Abstract
Cervical cancer is the second leading cause of cancer death for women in the Dominican Republic. Vaccination against human papillomavirus (HPV) could reduce mortality from cervical cancer globally by as much as 90%. The purpose of our study was to explore multi-level barriers and facilitators to implementation of a national HPV vaccine program in the Dominican Republic; this article focuses on parent-level barriers and facilitators. In this qualitative study, we conducted six focus groups (N = 64) with parents of school-age children in the Santo Domingo area of the Dominican Republic, representing diverse socioeconomic groups and geographic settings. Thematic content analysis, using inductive and deductive approaches, was done following transcription and translation of audio-recordings from focus group discussions. Among this group of parents in the Santo Domingo area, facilitators to vaccine uptake were favorable attitudes towards vaccines in general and concern about cervical cancer as a health issue. Barriers found were low to moderate knowledge of HPV and cervical cancer, especially in the rural and suburban groups, and cost and lack of public awareness of the vaccine. This study identified key barriers and facilitators to HPV vaccine implementation in the Dominican Republic. Health messaging, incorporating specialist providers as opinion leaders, will need to be tailored to broad audiences with varying levels of information and awareness, anticipating misinformation and concerns, and will need to emphasize HPV vaccine as a method to prevent cancer.
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Acknowledgements
Carlos DeCenza for transcription/translation, Sonya Romanoff for Atlas Ti data entry, Mimi Niles for help conducting focus groups, INCART for assistance with recruitment
Funding
The study was funded by the NYU University Research Challenge Fund (URCF) and funds from the College of Global Public Health for transportation, transcription and translations costs. The authors contributed “in kind” time to the design, conduct, data analysis and manuscript development of the paper. Saving Mothers provided additional support for travel and lodging during data collection.
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Liebermann, E., Devanter, N.V., Frías Gúzman, N. et al. Parent-Level Barriers and Facilitators to HPV Vaccine Implementation in Santo Domingo, Dominican Republic. J Community Health 45, 1061–1066 (2020). https://doi.org/10.1007/s10900-020-00830-y
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DOI: https://doi.org/10.1007/s10900-020-00830-y