Immigrant clinicians are vital to population healthcare delivery and therefore population health. One in four physicians in the USA is foreign-born and notably represented in family and pediatric medicine—specialties charged with administering childhood/adolescent vaccines, such as human papillomavirus vaccine (HPVV). Our examination suggests there may be unique cultural and socialization factors that influence clinician HPVV recommendation practice; however, immigrant clinicians have not been adequately engaged within the national HPVV agenda. Given the volume and significance of immigrant clinicians, engagement of these clinicians, in both community and nation-wide efforts to increase HPVV, is a necessary step for improving and achieving the national health goal of optimizing HPVV for cancer prevention.

Immigrant clinicians are vital to population healthcare delivery and therefore population health. One in four physicians in the United States are foreign-born and notably represented in family and pediatric medicine–specialties charged with administering childhood/adolescent vaccines, such as Human Papillomavirus vaccine (HPVV). Our examination suggests there may be unique cultural and socialization factors that influence clinician HPVV recommendation practice; however, immigrant clinicians have not been adequately engaged within the national HPVV agenda. Given the volume and significance of immigrant clinicians, engagement of these clinicians, in both community and nation-wide efforts to increase HPVV, is a necessary step for improving and achieving the national health goal of optimizing HPVV for cancer prevention.

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Objectives: Few studies examine the influence that different sources of medical information has on human papillomavirus (HPV)–related knowledge. We examined the relationship between the primary source of medical information and knowledge about HPV in young adults aged 18–26 years. Study design: This study used cross-sectional data from the Health Information National Trends Survey. Methods: Respondents (n = 404) self-reported their knowledge about HPV-related diseases and vaccinations and their sources of medical information. Sources of medical information included electronic/print media, family/friends, or a healthcare provider. Bivariate and multivariate analyses were used to examine the association between the source of information and HPV knowledge. Results: Fifty-six percent of respondents used electronic or print media as their primary source of medical information. A greater proportion of Hispanic (40.0%) and black (36.0%) respondents received medical information from their family/friends than white respondents (20.0%). Respondents who received medical information from family/friends had 4.34 (95% confidence interval [CI]: 2.14, 8.79), 4.06 (95% CI: 2.05, 8.04), and 2.35 (95% CI: 1.10, 5.04) times higher odds than those who received information from healthcare providers of not knowing that HPV causes cervical cancer, knowing HPV is a sexually transmitted infection, and hearing about the HPV vaccine, respectively. Conclusion: Source of medical information was significantly associated with knowledge of HPV. Receiving medical information from family/friends negatively influenced young adults' HPV knowledge. These findings may guide future interventions to target peer and familial influence on medical decisions.

Despite being safe and effective, human papillomavirus (HPV) vaccination rates are lower than other recommended adolescent vaccines. CDC recommends catch-up vaccination for all persons through age 26 years if not adequately vaccinated when younger making college campuses an important site for catch-up vaccination programs. The project is a quality improvement project being implemented on a public southeastern college campus. The campus health services clinic is the setting for the practice change. Aims: The overall purpose of the QI project is to enhance usage of current CDC HPV recommendations and increase campus population awareness of HPV. Processes: The project received a “Determination of Not Human Subjects Research” from the ETSU Human Research Protection Program. Staff in-service detailing the practice change for routine HPV vaccine status assessment and promotion of HPV vaccination, based on CDC HPV recommendations. Digital-based HPV education materials are being shared with both health services and the student wellness ambassador group. The ambassador group will share items with the campus community via social media and flyers. An optional, anonymous survey will be available when accessing the digital HPV content. De-identified chart audit data will be monitored to assess adoption of the practice change. Nonidentifiable digital access data will be used to assess usage of the educational materials. Results: The final results of the QI project will not be available. Preliminary descriptive statistics will be presented. Limitations: The vaccine isn’t available on campus and the electronic health record lacks directed HPV vaccine assessment on most visit forms. Conclusions: The preliminary conclusions and impact will be presented.

The human papilloma virus (HPV) is the most frequent cause of sexually transmitted diseases (STDs) and cancers for U.S. adults. The Affordable Care Act (ACA), enacted in 2010, eliminated copay expenses for childhood immunizations and expanded access to health care. The purpose of this secondary data analysis study was to determine if there was an association between ACA and the usage of HPV vaccine among adolescent females in Georgia. Data concerning HPV vaccinations from 2011 to 2015 were obtained from the National Immunization Survey-Teen dataset. Andersen's BM of health care use was applied to ascertain the factors that enhanced the usage of HPV vaccine. Multiple logistic regression analysis was used to determine if there was any association between ACA and HPV vaccination. The study results showed a significant association between ACA and provider visit (p<.05). Also, provider visit was significantly associated with HPV vaccination rate (p<.05). Adolescent females with health insurance had a higher rate of provider visit after the passage of ACA. From 2011 to 2015, 87.2% of insured adolescent females visited their provider. The rate of HPV vaccination increased among the insured adolescent females who visited the provider from 35.3% in 2011 to 53.9% in 2015. Provider visit was identified as the most influencing factor that enhanced usage of HPV vaccine. The knowledge gained from the results contributed to social change by providing insight on how, through increased provider visits, ACA has improved the HPV vaccination rate among teenage females in Georgia. The conclusion will assist in developing effective strategies and policies that will achieve the Healthy People 2020 goal of 80% of herd immunity against HPV.

This study examined the knowledge, sources of information, reasons for and against Gardasil® uptake, and possible relationships between unhealthy behaviors and vaccination for undergraduate college females at a public university. Utilizing an online survey, 2400 random students were emailed as well as recruited through online classes. The final sample size was 516 females. The study determined how many participants had been vaccinated and their rationale for or against vaccination. The majority of study participants were knowledgeable about HPV and Gardasil®. The primary sources of information about HPV and Gardasil® were doctors and television; however parents and friends were also common sources of information. Predictors for HPV inoculation included race, the belief that the vaccine would protect against HPV, alcohol use, and engagement in anal intercourse. Over 50% of participants had received at least one dose of Gardasil®, and 82% had completed the series. The most common rationale for not getting the vaccine, or not completing the vaccination series, was concern about side effects. The most common rationale for completing the vaccination or intending to complete the series was protection from cervical cancer. In conclusion, there is a continued need provide health education about HPV and HPV vaccination for college females.

Denna avhandling undersöker tre statligt finansierade kampanjer mot human papillomvirus (HPV) i Sverige. Författaren visar att kampanjerna innehåller och artikulerar olika former av omsorg som inte är begränsade till att endast uppmana människor att ”ta hand om sig själva” eller ”bry sig om andra”. Istället studeras omsorg som något mångfasetterat och kontextuellt, och som något som innefattar såväl mänskliga som icke-mänskliga komponenter. I studien fokuserar författaren på hur aktörer möjliggör och problematiserar olika former av omsorg. Dessa aktörer inkluderar yrkesverksamma inom landsting som försöker kommunicera omsorg till tjejer och deras anhöriga, men också olika materiella ting, såsom en ”HPV-app”, en Facebook-kampanjsida och en vaccinationshusvagn. Kampanjmedia, intervjuer och textbaserade cancerberättelser analyseras med hjälp av teoretiska perspektiv från fältet feministiska teknik- och vetenskapsstudier (STS). Studien är situerad till forskning kring omsorgspolitik inom teknik och vetenskap, och bidrar till diskussioner om tidsmässiga dimensioner av omsorg. I kampanjmaterialet som studeras dominerar ett fokus på omsorg som något som skall göras nu för att möjliggöra en hälsosam och lycklig framtid. Genom att använda sig av ett ”etiskt-politiskt” ställningstagande, och en analytisk ansats, där fokus ligger på att synliggöra marginella, frånvarande och alternativa omsorgsformer problematiserar författaren  sådana ”snabba” framtidsorienterade omsorgsvisioner enligt vilka omsorg ses som något som skall göras omedelbart i preventivt syfte. Detta görs genom ett synliggörande av ”långsammare” och sammanflätade ”omsorgstemporaliteter” som öppnar upp för osäkerheter, tveksamheter, obestämdheter samt för olika känslouttryck, och som möjliggör mer omsorgsfulla praktiker. / This dissertation examines three state-funded human papillomavirus (HPV) campaigns in Sweden. The author shows that they include and articulate a range of different forms of care that are not limited to just asking people to “take care of themselves” or “care for others”. Care is instead approached as a multilayered, contextual and contingent phenomenon, and as made by a heterogeneity of human and nonhuman components. The study shows how care is articulated by human actors such as county council professionals who try to communicate care to girls and their relatives, and by material devices like an “HPV app”, a Facebook campaign site and a vaccination trailer which enable, distribute and trouble different forms of care. Campaign devices and campaign media, interviews, and textual cancer narratives are analyzed using a feminist science and technology studies (STS) approach. The study is situated within feminist STS discussions on the politics of care in technoscience, and contributes to discussions on temporal dimensions of care. In the campaign material the study examines, there is a dominant focus on care as something that needs to be done now to enable a healthy and happy future. By working with an ethico-political and analytical standpoint that is focused on making present neglected, marginal, absent and alternative matters of care, the author disrupts and troubles such future-oriented visions of care as an “anticipatory immediacy” through a focus on other temporalities of care. These include slower, messier and folded temporalities which open up for uncertainties, hesitations, indeterminacies, a range of feelings, and for more caring articulations of what care is. / Prescriptive Prescriptions: Pharmaceuticals and "Healthy" Subjectivities

Cervical cancer rates among Vietnamese American women are the highest when compared to other women of color and white women. In an article by Taylor, Nguyen, and McPhee, a majority of Vietnamese Americans immigrated to the United States over the last three decades; and the President's Advisory Commission on Asian Americans identified cervical cancer among Vietnamese women as one of the most important health disparities experienced by the Asian American population. HPV vaccination, according to the CDC, helps prevent cervical cancer and it is recommended that female and male preteens, ages 11 or 12, receive the vaccination. My research aims to better understand what second generation Vietnamese American women know about the HPV vaccination, their relationship to healthcare, and their overall health. By interviewing second generation Vietnamese American women, I hope they become more empowered to ask their doctors about health disparities that affect their communities. In looking at preventative measures to cervical cancer and trying to better understand a vulnerable population's relationship to healthcare, I hope that the rates of cervical cancer will go down in Vietnamese American women. Furthermore, I hope to push for greater disaggregation of data collection among Asian American populations to better understand the health disparities that affect the various ethnicities that fall under the umbrella term, Asian American.

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