Browsing by Author "Donahue, Kelly"

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    The association between maternal human papillomavirus (HPV) experiences and HPV vaccination of their children
    (Taylor & Francis, 2021-04-03) Biederman, Erika; Donahue, Kelly; Sturm, Lynne; Champion, Victoria; Zimet, Gregory; School of Nursing
    HPV vaccination prevents most HPV-related cancers yet vaccination rates remain low. In this cross-sectional study, we examined the association between maternal HPV experiences and HPV vaccination uptake among children and whether this association may be explained by perceived benefits of vaccination. We used logistic regression models to estimate the effect of (1) maternal history of abnormal Pap smear, (2), family/friend history of cervical cancer, and (3) maternal history of cervical cancer on HPV vaccination uptake among children. Separate mediation analyses were conducted to determine if perceived benefits mediated the relationship between each maternal HPV experience and HPV vaccination uptake. History of abnormal Pap smear (OR = 1.50, 95% CI = 1.15, 1.97), family history of cervical cancer (OR = 1.72, CI = 1.26, 2.35), and personal history of cervical cancer (OR = 3.00, CI = 1.82, 4.95) predicted HPV vaccination of children. Perceived benefits mediated the relationship between history of abnormal Pap smear (indirect effect =.146, SE =.069, 95% CI =.014, .289), family history of cervical cancer (indirect effect =.228, SE =.079, CI =.080, .387), and personal history of cervical cancer (indirect effect =.298, SE =.116, CI =.082, .533) on HPV vaccination. Our results suggest that personal experiences with HPV-related disease may influence maternal HPV vaccine decision-making.
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    Familial Factors, Victimization, and Psychological Health Among Sexual Minority Adolescents in Sweden
    (American Public Health Association, 2017-02) Donahue, Kelly; Långström, Niklas; Lundström, Sebastian; Lichtenstein, Paul; Forsman, Mats; Pediatrics, School of Medicine
    OBJECTIVES: To determine the influences of victimization experience and familial factors on the association between sexual minority status and psychological health outcomes among adolescents. METHODS: We used data from the Child and Adolescent Twin Study in Sweden, a prospective, population-based study of all twins born in Sweden since 1992. Cross-sectional analyses included individuals who completed assessments at age 18 years (n = 4898) from 2000 to 2013. We also compared psychological health among sexual minority adolescents and their nonminority co-twins. RESULTS: Sexual minority adolescents were more likely than were unrelated nonminority adolescents to report victimization experiences, including emotional abuse, physical abuse or neglect, and sexual abuse. Sexual minority adolescents also reported significantly more symptoms of anxiety, depression, attention-deficit/hyperactivity disorder, disordered eating, and substance misuse in addition to increased parent-reported behavior problems. Victimization experience partially mediated these associations. However, when controlling for unmeasured familial confounding factors by comparing sexual minority adolescents to their same-sex, nonminority co-twins, the effect of sexual minority status on psychological health was almost entirely attenuated. CONCLUSIONS: Familial factors-common genetic or environmental influences-may explain decreased psychological adjustment among sexual minority adolescents.
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    IUPUI Center for HPV Research: Effects of a Brief Health Messaging Intervention on HPV Vaccine Acceptability among Parents of Adolescent Sons
    (Office of the Vice Chancellor for Research, 2014-04-11) Donahue, Kelly; Stupiansky, Nathan; Cox, Anthony; Cox, Dena; Zimet, Gregory
    Background: Human papillomavirus (HPV) is an very common infection that is a primary cause of warts and many cancers, including cervical, anal, vaginal, vulvar, penile, and head and neck cancers. In an effort to address the problems associated with HPV infection and prevention, the Center for HPV Research at IUPUI (Zimet & Fortenberry, Co-Directors) fosters collaboration among investigators from multiple disciplines and departments at IUPUI, IU Bloomington, Purdue University, and University of Notre Dame. There currently are 25 faculty and 7 pre- and post-doctoral trainees who are members of the Center. The Center for HPV Research was established in July, 2012 with funds from the IUPUI Signature Center Initiative, The Department of Pediatrics, and the IU Simon Cancer Center. In this abstract we highlight a study representing a collaboration among 5 center members, including our current center-supported post-doc. Objectives: HPV vaccination coverage remains very low among adolescent males in the U.S. We explored the effect of brief Web-based health messages on parents’ willingness to vaccinate their sons against HPV. Methods: A U.S. national sample of parents of 11-17-year-old sons (N=779) completed a Web-based survey assessing attitudes and behaviors related to HPV vaccination. Parents of non-vaccinated sons (79% of the sample) were randomized to a two-level normalizing message (NM) condition: no message vs. NM (“Millions of doses of the vaccine have been administered to adolescent girls in the US at this time.”) and a three-level protection message (PM) condition: no message vs. son-only PM (“The HPV vaccine can protect your son from most kinds of genital warts and anal cancers,”) vs. son+partner PM (son-only message plus “If your son gets vaccinated it can also protect his future spouse from genital warts and cancer.”). Parents then reported willingness to vaccinate their sons against HPV on a scale of 1-100. Intervention effects were analyzed using a 2×3 between-subjects ANOVA. Results: Mean willingness was 55.2 (SD=29.7). A significant interaction was found between health messaging conditions, F(2,576) = 3.17, p = 0.043). Parents receiving the son-only PM reported significantly lower willingness if they received the NM vs. no NM (p=.014). Parents receiving no NM reported significantly higher willingness if they received the son + partner PM vs. no PM (p=.029). Conclusions: Reading brief online health messages affected parents’ willingness to vaccinate their adolescent sons against HPV. Overall, presenting normalizing information pertaining to adolescent females (for whom routine immunization was first recommended) appeared to lower parent willingness to vaccinate their adolescent sons. Presenting information about protecting their son and/or son’s partner against HPV-associated outcomes appeared to increase parent willingness to vaccinate in the absence of such normalizing information.
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    Pediatrician-Parent Conversations about Human Papillomavirus Vaccination: An Analysis of Audio-Recordings
    (Elsevier, 2017-08) Sturm, Lynne; Donahue, Kelly; Kasting, Monica; Kulkarni, Amit; Brewer, Noel T.; Zimet, Gregory D.; Pediatrics, School of Medicine
    Purpose We sought to establish which human papillomavirus (HPV) vaccine communication approaches by pediatricians were associated with same-day HPV vaccination of 11- to 12-year-olds by evaluating audio recordings of visits. Methods Verilogue, a market research company maintaining a panel of primary care pediatricians, provided audio recordings and transcriptions of well-child visits for 11- to 12-year-old patients from January through June 2013. Seventy-five transcripts from 19 pediatricians were coded for use of presumptive language (i.e., words conveying assumption of vaccine delivery), offer of delay, recommendation strength, and information provision. Using logistic regression, we evaluated the association between pediatrician communication approaches and agreement to same-day HPV vaccination. Generalized estimating equations accounted for clustering of patients within pediatricians. Results Same-day agreement to HPV vaccination occurred in 29% of encounters. Pediatricians in the sample often provided parents with inconsistent, mixed messages and sometimes offered information about HPV or HPV vaccination that was inaccurate. Pediatricians used presumptive language in only 11 of 75 encounters; when used, presumptive language was associated with higher odds of accepting HPV vaccine (73% vs. 22%; odds ratio = 8.96; 95% confidence interval = 2.32–34.70). Pediatricians offered or recommended delay in most encounters (65%). HPV vaccine acceptance occurred far more often when pediatricians did not mention delaying vaccination (82% vs. 6%; odds ratio = 80.84; 95% confidence interval = 15.72–415.67). Same-day vaccination was not associated with strength of recommendation or pediatrician reference to vaccinating their own children. Conclusions Our findings highlight the need to develop and evaluate physician-focused trainings on using presumptive language for same-day HPV vaccination.
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    Provider Communication and Mothers’ Willingness to Vaccinate Against HPV and Influenza: A Randomized Health Messaging Trial
    (Elsevier, 2017) Donahue, Kelly; Hendrix, Kristin; Sturm, Lynne; Zimet, Gregory; Department of Pediatrics, School of Medicine
    Objective Understand the effect of a health messaging intervention focused on provider communication about vaccination on mothers’ willingness to vaccinate children against HPV and seasonal influenza. Methods 2,476 mothers of 9-13-year-olds in the U.S. completed a Web-based survey in August 2014. Mothers were randomized to one of two groups targeting HPV or influenza vaccine. Mothers whose child had not received the target vaccine (i.e., zero doses of HPV vaccine/no prior-year administration of influenza vaccine) were randomized to the intervention. The study used a 3x2 between-subjects design; illustrated vignettes depicted one of three levels of provider recommendation strength (brief mention of vaccination, strong recommendation of vaccination, or personal disclosure of vaccination of own children), and presence or absence of information comparing safety of vaccination to the safety of a common daily activity. Outcome was mothers’ willingness to have their child receive the target vaccine (0-100.) Perceived benefits of vaccination were assessed prior to viewing the intervention and included as a covariate in analyses, along with child gender. Results For HPV vaccine, there was a main effect of safety information, F(1,684)=7.99, p=.005, and perceived benefits of vaccination, F(1,684)=221.64, p<.001) on mothers’ willingness to vaccinate. For influenza, perceived benefits of vaccination significantly related to willingness, F(1,462)=105.78, p<.001). Child gender was not associated with willingness. Conclusions Provider communication about vaccination may need to be tailored to the vaccine in question. A next step to increasing coverage for both HPV and influenza vaccines may be an intervention aimed at increasing mothers’ perceived benefits of vaccination.
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    SUN-079 Baseline Body Satisfaction in Gender-Diverse Youth
    (Endocrine Society, 2020-05-08) Gohil, Anisha; Donahue, Kelly; Eugster, Erica A.; Medicine, School of Medicine
    Background: Body dissatisfaction often contributes to the distress experienced by transgender and nonbinary individuals. However, limited data exist regarding body image in the pediatric age range. Objective: To establish baseline ratings of body satisfaction among gender-diverse youth prior to puberty blocking medication. Methods: Subjects were recruited from the gender health clinic at Riley Hospital for Children beginning in January 2018. Eligible subjects met clinical criteria for a puberty blocker, were treatment naïve, and were anticipated to be on a blocker alone for ≥ 1 year. We assessed self-reported body satisfaction at baseline using the Body Image Scale-Gender Spectrum. Subjects rated various body parts on a scale of 1 (very satisfied) to 5 (very dissatisfied). For analysis, body parts were grouped into gendered features (primary sex, secondary sex, & neutral characteristics) and also body areas (appearance/hair/voice, head & neck, musculoskeletal, hips, chest, & genitals/gonads).1 Results: Twenty subjects (mean age 12.0, range 8.4-14.0) were enrolled of whom 13 were transmasculine (TM) and 7 were transfeminine (TF). TM subjects had a mean BMI percentile of 73.7% and height z-score of 0.50, with breast Tanner stage (TS) of II (n=2), III (n= 3), IV (n=3) and V (n=4). Estradiol levels ranged from <20-120 pg/mL and testosterone levels ranged from <10-38 ng/dL. TF subjects had a mean BMI percentile of 65.3% and height Z-score of 0.58, with testicular volumes of 5 cc (n=1), 6 cc (n=2), 9 cc (n=1), 10 cc (n=1) and 15 cc (n=1). Testosterone levels ranged from <10-215 ng/dL and estradiol levels ranged from <5-31 pg/mL. Among all subjects, mean satisfaction ratings for gendered features were 4.45 (primary sex characteristics), 3.21 (secondary sex characteristics), and 2.61 (neutral characteristics). Mean satisfaction ratings for body areas were 4.45 (genitals/gonads), 3.85 (chest), 3.23 (appearance/hair/voice), 3.03 (hips), 2.83 (musculoskeletal), and 2.55 (head & neck). The only significant between-group difference in satisfaction was for the chest region, with TM subjects reporting higher dissatisfaction (4.35 vs 2.93, p <0.004). Conclusion: The gender-diverse youth in our study reported high degrees of dissatisfaction with their genitals/gonads and, for TM subjects, their chest. In contrast, they reported generally neutral feelings toward many of their other body parts. To the best of our knowledge this is the youngest cohort of gender-diverse youth in whom body satisfaction has been explored. Further studies of the effects of endocrine treatment on body image in gender-diverse youth are warranted, specifically as they relate to other measures of well-being.