University of South Carolina Arnold School of Public Health, Department of Health Promotion, Education, Behavior, Rural and Minority Health Research Center, 915 Greene Street, Columbia, SC 29208, United States.
National Cancer Institute, Division of Cancer Control and Population Sciences, Health Communication and Informatics Research Branch, 9609 Medical Center Drive, 3E610, Rockville, MD 20850, United States.
Prev Med. 2021 Apr;145:106407. doi: 10.1016/j.ypmed.2020.106407. Epub 2021 Jan 1.
Uptake of human papillomavirus (HPV) vaccine in the United States (U.S.) is far below the Healthy People 2020 goal of 80% coverage among adolescents. In rural communities, HPV vaccination coverage is low, yet incidence and mortality rates of HPV-associated cancer are high. Much of the research focused on HPV vaccination in rural U.S. communities has involved qualitative investigations, observations, survey research, and secondary data analysis with limited implementation of interventional study designs. The purpose of this narrative review was to examine intervention studies to increase HPV vaccination in rural settings and to summarize study characteristics and associated outcomes. PubMed, PsycINFO, CINAHL, and Web of Science were searched utilizing systematic narrative review methodology for studies describing implementation of HPV vaccination interventions in rural U.S. settings from January 2006-December 2019. Using specific search criteria, 991 studies were identified. After abstract review, 30 full-text articles were assessed for eligibility, and 15 met the inclusion criteria. The 15 articles - published from 2011 to 2019 - described HPV vaccination interventions in rural settings of six states, including communities, health clinics, and schools. A range of primary and secondary outcomes were reported, including HPV vaccine receipt (series initiation, continuation, and/or completion); HPV vaccine knowledge; and/or cervical cancer knowledge. Across the studies, there was an absence of the description of rural context. As compared to the broader HPV vaccination intervention literature, interventions in rural settings were limited. More interventional research is needed in rural communities given the elevated rates of HPV-related cancer and low rates of HPV vaccine uptake.
美国（U.S.）的人乳头瘤病毒（HPV）疫苗接种率远低于 2020 年健康人目标的 80%。在农村社区，HPV 疫苗接种率较低，但 HPV 相关癌症的发病率和死亡率却很高。大多数关于美国农村社区 HPV 疫苗接种的研究都涉及定性调查、观察、调查研究和二次数据分析，很少有干预性研究设计的实施。本叙述性综述的目的是研究增加农村地区 HPV 疫苗接种的干预研究，并总结研究特征和相关结果。利用系统叙述性综述方法，在 PubMed、PsycINFO、CINAHL 和 Web of Science 上搜索了 2006 年 1 月至 2019 年 12 月期间在美国农村地区描述 HPV 疫苗接种干预的研究，研究描述了美国农村地区的 HPV 疫苗接种干预。使用特定的搜索标准，确定了 991 项研究。经过摘要审查，有 30 篇全文文章符合纳入标准，其中 15 篇符合纳入标准。这 15 篇文章——发表于 2011 年至 2019 年——描述了六个州农村地区的 HPV 疫苗接种干预措施，包括社区、诊所和学校。报告了一系列主要和次要结果，包括 HPV 疫苗接种（系列启动、继续和/或完成）；HPV 疫苗知识；和/或宫颈癌知识。在这些研究中，缺乏对农村背景的描述。与更广泛的 HPV 疫苗接种干预文献相比，农村地区的干预措施有限。鉴于 HPV 相关癌症的发病率较高和 HPV 疫苗接种率较低，农村社区需要更多的干预研究。
