papillomavirus and human papillomavirus vaccines in adolescents
Adolescent and Pediatric Gynecology
A study of women's knowledge regarding human papillomavirus infection, cervical cancer and human papillomavirus vaccines
Australian and New Zealand Journal of Obstetrics and Gynaecology
“I have never heard that one:” young girls’ knowledge and perception of cervical cancer
Journal of Health Communication
Knowledge and awareness of human papillomavirus (HPV): attitudes towards HPV vaccination among a representative sample of women in Victoria, Australia
Sexual Health
HPV knowledge among HPV positive women
American Journal of Health Behavior
Disparities in how parents are learning about the human papillomavirus vaccine
Cancer Epidemiology Biomarkers Prevention
Randomised controlled trial of an educational strategy to increase school-based adolescent hepatitis B vaccination
Australian and New Zealand Journal of Public Health
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