Sex Differences Among College Students in Awareness of the Human Papillomavirus Vaccine and Vaccine Options

Abstract

Objectives: To explore awareness of human papillomavirus (HPV) and use of HPV vaccines (Gardasil and Cervarix) by college students. Participants: The sample was composed of 817 undergraduates at 2 northeastern US universities; they participated between February and May 2010. Methods: Students were provided with a link to an anonymous, self-administered, Web-based survey comprised of 76 questions. The survey included questions about health behaviors, awareness, and knowledge of HPV and the 2 HPV vaccines, and vaccine uptake. Results: Results indicate high levels of awareness of HPV as well as marked sex differences related to vaccine awareness and uptake. Both sexes are largely unaware of Cervarix and the differences between Cervarix and Gardasil. Conclusion: The study affirms the importance of a clinician's recommendation for HPV vaccination. Public health messaging should become more inclusive of adolescent and young adult males. College students’ awareness of HPV vaccine options mirrors Gardasil's market dominance in the United States.     

Family factors associated with emerging adults’ human papillomavirus vaccine behavior

Abstract

Objective: The current study examined the role of family influences on the vaccine behavior of emerging adults. Participants: In Spring 2017, we conducted anonymous online surveys of undergraduate students (n?=?608) at a large, public university in the mid-Atlantic. Methods: Logistic regression was used to examine associations between family factors and students’ awareness of the HPV vaccine, vaccine receipt, and vaccine intentions. Family factors included sex communication, religiosity, parental monitoring, family structure, and parents’ birthplace. Results: More comprehensive family sex communication is associated with less uncertainty regarding HPV vaccine receipt and greater likelihood of being already vaccinated. More frequent family religiosity and more parental monitoring are associated with greater likelihood of having decided against vaccination rather than already being vaccinated. Significant gender and racial disparities exist. Conclusion: Further research, policy, and programmatic intervention are needed to reduce disparities and to improve emerging adults’ compliance with HPV vaccine recommendations.     

Knowledge,Beliefs, and Behaviors: Examining Human Papillomavirus–Related Gender Differences Among African American College Students

Abstract

Objective: Given recent approval for administration of a human papillomavirus (HPV) vaccine to men, it is important to assess the HPV-related perspectives of men and women. The purpose of this study was to examine gender differences in HPV knowledge, beliefs, and vaccine acceptance among college students attending 3 historically black colleges/universities in the Southeast. Participants and Methods: A nonprobability sample of 575 students completed a self-report questionnaire. Results: Males were significantly less likely to have heard of HPV, scored lower in HPV knowledge, were less likely to perceive HPV health outcomes as severe and that there was a benefit to vaccinate, reported fewer cues for vaccine acceptance, and perceived more barriers to vaccination compared to females (all p < .05). Conclusions: The gender disparities demonstrated in this study highlight the need to increase HPV-related communication/education to include men and to extend HPV research to a broader segment of the college population.     

Uptake of HPV vaccine in traditional-age undergraduate students: Knowledge,behaviors, and barriers

Abstract

Objective: This study investigated potential factors associated with HPV vaccine uptake in a diverse population of traditional-age undergraduate students. Participants: One hundred and twenty-nine undergraduate students aged 18–24 attending a small southeastern university completed surveys in January to March of 2013. Methods: Questionnaires included demographic information, basic HPV knowledge, HPV vaccine uptake, and factors influencing uptake decision. Survey results were analyzed with chi-square and t-test analyses. Results: Vaccine uptake was significantly higher in students who reported that health care provider, public health information, parents, and access to vaccine were important factors in their decision to get vaccinated. Female students had a significantly higher vaccine uptake in comparison to males and the HPV knowledge scores differed significantly by race but not gender. Conclusions: It is especially important to consider how public health campaigns and communication with parents and health care providers help promote HPV vaccine uptake in this high-risk group.     

How to Inform: Comparing Written and Video Education Interventions to Increase Human Papillomavirus Knowledge and Vaccination Intentions in Young Adults

Abstract

Objective: To compare the efficacy of 2 human papillomavirus (HPV) educational interventions on increasing HPV knowledge and vaccination intentions in college students. Participants: Male (n = 60) and female (n = 140) undergraduates (M _age = 20.4, SD = 2.3) recruited from a university in Montreal, Quebec, Canada, from October 2009 to March 2010. Methods: Using theory-based interventions, participants were randomly assigned to either a written HPV pamphlet, an HPV video, or a control. HPV knowledge and vaccination intentions were assessed pre and postintervention. Results: Low baseline knowledge and intentions were found across groups. Postintervention, participants in the written and video interventions had significantly higher knowledge and intentions than the control. No differences were found between written and video interventions on knowledge or intentions. Conclusion: This study, a first in comparing HPV educational formats, suggests that both written and video interventions are equally effective in educating about HPV and increasing young adults’ vaccination intentions.     

HPV Knowledge and Behaviors of Black College Students at a Historically Black University

College students are at high risk for human papillomavirus (HPV) infection, yet their knowledge and self-protective behaviors appear inadequate. Researchers who have measured HPV-related knowledge and behaviors in evaluating college intervention efforts pay secondary attention to black college students because this group generally represents only a small subset of samples of the broader college population. Objective and Participants The authors' purpose in this study was to examine HPV-related knowledge and behaviors in 351 black undergraduates attending a historically black southeastern university in the spring of 2003. Methods Voluntary and anonymous student participation was solicited in randomly selected undergraduate classes. Results Results indicated that most students lacked HPV awareness (64%), became aware of HPV largely after infection, and gained their HPV knowledge from a health-care provider or college class. The authors performed an analysis by gender and found that women were more knowledgeable about HPV than were men. Observed HPV-related knowledge and behaviors were similar to samples of the broader US college population. Conclusions Findings suggest a greater need for HPV intervention efforts for all college students, including those at black colleges.     

Understanding vaccine knowledge,attitudes, and decision-making through college student interviews

Abstract

Objective: We aimed to explore knowledge, attitudes, and beliefs about vaccines required for college-entry and vaccine-related behaviors among college students. Participants: Thirty-three full-time undergraduate students, ≥ 18 years old, enrolled at public (2) and private (3) colleges and universities in metropolitan Philadelphia in fall 2016. Methods: We conducted semistructured interviews, which were double-coded with 5,015 comments overall and 99.3% intercoder reliability (κ?=?0.779) using NVivo 11 software. Results: Six key themes emerged: (1) low knowledge about vaccines and requirements; (2) mixed attitudes about required vs. recommended vaccines; (3) high trust in medical professionals; (4) low perceived risk for vaccine-preventable disease outbreaks; (5) substantial parental influence on students’ decision-making; and (6) low utilization of Student Health Services. Conclusions: This study revealed lack of knowledge about and low prioritization of vaccination despite overall positive attitudes towards vaccines. Prematriculation education of college students is critical to increasing vaccine knowledge and use.     

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.     

Implementation of an intimate partner violence screening program in a university health care clinic

Abstract

Objectives: To examine whether an intimate partner violence (IPV) screening program is related to a positive change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening. Participants: Eleven health care providers at a university health care clinic participated in the IPV screening program. Methods: A one-group pretest-posttest design was used to examine whether an IPV screening program was related to a change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening. Results: Findings indicated that there was a significant difference (p?<?000) between the posttest scores and the pretest scores on the Domestic Violence Healthcare Provider Survey Scale. Domain analysis of the scale revealed a significant difference in perceived self-efficacy (p?=?.001), system support (p?=?<.002), victim provider safety (p?=?.015), and beliefs of blaming victims (p?=?<.004). No statistical difference was found in professional role resistance/fear of offending (p?=?.158). Conclusions: A university health care clinic IPV screening program was related to a positive change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening.     

Knowledge,Attitudes, and Informational Behaviors of College Students in Regard to the Human Papillomavirus

Abstract

Objective: To assess students’ human papillomavirus (HPV) knowledge, attitudes, and behaviors. Participants/ Methods: Students (N = 1,282) at a large, public university in the Northeast United States completed a questionnaire during February 2008 assessing HPV knowledge, prevalence, transmission, cervical cancer risk and stigma; sexual behavior, vaccination status, as well as past and preferred sources of information about HPV and sexual health. Results: A majority of respondents know of HPV. However, understanding was insufficient in several important areas. Overwhelmingly, respondents heard about HPV via television commercials yet preferred to obtain sexual health information from physicians. Hearing about HPV on a TV commercial was associated with increased knowledge. More knowledge of HPV was associated with less stigma. Men exhibit a higher level of stigma and less knowledge than women. Conclusions: Publicly funded health campaigns aimed at increasing knowledge about HPV are overdue and necessary. This is especially true for efforts targeting young adults about this extremely common sexually transmitted infection (STI).     

The role of human papillomavirus (HPV)-related stigma on HPV vaccine decision-making among college males

ABSTRACT

Objective: The goals of the present study are (1) to identify sociodemographic and psychosocial predictors of human papillomavirus (HPV)-related stigma and (2) to examine the relationship between HPV-related stigma in predicting HPV vaccine decision-making among college males. Participants: Six hundred and eighty college males aged 18–26 from 3 Canadian universities were recruited from September 2013 to April 2014. Methods: Participants completed a self-report survey assessing HPV-related stigma, psychosocial predictors of HPV-related stigma, and HPV vaccine decision-making. The results were analyzed using variance analyses and linear regressions. Results: Ethnicity, province of residence, and perceived severity of HPV were found to significantly influence HPV-related stigma. In addition, HPV-related stigma was higher in those unaware of the availability of the HPV vaccine for males. Conclusions: Promotion efforts should concentrate on Asian minorities and should avoid HPV severity messaging, as these may lead to higher HPV-related stigma, which in turn may act as a barrier to vaccination.     

“Consent is sexy”: A poster campaign using sex-positive images and messages to increase dyadic sexual communication

Abstract

Objective: “Consent is Sexy” (CIS) is a poster campaign incorporating sex-positive messages to promote consent and increase sexual communication among college students. We assess reactions to the campaign and associations between campaign recall and communication attitudes and behaviors. Participants: Male and female undergraduates at a Midwestern university were recruited (N?=?284). Methods: A cross-sectional survey was conducted. t-Tests, logistic and multiple linear regressions were used to analyze the data. Results: Over half (56%) of participants recalled the campaign and reactions were positive. Students who recalled CIS had more positive attitudes towards sexual communication (p?=?.04) and greater perceived behavioral control (PBC; p?<?.01). Conclusions: Results show many students paid attention and reacted positively to CIS posters and results offer dissemination insights. Consent campaigns should continue to cultivate positive attitudes and PBC in regards to sexual communication.     

Electronic cigarette and combustible cigarette use following a campus-wide ban: Prevalence of use and harm perceptions

Abstract

The current study examined changes in prevalence of e-cigarette use and perceptions of the harmfulness of e-cigarette and combustible cigarettes following a campus-wide tobacco ban. Undergraduate students completed surveys of tobacco use and perceived product harmfulness. Four samples were collected: in 2013 prior to the ban (n?=?792) and in fall 2014 (n?=?310), 2015 (n?=?208), and 2016 (n?=?417). E-cigarette use increased in the years following the ban (p?=?.01) while combustible cigarette use decreased from 2013 to 2016 (p?=?.02). Men were more likely than women to use both products (ps?<?.05). Students’ perceptions of the harmfulness of combustible and electronic cigarettes remained stable in the years following the ban (p?>?.05). This study is the first to examine the impact of including e-cigarettes in tobacco free policies. Combustible cigarette use declined, but e-cigarette use increased in the years following the e-cigarette ban. Prospective research is needed to understand the long-term impacts of e-cigarette bans.     

Evaluation of targeted human papillomavirus vaccination education among undergraduate college students

Abstract

Objective: To design and evaluate pharmacy student-led educational sessions to improve health beliefs about the HPV vaccine in college-aged students. Participants: Students aged 18–26 attending a large, urban university, including 545 respondents to a December 2014 needs assessment survey about HPV-related health beliefs, 131 students participating in educational sessions during 2015–2016 (intervention group), and 369 undergraduate respondents completing the needs assessment survey (control group). Methods: A needs assessment survey was conducted to inform design and implementation of pharmacy student-led educational sessions. A similar survey was administered to students after attending educational sessions. Health beliefs were compared for the intervention versus control group. Results: The intervention group was less likely to report high perceived barriers to HPV vaccination and more likely to report high perceived benefits and intention to vaccinate (if previously unvaccinated). Conclusions: Pharmacy student-led, health belief-based educational sessions were associated with improved health beliefs about HPV vaccination.     

The Lifestyling Program

Abstract

Objective: To assess knowledge of human papillomavirus (HPV) and perceived barriers to being vaccinated against the virus. Participants: Three hundred ninety-six undergraduate women enrolled at Penn State University in Fall 2008. Methods: A random sample of students were invited to participate in a Web-based survey. Results: Awareness of HPV and the vaccine was high, but knowledge of HPV-related facts averaged only 65% overall. Knowledge was significantly predicted by frequency of media exposure and physician encouragement to be vaccinated, but not by the number of sex partners nor the frequency of condom/dental dam use. On average, women indicated that 2 of the 10 barriers listed applied to them. Physician encouragement negatively predicted barriers at p = .066. No other predictors approached significance. Conclusions: Serious misconceptions remain about specific aspects of the diseases and how they are acquired. Health education efforts are needed to improve knowledge in college populations and counteract perceived barriers.     

HPV vaccine acceptance among a sample of Southern men who have sex with men: A comparison of younger and older men

Objectives: Do short, online educational messages about the human papillomavirus (HPV) influence younger and older men who have sex with men (MSM) differently? Second, what are the HPV knowledge levels and risk perceptions of Southern MSM living outside of major metropolitan areas? Methods: This study draws on participants who completed an anonymous online survey asking about their knowledge, risk assessment, and vaccine acceptance regarding HPV. Results: Knowledge about HPV was low among the MSM in this study. After reading a one-page information intervention, vaccine acceptability increased by a statistically significant amount among both a Younger and Older cohort but risk perception only increased among the younger respondents. Single men regardless of age cohort reported sharper increases in perceived risk after the intervention, but relationship status did not produce significant differences in vaccine acceptability. Conclusion: Online, brief interventions may be effective means of increasing motivation to vaccinate among Southern MSM.     

Visceral adiposity index is associated with benign prostatic enlargement in non-diabetic patients: a cross-sectional study

Objective: To evaluate the association between visceral adiposity index (VAI) - a novel indicator for the assessment of visceral adipose tissue and prostate enlargement in non diabetic patients.

Material and methods: Four hundred patients who were admitted to the Urology clinic between January and December 2014 with complaints of BPH(benign prostatic hyperplasia )/LUTS(male lower urinary tract symptoms)were enrolled in this cross-sectional study. Patients were divided into two groups according to their prostate volume and international prostate symptom score (IPSS) value. They were compared in terms of age, body mass index (BMI), VAI, prostate volume, PSA, post micturional residual volume (PMRV), uroflowmetry Q max value, triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and fasting blood sugar (FBS).

Results: Although univariate analyses reveal that age, BMI, waist circumference (WC), FBS, TG, HDL-C level and TG/HDL ratio were correlated with prostate volume, only age [1.125 OR (1.088–1.164), p?=?.00001], BMI [1.119 OR (1.040–1.204), p?=?.003], TG [1.043 OR (1.016–1.071), p?=?.002], HDL-C [0.923 OR (0.860–0.990), p?=?.025] and VAI [1.194 OR (1.110–1.305), p?=?.011] were statistically significant in multivariate analysis. A positive correlation was found between VAI value and prostate volume in the Spearman correlation test (r?=?0.29, p?=?.00001). The calculated area under the curve (AUC) for prostate volumes of 30, 40 and 50?ml were 0.680 (0.621–0.738), 0.625 (0.570–0.681) and 0.590 (0.528–0.652), respectively.

Conclusion: Our study revealed a positive correlation between VAI and prostate volume. Our results are needed to be tested with well-designed randomized prospective cohort studies.     

The Effects of a Web-Based Intervention on College Students' Knowledge of Human Papillomavirus and Attitudes toward Vaccination

ABSTRACT

Research suggests that college students know relatively little about human papillomavirus (HPV), and that educational interventions increase knowledge of HPV. However, to date, there are no published studies testing the effects of computer-based education on attitudes toward being vaccinated in this population. The present study of 119 college students explored the effect of a web-based intervention on participants' knowledge of HPV and attitudes toward HPV vaccination. Participants were randomized to a web-based, self-administered HPV educational intervention or to a control group. Knowledge and attitudes were assessed at baseline, after the completion of the intervention, and at one-month follow-up. At baseline, women knew more than men about risks and symptoms of HPV. At immediate and long-term follow-up, the intervention group had better knowledge of HPV and more positive attitudes toward HPV vaccination than the control group. There were some gender differences in response to the intervention; increases in knowledge of HPV were greater in men, while changes in attitudes toward vaccination were larger in women.     

Predicting Human Papillomavirus Vaccine Intentions of College-Aged Males: An Examination of Parents’ and Son's Perceptions

Abstract

Objective: To examine male students’ and their parents’ human papillomavirus (HPV) vaccine communication in relation to males’ willingness to discuss the vaccine with their health care provider and the likelihood of being vaccinated. Participants: Dyads (n = 111) of students and parents. Methods: Participants completed a HPV vaccine survey based on the risk perception attitude framework in 2009. Results: Male students’ perceived susceptibility for HPV and self-efficacy to talk to their provider were directly related to their intention to discuss the HPV vaccine, and their intention was directly related to their likelihood of being vaccinated. Parents’ perceived self-efficacy to talk to their son and response efficacy of the vaccine were directly related to their intention to talk to their son; however, parents’ intention was not related to the likelihood of their son being vaccinated. Conclusions: College males may benefit from HPV vaccine educational programs that include communication skills training to discuss the HPV vaccine with their parents.     

Eating disorders and academic performance among college students

Abstract

Objective: There is a paucity of research exploring eating disorders (EDs) and academic performance (AP). This study aimed to understand the effect of ED treatment on AP, hypothesizing that students receiving treatment for EDs would have a higher GPA. Participants: The Spring 2010 – Spring 2011 National College Health Assessment data (N?=?231,586) was utilized. Methods: Ordinal logistic regressions, controlling for key confounders, analyzed the association between those diagnosed with anorexia or bulimia and GPA. Results: Students diagnosed with anorexia or bulimia and treated with medication and psychotherapy were respectively 1.49 (1.24, 1.80; p?<?.0001) or 1.35 (1.13, 1.61; p?=?.0009) times more likely to have a higher GPA (p?<?.0001) compared to students without EDs. Conclusion: Findings expand the literature on EDs and AP among college students. Additional research is needed to determine whether the combination of medication and psychotherapy is the most effective way to improve AP among students with EDs.