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Browsing by Author "Latkin, Carl A."
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Item Associations of trust and healthcare provider advice with HPV vaccine acceptance among African American parents(Elsevier, 2017-02-01) Fu, Linda Y.; Zimet, Gregory D.; Latkin, Carl A.; Joseph, Jill G.; Pediatrics, School of MedicineOBJECTIVE: Healthcare providers (HCPs) are advised to give all parents a strong recommendation for HPV vaccination. However, it is possible that strong recommendations could be less effective at promoting vaccination among African Americans who on average have greater mistrust in the healthcare system. This study examines the associations of parental trust in HCPs and strength of HCP vaccination recommendation on HPV vaccine acceptance among African American parents. METHODS: Participants were recruited from an urban, academic medical center between July 2012 and July 2014. We surveyed 400 African American parents of children ages 10-12years who were offered HPV vaccine by their HCPs to assess sociodemographic factors, vaccine beliefs, trust in HCPs, and the HPV vaccine recommendation received. Medical records were reviewed to determine vaccination receipt. RESULTS: In multivariable analysis, children whose parents were "very strongly" recommended the HPV vaccine had over four times higher odds of vaccine receipt compared with those whose parents were "not very strongly" recommended the vaccine. Having a parent with "a lot of" versus "none" or only "some" trust in HCPs was associated with over twice the odds of receiving HPV vaccine. Very strong HCP recommendations were associated with higher odds of vaccination among all subgroups, including those with more negative baseline attitudes toward HPV vaccine and those with lower levels of trust. Adding the variables strength of HCP recommendation and parental trust in HCPs to a multivariable model already adjusted for sociodemographic factors and parental vaccine beliefs improved the pseudo R2 from 0.52 to 0.55. CONCLUSIONS: Among participants, receiving a strong vaccine recommendation and having a higher level of trust in HCPs were associated with higher odds of HPV vaccination, but did not add much to the predictive value of a model that already adjusted for baseline personal beliefs and sociodemographic factors.Item Social Networks for Human Papillomavirus Vaccine Advice Among African American Parents(Elsevier, 2019-04-05) Fu, Linda Y.; Zimet, Gregory D.; Latkin, Carl A.; Joseph, Jill G.; Pediatrics, School of MedicinePurpose Despite that human papillomavirus (HPV) vaccination could prevent ~90% of HPV-associated cancers, only 60.6% of American adolescents initiate vaccination. African Americans have the highest prevalence of morbidity and mortality from HPV-associated cancers. Mounting evidence suggests that advice from social contacts is associated with vaccine acceptance. The current study examines the associations of social processes with HPV vaccine refusal among African American parents. Methods A cross sectional survey was conducted among African American parents of children ages 10–12 years prior to a healthcare visit at which HPV vaccine was offered by the healthcare provider. Data from the 353 parents who named at least one social contact who advised them about vaccines were included in these analyses. Results Only 54.4% of the participants consented to HPV vaccination for their children. On average, parents had 2 to 3 social contacts who provided vaccine advice. Vaccine advice networks were generally dense, family-centric, and homophilous. Slightly over 80% of all parents trusted family members and friends for vaccine advice “some or “a lot.” Controlling for sociodemographic characteristics and reason for the healthcare visit, perceived high exposure to anti-HPV vaccine viewpoints and low exposure to pro-HPV vaccine viewpoints were both associated with HPV vaccine refusal (AOR=1.5, 95% CI=1.01, 2.3, and AOR=1.7, 95% CI=1.2, 2.6, respectively). Conclusions Social processes may be associated with HPV vaccine refusal among African American parents. Interventions designed to educate African American parents about HPV vaccine to increase uptake should consider leveraging vaccine advice networks for greater impact.