a Department of Social and Behavioral Sciences , Harvard T. H. Chan School of Public Health, Harvard University , Boston , USA.
b College of Education , Lehigh University , Bethlehem , USA.
Ethn Health. 2019 Apr;24(3):323-340. doi: 10.1080/13557858.2017.1332758. Epub 2017 May 29.
Much of the research on African-Americans' HPV vaccine acceptance has largely focused on racial/ethnic differences related to cognitive, socio-economical, and structural factors that contribute to differences in HPV vaccine acceptance and completion. A growing body of literature suggest that cultural factors, such as mistrust of healthcare providers (HCPs) and the healthcare system, religion, and social norms related to appropriate sexual behaviors, also plays a prominent role in their HPV vaccine acceptance. However, these studies were limited in their use of theoretical approaches necessary to conceptualize and operationalize culture.
To explore the influence of culture on African-American mothers' and daughters' HPV vaccine acceptance using the PEN-3, a culturally-centered conceptual framework.
Grounded theory techniques were used to explore cultural factors that influenced the acceptance of the HPV vaccine among African-American mothers (n = 28) and their daughters (n = 34).
Positive attitudes towards vaccination stemmed from beliefs that the HPV vaccine has cancer prevention benefits and that vaccinations in general protected against infectious diseases. Negative attitudes stemmed from beliefs that the HPV vaccine was too new, not effective, daughters were too young, and that vaccines were not a one-size-fits-all intervention. Majority of mothers and daughters indicated that their religious doctrine did not impede their HPV vaccination decisions. For a few mothers, religious beliefs could not be separated from their HPV vaccination decisions and ultimately deterred HPV vaccine acceptance. HCP recommendations were valued however mothers were often dissatisfied with the detail of information communicated. Support networks provided both positive and negative types of social support to mothers and daughters. The media highlighted the cancer prevention benefits of the HPV vaccine and unintentionally communicated negative information of the HPV vaccine, which deterred HPV vaccine acceptance.
Study findings can inform the development of culturally appropriate interventions that advances the evidence on cervical cancer prevention.
大多数关于非裔美国人 HPV 疫苗接种接受度的研究主要集中在与认知、社会经济和结构因素相关的种族/民族差异上，这些因素导致 HPV 疫苗接种接受度和完成度存在差异。越来越多的文献表明，文化因素，如对医疗保健提供者（HCP）和医疗保健系统的不信任、宗教信仰以及与适当性行为相关的社会规范，也在其 HPV 疫苗接种接受度方面发挥着重要作用。然而，这些研究在使用必要的理论方法来概念化和操作化文化方面存在局限性。
使用 PEN-3（一种以文化为中心的概念框架）探讨文化对非裔美国母亲及其女儿 HPV 疫苗接种接受度的影响。
采用扎根理论技术探讨了影响非裔美国母亲（n=28）及其女儿（n=34）接受 HPV 疫苗的文化因素。
对疫苗接种的积极态度源于相信 HPV 疫苗具有癌症预防益处，以及一般疫苗可预防传染病的信念。消极态度源于 HPV 疫苗太新、效果不佳、女儿太年轻以及疫苗并非一刀切的干预措施等信念。大多数母亲和女儿表示，他们的宗教教义不妨碍他们的 HPV 疫苗接种决定。对于少数母亲来说，宗教信仰无法与 HPV 疫苗接种决定分开，最终阻碍了 HPV 疫苗的接种。医疗保健提供者的建议很有价值，但母亲通常对传达的信息细节不满意。支持网络为母亲和女儿提供了积极和消极的社会支持。媒体强调了 HPV 疫苗的癌症预防益处，但无意中传达了 HPV 疫苗的负面信息，从而阻碍了 HPV 疫苗的接种。
研究结果可以为制定文化上适当的干预措施提供信息，从而推进宫颈癌预防方面的证据。
