- Email: [email protected]
22. Perceived Vulnerability to Cancer and Vaccination in Rural Georgia
Poster Abstracts / 48 (2011) S18 –S120
parent acceptability of vaccines, potential barriers to vaccinating their child with a special health care need against HPV (contact with health care provider in the last year, vaccine offered by the health care provider, parent knowledge of HPV infection) were collected. Descriptive frequencies were obtained using SSPS software. Results: Seventeen caregivers, ages 33-54 years, of special needs children responded to the survey. All 17 respondents were women. Eleven respondents (65%) were white, 4 (24%) African American, 2 (12%) Hispanic and 1 responded “other race.” Four (23.5%) of the respondents have one child, 4 (23.5%) have 2 children, 4 (23.5%) have 3 children, and 5 (29.5%) have 4 or more children. The ages of children with special needs ranged from 12-22 years, mean 15.6 years. The parent-reported Child’s Function Disability Inventory has 15 questions, with a minimum disability score of 0 and a maximum disability score of 60. Seven (41%) of the parent respondents reported their special needs child’s disability score to be between 0-20, 5 (29%) reported a disability score of 21-40, and 5 (29%) reported a disability score of 41-60. Four respondents (23.5%) admitted to refusing vaccinations for their child, 12 (71%) have not refused any vaccinations. The vaccines refused include Varicella (n ⫽ 1), meningococcemia (n ⫽ 1), MMR (n ⫽ 1), influenza (n ⫽ 1), and HPV (n ⫽ 1). Eight respondents (47%) answered that their child’s pediatrician has offered the HPV vaccine, while 7 respondents (41%) responded that their child’s pediatrician has NOT offered the HPV vaccine. All respondents had been to their pediatrician in the past year. Seventeen percent (n ⫽ 3) of the respondents answered that their special needs child has been vaccinated against HPV. Thirty-five percent (n ⫽ 6) missed 3 or more of the 7 HPV knowledge questions. Conclusions: This small sample suggests that acceptability of the HPV vaccine in parents of special needs children is lower than that reported in the general population. Previously, we reported 90% of primary care physicians in our sample offered HPV vaccine to patients with special needs. In this study, only 47% of caregivers reported that their daughter’s primary care physician offered them the HPV vaccine. Further research on interventions to increase provider and parent awareness of importance of HPV vaccine is needed. Sources of Support: American Academy of Pediatrics, Resident research grant. 22. PERCEIVED VULNERABILITY TO CANCER AND VACCINATION IN RURAL GEORGIA Tami Thomas, PhD1, Jennifer Waller, PhD2. 1 Emory University 2Medical College of Georgia Purpose: The purpose of this secondary analysis was to identify parents’ perceived vulnerability of their son or daughter to HPV infection and subsequent cancer. Methods: Parents with children 9 to 13 years of age were surveyed anonymously using a 42-item instrument based on constructs from the Health Belief Model and developed by the Principal Investigator. Results: The majority of parents were women, protestant, married with a mean age of 38.3 (SD ⫽ 7.4). Thirty-five percent had incomes less than $15,000. Fifty-six percent knew someone with an STD. Significant associations with race were found for dis-
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agreement with the following perceived vulnerability questions: HPV is a sexually transmitted disease, HPV can cause cervical cancer, required vaccines protect children from getting disease from unvaccinated children, an HPV vaccine could prevent future problems, and having genital warts makes it difficult to find a sexual partner. Specifically, blacks were more likely than whites or Hispanics to disagree that HPV is a sexually transmitted disease than whites (OR ⫽ 4.33). Blacks were more likely than whites or Hispanics to disagree that HPV can cause cervical cancer (OR ⫽ 2.99). Blacks were more likely than whites or Hispanics to disagree that required vaccines protect children from getting disease (OR ⫽ 2.59). Blacks were less likely than whites or Hispanics to disagree that the HPV vaccine could prevent future problems (OR ⫽ 0.26). Conclusions: This information provides an opportunity for providers and health educators to focus on parents perceptions of their son or daughter’s vulnerability to HPV infection and the possibility of a future diagnosis of cancer. Sources of Support: Sponsored in part by the Robert Wood Johnson Foundation. 23. FACTORS ASSOCIATED WITH THE HUMAN PAPILLOMAVIRUS VACCINATION AND ITS RECOMMENDATION IN U.S. ADOLESCENT FEMALES May Lau, MD, MPH, Hua Lin, PhD, Glenn Flores, MD. University of Texas - Southwestern Purpose: Human papillomavirus (HPV) vaccine has been recommended for adolescent females 11-12 years old since 2007. The goal of this study was to identify the number of adolescent females who received the HPV vaccine, factors associated with HPV vaccination, and healthcare provider (HCP) recommendation of the HPV vaccine in adolescent females. Methods: The 2007 National Survey of Children’s Health, sponsored by the Maternal and Child Health Bureau, was a random-digit-dial phone survey of a nationally representative sample of households with children 0-17 years old. One child was randomly selected to be the index child for the survey. The parent/guardian most responsible for the child’s healthcare was interviewed in English or Spanish. The number of adolescent females 12-17 years old who received the HPV vaccine was calculated. Bivariate and multivariable analyses were used to examine associations of sociodemographic and healthcare factors with HPV vaccination and HCP recommendation of the HPV vaccine for adolescent females 12-17 years old. Results: Data were analyzed on 16,139 adolescent females. Out of approximately 11.4 million adolescent females, almost 9.3 million (81%) of US adolescents did not receive the HPV vaccine. Significantly higher proportions of HPV-immunized vs. HPV-unimmunized adolescent females received the tetanus/TD/Tdap (94% vs. 81%) and meningitis (65% vs. 31%) vaccines, were insured (94% vs. 91%), had a usual source of care (96% vs. 93%), had a preventive medical visit in the past year (94% vs. 91%), and had their HCP recommend the HPV vaccine (84% vs. 20%). In multivariable analyses adjusting for eight covariates, adolescent females who were American Indian/Alaska Native, multiracial, or had received the meningitis vaccine had about triple the adjusted odds of HPV vaccine receipt; those who received the tetanus/TD/ Tdap vaccine or were poor had about double the adjusted odds of
parent acceptability of vaccines, potential barriers to vaccinating their child with a special health care need against HPV (contact with health care provider in the last year, vaccine offered by the health care provider, parent knowledge of HPV infection) were collected. Descriptive frequencies were obtained using SSPS software. Results: Seventeen caregivers, ages 33-54 years, of special needs children responded to the survey. All 17 respondents were women. Eleven respondents (65%) were white, 4 (24%) African American, 2 (12%) Hispanic and 1 responded “other race.” Four (23.5%) of the respondents have one child, 4 (23.5%) have 2 children, 4 (23.5%) have 3 children, and 5 (29.5%) have 4 or more children. The ages of children with special needs ranged from 12-22 years, mean 15.6 years. The parent-reported Child’s Function Disability Inventory has 15 questions, with a minimum disability score of 0 and a maximum disability score of 60. Seven (41%) of the parent respondents reported their special needs child’s disability score to be between 0-20, 5 (29%) reported a disability score of 21-40, and 5 (29%) reported a disability score of 41-60. Four respondents (23.5%) admitted to refusing vaccinations for their child, 12 (71%) have not refused any vaccinations. The vaccines refused include Varicella (n ⫽ 1), meningococcemia (n ⫽ 1), MMR (n ⫽ 1), influenza (n ⫽ 1), and HPV (n ⫽ 1). Eight respondents (47%) answered that their child’s pediatrician has offered the HPV vaccine, while 7 respondents (41%) responded that their child’s pediatrician has NOT offered the HPV vaccine. All respondents had been to their pediatrician in the past year. Seventeen percent (n ⫽ 3) of the respondents answered that their special needs child has been vaccinated against HPV. Thirty-five percent (n ⫽ 6) missed 3 or more of the 7 HPV knowledge questions. Conclusions: This small sample suggests that acceptability of the HPV vaccine in parents of special needs children is lower than that reported in the general population. Previously, we reported 90% of primary care physicians in our sample offered HPV vaccine to patients with special needs. In this study, only 47% of caregivers reported that their daughter’s primary care physician offered them the HPV vaccine. Further research on interventions to increase provider and parent awareness of importance of HPV vaccine is needed. Sources of Support: American Academy of Pediatrics, Resident research grant. 22. PERCEIVED VULNERABILITY TO CANCER AND VACCINATION IN RURAL GEORGIA Tami Thomas, PhD1, Jennifer Waller, PhD2. 1 Emory University 2Medical College of Georgia Purpose: The purpose of this secondary analysis was to identify parents’ perceived vulnerability of their son or daughter to HPV infection and subsequent cancer. Methods: Parents with children 9 to 13 years of age were surveyed anonymously using a 42-item instrument based on constructs from the Health Belief Model and developed by the Principal Investigator. Results: The majority of parents were women, protestant, married with a mean age of 38.3 (SD ⫽ 7.4). Thirty-five percent had incomes less than $15,000. Fifty-six percent knew someone with an STD. Significant associations with race were found for dis-
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agreement with the following perceived vulnerability questions: HPV is a sexually transmitted disease, HPV can cause cervical cancer, required vaccines protect children from getting disease from unvaccinated children, an HPV vaccine could prevent future problems, and having genital warts makes it difficult to find a sexual partner. Specifically, blacks were more likely than whites or Hispanics to disagree that HPV is a sexually transmitted disease than whites (OR ⫽ 4.33). Blacks were more likely than whites or Hispanics to disagree that HPV can cause cervical cancer (OR ⫽ 2.99). Blacks were more likely than whites or Hispanics to disagree that required vaccines protect children from getting disease (OR ⫽ 2.59). Blacks were less likely than whites or Hispanics to disagree that the HPV vaccine could prevent future problems (OR ⫽ 0.26). Conclusions: This information provides an opportunity for providers and health educators to focus on parents perceptions of their son or daughter’s vulnerability to HPV infection and the possibility of a future diagnosis of cancer. Sources of Support: Sponsored in part by the Robert Wood Johnson Foundation. 23. FACTORS ASSOCIATED WITH THE HUMAN PAPILLOMAVIRUS VACCINATION AND ITS RECOMMENDATION IN U.S. ADOLESCENT FEMALES May Lau, MD, MPH, Hua Lin, PhD, Glenn Flores, MD. University of Texas - Southwestern Purpose: Human papillomavirus (HPV) vaccine has been recommended for adolescent females 11-12 years old since 2007. The goal of this study was to identify the number of adolescent females who received the HPV vaccine, factors associated with HPV vaccination, and healthcare provider (HCP) recommendation of the HPV vaccine in adolescent females. Methods: The 2007 National Survey of Children’s Health, sponsored by the Maternal and Child Health Bureau, was a random-digit-dial phone survey of a nationally representative sample of households with children 0-17 years old. One child was randomly selected to be the index child for the survey. The parent/guardian most responsible for the child’s healthcare was interviewed in English or Spanish. The number of adolescent females 12-17 years old who received the HPV vaccine was calculated. Bivariate and multivariable analyses were used to examine associations of sociodemographic and healthcare factors with HPV vaccination and HCP recommendation of the HPV vaccine for adolescent females 12-17 years old. Results: Data were analyzed on 16,139 adolescent females. Out of approximately 11.4 million adolescent females, almost 9.3 million (81%) of US adolescents did not receive the HPV vaccine. Significantly higher proportions of HPV-immunized vs. HPV-unimmunized adolescent females received the tetanus/TD/Tdap (94% vs. 81%) and meningitis (65% vs. 31%) vaccines, were insured (94% vs. 91%), had a usual source of care (96% vs. 93%), had a preventive medical visit in the past year (94% vs. 91%), and had their HCP recommend the HPV vaccine (84% vs. 20%). In multivariable analyses adjusting for eight covariates, adolescent females who were American Indian/Alaska Native, multiracial, or had received the meningitis vaccine had about triple the adjusted odds of HPV vaccine receipt; those who received the tetanus/TD/ Tdap vaccine or were poor had about double the adjusted odds of