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评估城市服务不足地区污名、社会影响与宫颈癌预防之间的相互关系:一项探索性研究。

Assessing the interrelationship between stigma, social influence, and cervical cancer prevention in an urban underserved setting: An exploratory study.

机构信息

Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America.

College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America.

出版信息

PLoS One. 2022 Dec 1;17(12):e0278538. doi: 10.1371/journal.pone.0278538. eCollection 2022.

Abstract

In the US, incidence and mortality from cervical cancer disproportionately affects racial/ethnic minorities and low-income women. Despite affordable access to primary and secondary prevention measures at Federally Qualified Health Centers (FQHCs), Human Papillomavirus (HPV) vaccination and screening rates are low, suggesting the presence of non-financial barriers to uptake in this population. This explanatory sequential mixed-methods study sought to explore factors that influence the acceptability of cervical cancer prevention services among parents and legal guardians of vaccine-eligible girls attending an urban FQHC and to assess social influences related to cervical cancer prevention. Participants included eight mothers, one father, and two grandparents/legal guardians. Nine participants self-identified as Black/Afro-Caribbean, or African American, two as Latinx, and one as Native American. The quantitative data suggested discordance between participants' cervical cancer prevention knowledge and their practices. Most indicated that their daughters had received the HPV vaccine but were unsure about HPV transmission modes. Qualitative data revealed that participants were comfortable disclosing information on HPV infection and vaccination status, and most women were likely to share information related to cervical cancer testing and diagnosis. Few comments indicated personal stigma on the part of participants, but there was frequent expression of perceived public stigma (shaming and blaming women), gender differences (men are indifferent to risk), and distrust of the healthcare system. Findings highlight several concepts including the disharmony between knowledge and practice, prevalent perceived public stigma, cumbersome attitudes on the part of men regarding HPV and cervical cancer, and distrust of the healthcare system.

摘要

在美国,宫颈癌的发病率和死亡率不成比例地影响着少数族裔和低收入妇女。尽管在合格的联邦卫生中心(FQHCs)可以获得负担得起的初级和二级预防措施,但 HPV 疫苗接种和筛查率仍然很低,这表明该人群中存在非财务障碍因素,导致接受度不高。本解释性顺序混合方法研究旨在探讨影响城市 FQHC 中符合疫苗接种条件的女孩的父母和法定监护人对宫颈癌预防服务的可接受性的因素,并评估与宫颈癌预防相关的社会影响。参与者包括八名母亲、一名父亲和两名祖父母/法定监护人。九名参与者自我认定为黑人/非裔加勒比或非裔美国人,两名拉丁裔,一名美国原住民。定量数据表明,参与者的宫颈癌预防知识与其做法之间存在不一致。大多数人表示他们的女儿已经接种了 HPV 疫苗,但不确定 HPV 的传播模式。定性数据显示,参与者愿意透露 HPV 感染和疫苗接种状况的信息,大多数女性可能会分享与宫颈癌检测和诊断相关的信息。很少有评论表明参与者个人有耻辱感,但经常表达了对公众耻辱感的看法(指责女性)、性别差异(男性对风险漠不关心)和对医疗保健系统的不信任。研究结果强调了几个概念,包括知识和实践之间的不和谐、普遍存在的公众耻辱感、男性对 HPV 和宫颈癌的态度繁琐、以及对医疗保健系统的不信任。

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