Development and Testing of a Culturally Tailored Intervention to Promote HPV Vaccination Intentions in Latina Young Adults

摘要

The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a known risk factor for cervical cancer. Several HPV vaccines have been approved as a primary prevention option. Vaccine administration is recommended for individuals between the ages of 9 and 26. Despite recommendations to vaccinate and a disproportionately high rate of cervical cancer among Latinas, rates of vaccination remain low among this population. The HPV vaccine consists of three doses applied six months apart. Vaccination initiation and completion rates are particular low among Latina young adults (18--26 years of age) and adolescents (13--17 years of age), respectively. Presently, few culturally tailored interventions to promote HPV vaccination have been developed for Latina young adults. The first objective of the present study was to develop a culturally tailored health intervention to promote HPV vaccination intentions among Latina young adults. An experimental design was conducted to test the impact of a culturally-tailored fotonovela on HPV knowledge, vaccine attitudes, and intentions to obtain the vaccine compared to a CDC informational sheet that was not culturally tailored. The second objective of this study was to test the effect of HPV knowledge and constructs of the Health Belief Model (perceived severity of contracting HPV, barriers to vaccination and self-efficacy), and the influence of culture normative contextual influences such as engagement in sexuality-related discussions with mother, perceived parental objection to getting vaccinated, and preference for Spanish) on HPV vaccination intention using structural equation modeling (SEM). Results revealed that intentions to get vaccinated and perceived severity of HPV were significantly higher among participants randomly assigned to receive information through the culturally tailored intervention compared to participants assigned to receive information via the CDC informational sheet. Additionally, results from the SEM emphasize the role of the family and culture in the decision to vaccinate. Findings could inform patient-provider communication regarding HPV vaccination and help to identify potential points of intervention for this at-risk group.