Harrington Nicole, Chen Yuku, O'Reilly Alana M, Fang Carolyn Y
Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
Cancer Prevention & Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
AIMS Public Health. 2021 Apr 6;8(2):352-368. doi: 10.3934/publichealth.2021027. eCollection 2021.
Despite the clinically proven benefits of the human papillomavirus (HPV) vaccine in preventing cervical and other HPV-associated cancers, vaccination coverage has been suboptimal among adolescents and young adults in the United States (US), particularly among racial and ethnic minority adolescents. Historical legacies, combined with current racial/ethnic disparities in healthcare, may contribute to suboptimal uptake and completion of the HPV vaccine in part through differing levels of trust in doctors and healthcare institutions. The purpose of this narrative review was to characterize trust and its role in decision making about HPV vaccine uptake among US racial and ethnic minorities. We conducted a literature search using the PubMed database, and our search terms yielded 1176 articles. We reviewed 41 full-text articles for eligibility and included 20 articles in this review. These studies used varied measures of trust or mistrust and assessed trust in not only doctors/healthcare providers, but also other sources including pharmaceutical companies, media, and clergy. Our review findings revealed generally high levels of trust in doctors and healthcare providers, but less so in pharmaceutical companies. Mistrust of either healthcare providers, government agencies or pharmaceutical companies was consistently associated with less favorable attitudes and lower vaccine uptake. The downstream effects of mistrust may occur through selected health beliefs regarding the perceived efficacy and safety of the vaccine. Minority groups were more likely to report trust in family members, religious organizations, and media sources compared to their white counterparts. Decision making about vaccine uptake is a multilayered process that involves comparing the perceived benefits of the vaccine against its perceived risks. Understanding how trusted sources can effectively harness the tools of social and traditional media to increase knowledge and awareness may help combat misinformation about the HPV vaccine and improve engagement with diverse communities.
尽管人乳头瘤病毒（HPV）疫苗在预防宫颈癌和其他HPV相关癌症方面已得到临床验证，但在美国青少年和年轻成年人中，疫苗接种覆盖率一直不理想，尤其是在少数族裔青少年中。历史遗留问题，再加上当前医疗保健领域的种族/族裔差异，可能部分导致HPV疫苗接种率和完成率不理想，原因包括对医生和医疗机构的信任程度不同。本叙述性综述的目的是描述信任及其在美国少数族裔HPV疫苗接种决策中的作用。我们使用PubMed数据库进行了文献检索，检索词共产生1176篇文章。我们审查了41篇全文文章的合格性，本综述纳入了20篇文章。这些研究使用了不同的信任或不信任衡量方法，不仅评估了对医生/医疗服务提供者的信任，还评估了对制药公司、媒体和神职人员等其他来源的信任。我们的综述结果显示，人们对医生和医疗服务提供者的信任度普遍较高，但对制药公司的信任度较低。对医疗服务提供者、政府机构或制药公司的不信任一直与不太积极的态度和较低的疫苗接种率相关。不信任的下游影响可能通过对疫苗的感知效力和安全性的特定健康信念而产生。与白人相比，少数族裔群体更有可能报告对家庭成员、宗教组织和媒体来源的信任。疫苗接种决策是一个多层次的过程，涉及比较疫苗的感知益处与其感知风险。了解受信任的来源如何有效地利用社会和传统媒体工具来增加知识和提高认识，可能有助于对抗关于HPV疫苗的错误信息，并改善与不同社区的互动。
