Disparities in Human Papillomavirus Vaccine Literacy and Vaccine Completion Among Asian American Pacific Islander Undergraduates: Implications for Cancer Health Equity

Abstract

Purpose: Low rates of human papillomavirus (HPV) vaccination among young Asian American and Pacific Islander (AAPI) women need to be addressed, particularly given the high incidence of cervical cancer in this population. The current study aims to investigate predictors of HPV vaccination in young AAPI and non-Latina white (NLW) women. Methods: A secondary data analysis was conducted of a health survey administered to college-aged women (N = 2,270) at a large public university in the Midwest. Andersen's behavioral model of health services utilization guided the study theoretically, and hierarchical logistic regression analysis was conducted to investigate research aim. Results: NLW women had a significantly higher rate of vaccine completion than AAPI women (NLW = 60.7%; AAPI = 38.6%). NLW women also scored higher on all 5 measures of HPV vaccine literacy than AAPI women. Both groups of undergraduate women reported that increasing age, knowledge about HPV, greater use of gynecological services, and knowing someone who had cancer were significant factors related to HPV vaccination completion. In the NLW group, father's income was also found to be a predictor of HPV vaccination completion. Conclusions: Rate and predictors of HPV vaccination completion vary between NLW and AAPI women. Greater promotion of HPV literacy and gynecological service use should be made to young AAPI women to increase their HPV uptake. Further research should examine sociocultural factors that could hinder or promote HPV vaccination in young AAPI women.     

Teaching intercultural awareness in the English as a foreign language classroom: a case study using critical reading

This paper reports on an educational intervention study that used linguistic and rhetorical approaches to critical reading, in order to teach intercultural awareness. The intervention was implemented with a group of Mexican college students learning English as a foreign language. The study focuses on changes between participants’ pre- and post-intervention articulated understandings of the targeted cultural context, namely the USA. The data was coded and analyzed using a complexity theory perspective and directed qualitative analysis. The results indicate that drawing students’ attention to the cultural situatedness of language use can increase their awareness of the multiple ideological positions existing in a cultural context. Based on these results, the paper argues that the field of intercultural education needs to take a linguistic turn in order to further its goals.     

HPV vaccination campaign fear visuals: An eye-tracking study exploring effects of visual attention and type on message informative value,recall, and behavioral intentions

HPV is the most common sexually transmitted disease, and there are alarming global disparities in cervical cancer and HPV vaccination uptake (CDC, 2016a). To inform HPV vaccination public health campaigns, an experiment with a psychophysiological measure (eye-tracking) explores the effects of visual attention to vaccination messages on message recall, informative value, and behavioral intentions. Results indicate 1) visual type affects recall and informative value of vaccination messages as well as intentions to vaccinate; 2) visual attention is negatively related to message recall only when a non-fear visual is used; and 3) visual attention predicts intent to vaccinate only when a fear visual is utilized. These results suggest the use of fear appeals in health, crisis, and risk public relations campaigns may promote performance of recommended safeguarding behaviors.     

Language educators’ regard for variation in late modernity: Perceptions of linguistic variation in minority contexts

This article investigates language educators’ regard for linguistic variation in a minority language context. It argues that teachers function as language norm authorities who may influence the linguistic practices and ideologies of students, and that this role takes on added significance in minority language contexts where access to the target language may be limited. Data are presented from a study on the linguistic ideologies of Irish language educators – ‘new speakers’ who acquired the language mainly thorough the education system. Participants’ ideologies on variation in modern spoken Irish were explored using semi‐structured interviews incorporating a speaker evaluation design. Although participants valorise traditional dialectal varieties of Irish, in line with established hierarchies, ideological frameworks are contested so that new ways of using Irish are beginning to gain overt acceptance. The results reveal the manner in which hierarchies of language variation in the Irish language are in flux in our contemporary late‐modern period.     

Dilemmas in planning English/vernacular relations in post‐colonial communities

In the context of globalization and post‐modern discourses, the debate about the relative status of local and dominant languages poses serious policy problems for post‐colonial communities. Critics of minority language rights (MLR) generally point out that engineering a language shift on behalf of a vernacular language – motivated by the preservationist interests, collective rights and sentimental associations of an ethnic group – is futile, as the economic and social mobilities of individuals are bound to work against this enterprise. Proponents of MLR have gone to the other extreme of essentializing the linguistic identity of minority communities, generalizing their language attitudes, and treating local language rights as non‐negotiable. This article addresses this debate in the context of the attempts to promote Tamil by the military leadership in the North and East of Sri Lanka. The paper brings together data gathered in sociolinguistic studies for four years in the Jaffna society in order to understand the reception of the language policy in everyday life. The leadership recognizes that language policy is a symbolic statement for political purposes and tolerates certain inconsistencies in policy and practice. While the community assures itself of ethnic pride and linguistic autonomy with the stated policies, it negotiates divergent interests in the gaps between the policy/practice divide. Scholars should recognize the agency of subaltern communities to negotiate language politics in creative and critical ways that transcend the limited constructs formulated to either cynically sweep aside or unduly romanticize language rights.     

From desire to disease: human papillomavirus (HPV) and the medicalization of nascent female sexuality

This article critically examines the proliferation of information on the human papillomavirus (HPV) vaccination as integral to contemporary processes of medicalization that take the young female body and her nascent sexuality as its primary object and target. We suggest that the recent introduction of voluntary HPV vaccination for girls, in North America and elsewhere, constitutes a form of neomedicalization (Batt & Lippman, 2010 ) that links risks for future disease (cervical cancer) with the transmission of a common, sexually transmitted infection (HPV). Informed by findings from a critical discourse analysis of Canadian English newspapers, magazines, and public information about HPV vaccination, our interest is on how the emergence of sexual relationships becomes constructed as a time fraught with risks to future health, and that must be managed through biotechnological intervention (vaccination). We suggest that this configuration of medicalization, rather than demarcate a new category of abnormality that can be treated with pharmaceutical or medical intervention, positions the emergence of sexuality itself as the basis of risk and pathologization. The article concludes by considering the implications of this form of medicalization for constructions of female sexuality and sexual health education.     

Commodified language in Chinatown: A contextualized approach to linguistic landscape1

In Washington DC's newly gentrified Chinatown, recent commercial establishments, primarily non‐Chinese owned chains, use Chinese‐language signs as design features targeted towards people who neither read nor have ethnic ties to Chinese. Using this neighborhood as a case study, we advocate a contextualized, historicized and spatialized perspective on linguistic landscape which highlights that landscapes are not simply physical spaces but are instead ideologically charged constructions. Drawing from cultural geography and urban studies, we analyze how written language interacts with other features of the built environment to construct commodified urban places. Taking a contextually informed, qualitative approach, we link micro‐level analysis of individual Chinese‐language signs to the specific local socio‐geographic processes of spatial commodification. Such a qualitative approach to linguistic landscape, which emphasizes the importance of sociohistorical context, and which includes analysis of signage use, function, and history, leads to a greater understanding of the larger sociopolitical meanings of linguistic landscapes.     

Men's perceptions and knowledge of human papillomavirus (HPV) infection and cervical cancer

The authors assessed young men's knowledge and perceptions of genital human papillomavirus (HPV) infection to identify factors that predict intention to make positive behavioral changes. Male university students aged 18 to 25 years completed a self-report instrument to assess knowledge and perceptions of genital HPV infection. If diagnosed with HPV, most men (95%) reported that they would use condoms with new partners. The intention to reduce number of sex partners was associated with an understanding that HPV may have severe consequences for women, whereas intention to encourage female sex partners to undergo Pap smear screening was associated with increased general knowledge of HPV infection. The authors concluded that it is important to include men in HPV education and prevention efforts, especially within the context that HPV may lead to cervical cancer in female partners.     

Language,structure and agency: What can realist social theory offer to sociolinguistics?

The sociolinguistic enterprise raises fundamental questions about the nature of the relationships between social phenomena (such as social class or gender) and linguistic variation, while within social theory a persistent concern is the nature of the relationship between structure and agency. Sociolinguistics can draw on social theory for analysis of the relationship between speaker and system, the role of language in the creation, maintenance and change of social institutions, and the role of human agency in sociolinguistic phenomena. This article summarises the key tenets of a sociological realism, based on the recent work of Margaret Archer (in particular her exploration of analytical dualism) and of Derek Layder (specifically his theory of ‘social domains’). It relates these ideas to sociolinguistics, arguing that language can be seen to have a different significance, depending on which domain is the focus of the researcher's interest. The article considers the distinctiveness of this approach, contrasting it with structuralist and social constructionist accounts and with structuration. It concludes by identifying some methodological implications, suggesting that sociological realism offers a productive theoretical framework for sociolinguistics in dealing with questions of language, structure and agency.     

Health activism and the logic of connective action. A case study of rare disease patient organisations

This exploratory work investigates the role of digital media in expanding health discourse practices in a way to transform traditional structures of agency in public health. By focusing on a sample of rare disease patient organisations as representative of contemporary health activism, this study investigates the role of digital communication in the development of (1) bottom-up sharing and co-production of health knowledge, (2) health public engagement dynamics and (3) health information pathways. Findings show that digital media affordances for patient organisations go beyond the provision of social support for patient communities; they ease one-way, two-way and crowdsourced processes of health knowledge sharing, exchange and co-production, provide personalised routes to health public engagement and bolster the emergence of varied pathways to health information where experiential knowledge and medical authority are equally valued. These forms of organisationally enabled connective action can help the surfacing of personal narratives that strengthen patient communities, the bottom-up production of health knowledge relevant to a wider public and the development of an informational and eventually cultural context that eases patients’ political action.     

Agency among young people in marginalised positions: towards a better understanding of mental health problems

ABSTRACT

Agency in marginalised youth has been studied from various perspectives, yet the challenges that mental health problems pose for their agency remain poorly understood. Drawing on data from a study on youth transitions fractured by mental health problems, this study sheds light on this important issue. The data consists of 49 life story interviews with young adults. Using Ruth Lister’s four-dimensional taxonomy of agency, the analysis shows how everyday struggles with mental distress are entangled with the practices of the social security system, medical care, education, labour markets, and work life. It also reveals how emerging attempts at strategic agency can fail or flourish depending on the response of the social and structural context. If strategic agency is restricted by institutional practices, it will soon return to day-to-day struggling or become everyday resistance and cynicism towards the system. However, if the strategic agency is supported by institutional practices, a genuine path out of distress emerges. The paper suggests that taking seriously the experiences of mental distress and situating them in a specific socio-political context is essential for understanding youth agency today.     

Exploring the Socioeconomic and Immigration Health Contexts of Asian Americans

Despite an overall picture of good health for Asian Americans in the aggregate, growing evidence shows that specific subgroups—particularly those with high proportions of immigrants—have diverse patterns relative to socioeconomic position and health. Using data from the largest U.S. state health survey, this study explores the contributions of socioeconomic and immigration factors to health status among Asian American subgroups. Results indicate that level of education, income, and English language ability were significant predictors of health status for the Chinese, Korean, and Vietnamese subgroups. Varying patterns in the results by subgroup are discussed in the context of immigration policy.     

Using the Theory of Planned Behavior to predict HPV vaccination intentions of college men

Objective: The purpose of this study was to test Theory of Planned Behavior (TPB) constructs in predicting human papillomavirus (HPV) vaccination behavioral intentions of vaccine-eligible college men. Participants: Participants were unvaccinated college men aged 18–26 years attending a large public university in the southeastern United States during Spring 2015. Methods: A nonexperimental, cross-sectional study design was employed. Instrumentation comprised a qualitative elicitation study, expert panel review, pilot test, test-retest, and internal consistency, construct validity, and predictive validity assessments using data collected from an online self-report questionnaire. Results: The sample consisted of 256 college men, and the final structural model exhibited acceptable fit of the data. Attitude toward the behavior (β = .169) and subjective norm (β = 0.667) were significant predictors of behavioral intention, accounting for 58% of its variance. Conclusions: Practitioners may utilize this instrument for the development and evaluation of TPB-based interventions to increase HPV vaccination intentions of undergraduate college men.     

Generational Shifts in Language Use Among US Latinos: Mobility,Education and Occupation

The role of language and linguistic assimilation among Latinos has a direct impact on both education and occupation in terms of social mobility. The relationship can be examined with a generational context as language usage changes from first generation immigrants to third generation immigrants. The specific question being addressed herein is whether language or ethnicity had more impact on Latinos’ mobility in terms of educational achievement and occupational prestige. Results presented in this paper imply the importance and impact of the maximization of the accumulation of linguistic capital in order to accelerate the acquisition of educational attainment.     

Living with an accent: a sociological analysis of linguistic strategies of immigrant youth in Canada

This research explores the cultural and linguistic strategies of immigrant youth to negotiate inclusion/exclusion, including language discrimination in Vancouver, Canada. My theoretical framework draws upon the Arendtian notions of ‘public space’, and ‘action and speech’ as well as Bourdieu’s concepts of ‘symbolic violence’ and ‘habitus’. My methodology is a critical qualitative approach. Fourteen immigrant youth, aged 15–25, were involved in this research. The findings of this study indicate that unlike second-generation immigrants, first-generation immigrant youth face cultural and linguistic challenges. Non-recognition of youths’ distinct linguistic and social capitals, the imposition of official languages and the regulation of the education and language market according to the dominant linguistic norms include forms of discrimination against Turkish minority youth in Canada. Taken together, the findings suggest that immigrant youths’ cultural and linguistic experiences of inclusion and exclusion cannot be dissociated from the wider politics of the nation-state, popular hegemony and social inequalities in the host society.     

Trends and issues in language policy and language education in Crimea

This work identifies and discusses developments in language policy and language education in Crimea since the peninsula’s incorporation into the Russian Federation in March 2014. Working on the assumption that post-Soviet reforms and changes in language and education policies cannot be understood outside their historical context, the article starts by briefly outlining some of the defining features of the historical and sociolinguistic situation of Crimea until March 2014. It then presents the changing linguistic situation of the peninsula since its accession into Russia and discusses present developments in light of the broader context of post-Soviet language ideologies, policies and practices. It suggests that the new Crimean authorities are following a double strategy: the imposition of monolingual educational and linguistic policies, accompanied by largely symbolic concessions to the demands of local ethnic communities.     

Child language brokering: challenges in Spanish intercultural education

Globalisation has resulted in multicultural and multilingual societies where individuals, who often do not speak the official language, need to communicate with different services offered by public institutions in the host country. School plays a vital role as an education and training institution, and must guarantee that every student receives equal opportunities, and, in accordance with the principles of intercultural education, facilitate the integration of foreign students both into society and the educational context. However, linguistic and cultural barriers may sometimes prevent communication between foreign students, their families and the education centre.

The purpose of this paper is to analyse survey responses and interview talk about communication between teachers and immigrant users who do not speak or barely know the host country language, especially the methods employed and the resources available to Spanish education centres to communicate with students and families who lack the necessary host language skills. A case study will be used as example of the situation in which both educators and families very frequently have to turn to child language brokering, using methodology based on qualitative analysis of surveys and interviews carried out in two primary schools in the Madrid area.