University of Utah College of Nursing, Salt Lake City, UT, 84112, USA.
Jonas Center for Nursing and Veterans Healthcare, New York, NY, 10021, USA.
J Community Health. 2017 Oct;42(5):911-920. doi: 10.1007/s10900-017-0334-7.
Rural and highly religious Intermountain West states demonstrate low levels of HPV vaccination uptake. The Intermountain West HPV Vaccination Coalition (IWHVC) was formed to improve HPV vaccination by enhancing collaborations between cancer centers, health departments, health clinics, religious groups, and community organizations. Coalition members' perceptions and experiences are described within.
A cross-sectional online survey was distributed to the IWHVC. N = 86 responded to the online survey. Six subsequent focus groups were conducted (N = 36). Participant demographics, barriers, and facilitators of HPV vaccination were summarized. The first three focus groups were coded in an iterative manner based on a coding scheme. The final three focus groups were selectively coded for content related to five themes: barriers and facilitators to HPV vaccination, how the coalition has been useful, future directions of the coalition, and how to engage religious communities.
Participants suggested that HPV vaccination should occur in a doctor's office (70.9%), public health clinic (64.0%), or at a community health fair (58.1%). Perceived barriers included a lack of education/low knowledge about the HPV vaccine (55.8%), concerns about sexuality/promiscuity (44.2%), and not knowing the vaccine is recommended for boys (38.4%). Participants stressed the importance of gaining buy-in from religious leaders, and felt the coalition helped them advocate for HPV vaccination through networking, idea and information sharing, and voicing their community's needs. Future goals emphasized targeted outreach, sustainable funding, expanded environmental scans, gaining religious support, and policy reforms.
Targeted coalition work builds community capacity and coordinates HPV vaccination efforts. A community driven coalition approach could help improve HPV vaccination in other rural and highly religious regions.
农村和宗教氛围浓厚的美国山间西部各州的 HPV 疫苗接种率较低。为了提高 HPV 疫苗接种率，山间西部 HPV 疫苗接种联盟（IWHVC）成立，通过加强癌症中心、卫生部门、卫生诊所、宗教团体和社区组织之间的合作来实现这一目标。本文描述了联盟成员的看法和经验。
采用横断面在线调查的方式对 IWHVC 进行调查。共有 86 名参与者在线回答了问卷。随后进行了 6 次焦点小组讨论（N=36）。总结了 HPV 疫苗接种的参与者人口统计学特征、障碍和促进因素。前 3 次焦点小组按照编码方案进行迭代编码。最后 3 次焦点小组则根据 5 个主题选择性地进行编码：HPV 疫苗接种的障碍和促进因素、联盟的作用、联盟的未来方向以及如何让宗教团体参与进来。
参与者认为 HPV 疫苗接种可以在医生办公室（70.9%）、公共卫生诊所（64.0%）或社区健康博览会上（58.1%）进行。据报道，HPV 疫苗接种的主要障碍包括缺乏有关 HPV 疫苗的教育/知识（55.8%）、对性行为/滥交的担忧（44.2%）和不知道该疫苗也推荐给男孩接种（38.4%）。参与者强调了获得宗教领袖支持的重要性，并认为联盟通过网络联系、思想和信息共享以及表达社区需求，帮助他们倡导 HPV 疫苗接种。未来的目标强调了针对性的外联、可持续的资金、扩大环境扫描、获得宗教支持和政策改革。
有针对性的联盟工作可以建立社区能力，并协调 HPV 疫苗接种工作。以社区为驱动的联盟方法可能有助于提高其他农村和宗教氛围浓厚地区的 HPV 疫苗接种率。
