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Original Investigation |

Efficacy of a Human Papillomavirus Vaccination Educational Platform in a Diverse Urban Population

Jacqueline E. Weinstein, MD1; Ashwin Ananth, MD, MBA1; Jacob P. Brunner, MD1; Ryan E. Nelson, MD2; Marjorie E. Bateman, BS1; John M. Carter, MD1; Joseph F. Buell, MD, MBA3; Paul L. Friedlander, MD1
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana
2Department of Internal Medicine, Tulane University School of Medicine, New Orleans, Louisiana
3Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
JAMA Otolaryngol Head Neck Surg. 2016;142(6):590-595. doi:10.1001/jamaoto.2016.0433.
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Importance  Human papillomavirus (HPV) is a preventable disease that plays a causative role in a significant proportion of malignant neoplasms of the head and neck. Inner-city populations are at risk for HPV-related oropharyngeal cancer, are least likely to receive HPV vaccination, and report a lack of information regarding HPV.

Objective  To determine whether an educational platform affects knowledge, attitudes, and practices regarding HPV vaccination in an inner-city community.

Design, Setting, and Participants  This prospective cohort study, conducted from March 1 to December 31, 2014, surveyed 128 participants at multiple inner-city community centers regarding their knowledge of, attitudes toward, and practices regarding HPV vaccination before and after a brief educational presentation. No eligible individuals refused to participate in the educational session. Surveys were excluded from analysis if they were incomplete.

Interventions  Participants completed two 20-question surveys separated by a 15-minute educational session on HPV-related disease, including a short PowerPoint presentation.

Main Outcomes and Measures  Presence of statistically significant differences in survey scores before and after the educational session.

Results  Eighty-six participants met eligibility criteria (61 male [70.9%]; 68 with a high school education [79.1%]). Baseline knowledge of HPV, its causal association with cancer, and the existence of a vaccine against HPV were poor: of a total composite score of 20, the mean knowledge score before the educational session was 9.69. Participants’ self-rated knowledge regarding HPV disease and vaccination improved significantly as a result of the educational session; the absolute increase in mean knowledge composite score from before the educational session to after the session was 3.52 (17.6%) (95% CI, –2.87 to 9.92; P < .01). Attitudes regarding government involvement in vaccination did not change as a result of the educational session (composite attitudes score before the educational session, 16.57 of 28; score after the session, 15.22; P = .98). Participants’ intent to vaccinate their children increased significantly following the educational presentation: before the presentation, 34 respondents (40%) intended to have their children vaccinated; after the presentation, 60 (70%) intended to do so (P = .002).

Conclusions and Relevance  Lack of knowledge regarding HPV vaccination and unwillingness to undergo vaccination contribute to low rates of HPV vaccination within urban populations. Community-based educational sessions successfully teach the link between HPV and various cancers, provide information regarding the risks and benefits of vaccination, and increase participants’ willingness to vaccinate their children against HPV. Attitudes regarding government involvement in health programs are resistant to change.

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