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HPV Knowledge, Attitudes, and Beliefs Among Northern Plains American Indian Adolescents, Parents, Young Adults, and Health Professionals

Journal of Cancer Education volume 28, pages 357–366 (2013)Cite this article

Abstract

Native American women in the Northern Plains have a high prevalence of human papillomavirus (HPV) and high incidence of cervical disease and cervical cancer. HPV vaccination coverage is shown to be lower among nonwhite populations and disparity populations. We assessed HPV knowledge, attitudes, and beliefs towards HPV and HPV vaccination during a community-based participatory research project among tribal youth, young adults, parents, and health professionals. In 2009, we recruited a total of 73 individuals to participate in four tribal focus groups: tribal health providers, (n = 10), Indian Health Service providers (n = 7), young adult women ages 19–26 (n = 22), girls (14–18) (n = 18), and parents (n = 16). Of these, 62 (84.93 %) completed a survey, which included 10 healthcare providers, 22 young adults, 14 teens, and 16 parents. We employed a qualitative thematic analysis of focus group transcript data and conducted frequency analysis of survey data, which were both reviewed and triangulated by a Community Advisory Board. Based on the results of this study, the tribal community advisory board identified local tribal settings for interventions to increase HPV vaccination coverage through health education classes and a school-based vaccination clinic. In addition to tribal community-wide education events to increase awareness of HPV disease, the HPV vaccine, provider-specific training was identified as a potential intervention. These community-based focus group findings underscore the importance of locally and cultural tailored educational interventions to further increase HPV knowledge and HPV vaccination among disparate populations like American Indian adolescent and young adult women.

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References

  1. Cobb N, Paisano R (1997) Cancer mortality among American Indians and Alaska Natives in the United States: regional differences in Indian health, 1989–1993. Indian Health Service, Rockville

    Google Scholar 

  2. Espey D, Paisano R, Cobb N (2005) Regional patterns and trends in cancer mortality among American Indians and Alaska Natives, 1990–2001. Cancer 103(5):1045–1053

    PubMed  Article  Google Scholar 

  3. Leman RF, Espey D, Cobb N (2005) Invasive cervical cancer among American Indian women in the Northern Plains, 1994–1998: incidence, mortality, and missed opportunities. Public Health Rep 120(3):283

    PubMed  Google Scholar 

  4. Becker TM, Espey DK, Lawson HW, Saraiya M, Jim MA, Waxman AG (2008) Regional differences in cervical cancer incidence among American Indians and Alaska Natives, 1999–2004. Cancer 113(S5):1234–1243

    PubMed  Article  Google Scholar 

  5. Indian Health Service (IHS) 2010–12, unpublished results

  6. Haverkamp D, United States (2008) Indian Health Service, Center for Disease Control. Cancer mortality among American Indians and Alaska Natives: regional differences, 1999–2003: Department of Health and Human Services, Indian Health Service

  7. Indian Health Service. Regional differences in Indian Health, 2002–2003 edn

  8. Department of Health (2008) Cancer in South Dakota, 2011 March 2011

  9. Bell MC, Schmidt-Grimminger D, Jacobsen C, Chauhan SC, Maher DM, Buchwald DS (2011) Risk factors for HPV infection among American Indian and white women in the Northern Plains. Gynecol Oncol 121:532–536

    PubMed  Article  Google Scholar 

  10. Bell MC, Schmidt-Grimminger D, Patrick S, Ryschon T, Linz L, Chauhan SC (2007) There is a high prevalence of human papillomavirus infection in American Indian women of the Northern Plains. Gynecol Oncol 107(2):236–241

    PubMed  Article  Google Scholar 

  11. Schmidt-Grimminger D, Bell M, Buchwald D, Jacobsen C, Maher D, Chauhan S (2011) HPV infection among rural American Indian women and urban White women in South Dakota: an HPV prevalence study. BMC Infectious Diseases 11:252. doi:10.1186/1471-2334-11-252

    PubMed  Article  Google Scholar 

  12. Dorell C, Stokley S, Yankey D, Liang J, Markowitz L (2011) National and state vaccination coverage among adolescents aged 13 through 17 years—United States, 2010. Morb Mortal Weekly Rep 60(33):1117–11123

    Google Scholar 

  13. Dempsey AF, Abraham LM, Dalton V, Ruffin M (2009) Understanding the reasons why mothers do or do not have their adolescent daughters vaccinated against human papillomavirus. Ann Epidemiol 19(8):531–538

    PubMed  Article  Google Scholar 

  14. Das A, Madhwapathi V, Davies P, Brown G, Dearnley E, Spencer A et al (2010) Knowledge and acceptability of the HPV vaccine by school children and their parents in Birmingham. Vaccine 28(6):1440–1446

    PubMed  Article  CAS  Google Scholar 

  15. Allen JD, Othus MKD, Shelton RC, Li Y, Norman N, Tom L et al (2010) Parental decision making about the HPV vaccine. Cancer Epidemiology Biomarkers & Prevention 19(9):2187–2198

    Article  Google Scholar 

  16. Williams K, Forster A, Marlow L, Waller J (2011) Attitudes towards human papillomavirus vaccination: a qualitative study of vaccinated and unvaccinated girls aged 17–18 years. Journal of Family Planning and Reproductive Health Care 37(1):22

    PubMed  Article  Google Scholar 

  17. Weiss TW, Rosenthal SL, Zimet GD (2011) Attitudes toward HPV vaccination among women aged 27 to 45. ISRN Obstet Gynecol 2011:670318

  18. Dillard JP, Spear ME (2010) Knowledge of human papillomavirus and perceived barriers to vaccination in a sample of US female college students. J Am Coll Heal 59(3):186–190

    Article  Google Scholar 

  19. Mishra A, Implementing HPV (2010) Vaccines: public knowledge, attitudes, and the need for education. International Quarterly of Community Health Education 31(1):71–98

    PubMed  Article  Google Scholar 

  20. Trim K, Naushin N, Elit L, Roy K (2012) Parental knowledge, attitudes, and behaviours towards human papillomavirus vaccination for their children: a systematic review from 2001 to 2011. Obstetrics and Gynecology International 2012

  21. Zimet G, Weiss T, Rosenthal S, Good M, Vichnin M (2010) Reasons for non-vaccination against HPV and future vaccination intentions among 19–26 year-old women. BMC Womens Health 10(1):27

    PubMed  Google Scholar 

  22. Hughes J, Cates JR, Liddon N, Smith JS, Gottlieb SL, Brewer NT (2009) Disparities in how parents are learning about the human papillomavirus vaccine. Cancer Epidemiology Biomarkers & Prevention 18(2):363–372

    Article  Google Scholar 

  23. Cates JR, Brewer NT, Fazekas KI, Mitchell CE, Smith JS (2009) Racial differences in HPV knowledge, HPV vaccine acceptability, and related beliefs among rural, southern women. J Rural Heal 25(1):93–97

    Article  Google Scholar 

  24. Kemberling M, Hagan K, Leston J, Kitka S, Provost E, Hennessy T (2011) Alaska Native adolescent views on cervical cancer, the human papillomavirus (HPV), genital warts and the quadrivalent HPV vaccine. Int J Circumpolar Health 70(3):245–253

    PubMed  Google Scholar 

  25. Buchwald D, Jacobsen C, Bell M, Schmidt-Grimminger D (2013) Attitudes towards HPV Vaccination among Rural American Indian women and Urban White women in the Northern Plains. Health Educ Behav. doi:10.1177/1090198113477111

  26. Glaser BG, Strauss AL (1967) The discovery of grounded theory, strategies for qualitative research. Aldine de Gruyter, New York

    Google Scholar 

  27. Glaser BG (1965) The constant comparative method of qualitative analysis. Social Problems 12:436–445

    Article  Google Scholar 

  28. Guest G, MacQueen K (eds) (2008) Handbook for team-based qualitative research. Altamira Press, Lanham

    Google Scholar 

  29. Popping R (1988) On agreement indices for nominal data. St Martin’s Press, New York

    Google Scholar 

  30. Saris WE, Gallhofer IN (eds), Sociometric research. Volume 1: data collection and scaling. New York: St. Martin's Press, pp 90–105

  31. Duvall J, Buchwald D (2012) Human papillomavirus vaccine policies among American Indian tribes in Washington State. J Pediatr Adolesc Gynecol 25:131–135

    PubMed  Article  Google Scholar 

  32. Downs LS Jr, Scarinci I, Einstein MH, Collins Y, Flowers L (2010) Overcoming the barriers to HPV vaccination in high-risk populations in the US. Gynecol Oncol 117(3):486–490

    PubMed  Article  Google Scholar 

  33. Kessel SJM, Marshall HS, Watson M, Braunack-Mayer AJ, Reuzel R, Tooher RL (2012) Factors associated with HPV vaccine uptake in teenage girls: A systematic review. Vaccine 30:3546–3556

    Article  Google Scholar 

  34. Rose SB, Lanumata T, Lawton BA (2011) Promoting uptake of the hpv vaccine: the knowledge and views of school staff. J Sch Health 81(11):680–687

    PubMed  Article  Google Scholar 

  35. US Commission on Civil Rights (2003) A Quiet Crisis, federal funding and unmet needs in Indian Country

  36. Zuckerman S, Haley J, Roubideaux Y, Lillie-Blanton M (2004) Health service access, use, and insurance coverage among American Indians/Alaska Natives and Whites: what role does the Indian Health Service play? Am J Public Health 94(1):53–59

    PubMed  Article  Google Scholar 

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Acknowledgments

Many thanks are due to the tribal community advisory board and the tribal focus group participants for their time, interest, and enthusiasm to make this study a success. This work was supported by the American Cancer Society, ACS, Midwest Division Community Based Participatory Research Grants Program to Dr. Schmidt-Grimminger

Author information

Affiliations

  1. Avera Cancer Institute, Sioux Falls, SD, USA

    Delf Schmidt-Grimminger

  2. Department of Obstetrics and Gynecology, Sanford School of Medicine at the University of South Dakota, 1400 West 22nd Street, Sioux Falls, SD, 57105, USA

    Delf Schmidt-Grimminger & Mitchell Dobberpuhl

  3. College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA

    Leah Frerichs & Shinobu Watanabe-Galloway

  4. Cheyenne River Tribal Health, Eagle Butte, SD, USA

    Arlene E. Black Bird

  5. Great Plains Tribal Epidemiology Center, Rapid City, SD, USA

    Karen Workman

Authors
  1. Delf Schmidt-Grimminger
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  2. Leah Frerichs
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  3. Arlene E. Black Bird
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  4. Karen Workman
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  5. Mitchell Dobberpuhl
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  6. Shinobu Watanabe-Galloway
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Correspondence to Delf Schmidt-Grimminger.

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Schmidt-Grimminger, D., Frerichs, L., Black Bird, A.E. et al. HPV Knowledge, Attitudes, and Beliefs Among Northern Plains American Indian Adolescents, Parents, Young Adults, and Health Professionals. J Canc Educ 28, 357–366 (2013). https://doi.org/10.1007/s13187-013-0468-y

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  • DOI: https://doi.org/10.1007/s13187-013-0468-y

Keywords

  • Health disparities
  • Community-based participatory research
  • Cervical cancer
  • Pap screening
  • HPV genotypes
  • American Indians
  • Human papillomavirus