Browsing by Author "Wilson, Shannon"

Now showing 1 - 4 of 4
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    Differences in cervical cancer screening knowledge, practices, and beliefs: An examination of survey responses
    (Elsevier, 2016-12-21) Kasting, Monica L.; Wilson, Shannon; Zollinger, Terrell W.; Dixon, Brian E.; Stupiansky, Nathan W.; Zimet, Gregory D.; Department of Epidemiology, Richard M. Fairbanks School of Public Health
    Among the identified barriers to HPV vaccination is the concern that women may compensate for their reduced susceptibility to cervical cancers by reducing cervical cancer screening. This exploratory study examined the relationship between cervical cancer screening rates and HPV vaccination. We conducted a cross-sectional survey using a convenience sample of women aged 21-35 attending a local minority health fair in July 2015. Data were analyzed in 2015-2016. Outcomes assessed were: receiving a Pap test within the last three years, awareness and comfort with current Pap test recommendations, and knowledge regarding the purpose of a Pap test. A total of 291 women were included in the analyses. Mean age was 28.5 years and 62% were non-Hispanic black. 84% had received a Pap test in the last three years and 33% had received at least one HPV vaccine. Logistic regression results showed that women who had been vaccinated did not have lower odds of having a Pap test in the past three years (OR = 1.32; 95% CI = 0.66-2.65). In an adjusted regression model controlling for age and race, vaccinated women were significantly more likely to have had a Pap test (AOR = 3.06; 95% CI = 1.37-6.83). Yet only 26% of women knew the purpose of a Pap test and the proportion who answered correctly was higher among non-Hispanic white women. Women who have been vaccinated for HPV are more likely to have been screened for cervical cancer. These results suggest areas for more robust studies examining pro-health attitudes, behaviors, and communication regarding vaccination and preventive screening.
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    Health care providers’ perceptions of use and influence of clinical decision support reminders: qualitative study following a randomized trial to improve HPV vaccination rates
    (BMC, 2017-08-10) Dixon, Brian E.; Kasting, Monica L.; Wilson, Shannon; Kulkarni, Amit; Zimet, Gregory D.; Downs, Stephen M.; Epidemiology, School of Public Health
    Background Human Papillomavirus (HPV) leads to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. Furthermore, providers recommend the HPV vaccine less than half the time for eligible patients. Prior informatics research has demonstrated the effectiveness of computer-based clinical decision support (CDS) in changing provider behavior, especially in the area of preventative services. Methods Following a randomized clinical trial to test the effect of a CDS intervention on HPV vaccination rates, we conducted semi-structured interviews with health care providers to understand whether they noticed the CDS reminders and why providers did or did not respond to the prompts. Eighteen providers, a mix of medical doctors and nurse practitioners, were interviewed from five publicly-funded, urban health clinics. Interview data were qualitatively analyzed by two independent researchers using inductive content analysis. Results While most providers recalled seeing the CDS reminders, few of them perceived the intervention as effective in changing their behavior. Providers stated many reasons for why they did not perceive a change in their behavior, yet the results of the trial showed HPV vaccination rates increased as a result of the intervention. Conclusions CDS reminders may be effective at changing provider behavior even if providers perceive them to be of little use. Trial registration ClinicalTrials.gov Identifier: NCT02551887 , Registered on September 15, 2015 Electronic supplementary material The online version of this article (doi:10.1186/s12911-017-0521-6) contains supplementary material, which is available to authorized users.
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    Healthcare providers’ beliefs and attitudes regarding risk compensation following HPV vaccination
    (Elsevier, 2016-05-28) Kasting, Monica L.; Wilson, Shannon; Dixon, Brian E.; Downs, Stephen M.; Kulkarni, Amit; Zimet, Gregory D.; Epidemiology, School of Public Health
    Background Provider recommendation is a significant predictor of HPV vaccine uptake. Prior research suggests that concerns regarding risk compensation could cause some providers to hesitate recommending the HPV vaccine. Methods During 15–30 min semi-structured interviews in early 2015, 22 U.S. pediatric providers were asked about their beliefs regarding sexual risk compensation and cervical cancer screening following HPV vaccination. Providers were asked if these beliefs result in reservations recommending the vaccine. Interviews were audio-recorded, transcribed, and analyzed using inductive content analysis. Results None of the providers believed the HPV vaccine would result in risky sexual behavior. Half indicated it was better to start vaccination early, before sexual activity was a worry. Others noted that patients’ risky behavior decisions happen independently of vaccination. When providers were asked if they were concerned about decreased cervical cancer screening, half said they did not know and some stated they had never thought about it before. The main themes addressed were the significant time lapse between vaccination and screening and that women tend to get over-screened as opposed to under-screened. Conclusion Providers were generally in favor of HPV vaccination and do not perceive risk compensation as a barrier to HPV recommendation.
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    A qualitative study of healthcare provider awareness and informational needs regarding the nine-valent HPV vaccine
    (Elsevier, 2016-03) Kasting, Monica L.; Wilson, Shannon; Dixon, Brian E.; Downs, Stephen M.; Kulkarni, Amit; Zimet, Gregory D.; Department of Epidemiology, Richard M. Fairbanks School of Public Health
    The 9-valent Human Papillomavirus (HPV) vaccine, 9vHPV, was licensed in the U.S. in December, 2014. We assessed healthcare provider (HCP) awareness of the newly approved vaccine and identified questions HCPs have about the vaccine. As part of a larger study, we used semi-structured interviews to ask 22 pediatric HCPs about their awareness of 9vHPV, questions they have about the vaccine, and questions they anticipate from patients and parents. Interviews were audio-recorded and transcribed then analyzed using inductive content analysis. Over half were aware of the vaccine but few HCPs claimed to be familiar with it. HCPs indicated several questions with common themes pertaining to efficacy, side effects, and cost. Only half of HCPs believed patients or parents would have questions. The results suggest strategies and areas for health systems and public health organizations to target in order to resolve unmet educational needs among HCPs regarding 9vHPV.