Introductions: Cervical cancer has been the second most frequent cancer among females worldwide. Over 85% of women’s deaths from the disease are living in developing countries in 2008. Human papillomavirus (HPV) vaccination may provide a feasible strategy for cervical cancer prevention so as to reduce the disease burden. However the uptake of HPV vaccination is low. To promote HPV vaccination, the design of message frame, may be important. However, little research has been conducted to provide a clear interpretation of the effectiveness of health message frame on uptake of HPV vaccination. Objectives: To evaluate the effects of gain- and loss-framing message on HPV vaccination acceptability and explore the factors that might influence the acceptability of HPV vaccination. Methods: Literature search on the studies investigating gain- and loss-framed message on HPV vaccination. PubMed and Google Scholar during 2006 to 2013. Results: Ten articles, seven from U.S.A, two from Canada, and one from Ireland, were included in the systematic review. The effectiveness between message framing and the context of HPV vaccination were different by studies; the different effect of message framing may be due to in the studies population. Age, sex, culture and individuals’ risk perceiving level might have influence on the effect of gain- and loss-message framing. Four of five articles, which targeted at young population, showed that loss-farmed message is more effective to increase individual’s positive attitude and response to HPV vaccination. Participants with a greater number of sexual partner with higher avoidance-oriented attitudes, or are less likely to use protection; loss-framed message is more effective. In turn, when young people, particularly female with a lower number of sexual partner, with approach-oriented attitudes, or are more likely to use protection, both gain-and loss-framed message have no effect on their intention to vaccinate. However, another five articles in this review targeted at parents with young children found inconsistent results of framing effects on HPV vaccine acceptability. Discussion: The effect of gain- or loss-framed tends to be different, depending on types of health behavior promoted. Loss- and gain-framed messages might have different effect to different audience. Framing message selection is matching on individuals’ motivational orientation may help in prompting HPV vaccine acceptability. However, there is a lack of studies on the association between message framing effects and HPV vaccine acceptability, especially for Chinese population. Further investigations of message framing effects on acceptance of HPV vaccination in Chines population are necessary. / published_or_final_version / Medicine / Master / Master of Public Health

Objective: Toanalyze the clinical efficacy of quadrivalent human papillomavirus vaccine (QHPV)in preventing human papillomavirus (HPV) related diseases in males and to evaluate the potential epidemiological impact of the vaccine in males. Methods: All published studies were searched using specified keywords via EMBASE, PubMed, Cochrane Library and ClinicalTrials.gov to review systematically the efficacy of QHPV in males. Studies that modeled the impact of QHPV in males were also searched using specified keywords from PubMed, EMBASE and Cochrane Library to evaluate the vaccine impact on males. Results: A total of 5 studies were selected for the systematic review of QHPV efficacy in males. Observed efficacy of QHPV in preventing genital warts(GW)due to HPV types 6 and 11 in males is found to be statistically significant. Efficacies of QHPV in preventing anal intraepithelial neoplasia (AIN), HPV-related cancers in males are yet to be confirmed. A total of 9 studies were selected for the review of modeled impact of QHPV vaccination in males. QHPV vaccination in girls is predicted to reduce the incidence of HPV infections and GW in males. Inclusion of males in the vaccination program could only produce limited additional benefit if vaccination coverage of girls is high. Discussion: Analysis and implications of clinical efficacy of QHPV in males are discussed. The approved indications of QHPV vaccine in various countries were not fully substantiated by clinical evidence. Factors affecting the epidemiological impact of QHPV in males were also discussed. Questionable efficacy of QHPV in males casts doubt on the vaccine’s impact. Conclusion: Clinical efficacy of QHPV in males is basically unclear, except against GW. Impact of the vaccine in males is greatly limited by its efficacy. More research should be conducted in order to obtain a clearer picture on the efficacy and impact of QHPV in males. / published_or_final_version / Public Health / Master / Master of Public Health

Human papillomavirus (HPV) has a high prevalence among the population, and brings an enormous health impact and burden to the public. Vaccines have been developed in recent years, and their efficacy has been noted in many studies. Although there is much theoretical research conducted worldwide on the indirect protective effect of HPV vaccines to the unvaccinated population, convincing evidence on real world settings is still to be found. This systematic review recruits studies from two databases, PubMed and MEDLINE ovidSP and is intended to examine herd protection on community levels. 5 studies are included and the conclusion suggests that the herd protection is most significant among the sexually active young population, whereas it doesn’t seem to benefit people of older age. Therefore, follow up studies in the future are still needed to evaluate the herd immunity among the old age groups. / published_or_final_version / Public Health / Master / Master of Public Health

Introduction: Influenza is one of the commonest infectious diseases among human beings. The annual attack rates were 5-10% and 20-30% in adult and children respectively around the world. Fortunately, this is a vaccine preventable disease. Vaccinating health care workers can reduce risk of infection among themselves so as to maintain the availability of health care services. This can also prevent nosocomial infections and associated morbidity and mortality of their patients. The World Health Organization recommended 60% influenza vaccination coverage by 2006 in high risk groups and targeted 75% by 2010. However, the vaccine uptake rate among health care workers is still low globally. The vaccination coverage is in Western Europe 20-40%, in Hong Kong 30%, in Australia 16-60% and in the United States 63.5%. This systematic review aims at identifying the factors influencing influenza vaccine uptake among health care workers which can help formulation of future vaccination strategies so as to protect health care workers themselves and their patients. Methods: Electronic databases (PubMed, MEDLINE and eKG) of journal articles published after January 2011 using title and keywords related to health care workers and influenza vaccination uptake were searched. Predefined inclusion and exclusion criteria were applied. Data were extracted and quality was assessed from the eligible studies using individualized data extraction form and quality assessment form by two reviewers. The reasons of vaccination acceptance and declination were divided into different categories. A score was given to each category according to the percentage of respondents stating that as an important influencing factor. The factor with higher score indicated the more important it is. The predictive factors positively associated with vaccination acceptance were retrieved from results of multivariate logistic regression models of the studies which had an odd ratio greater than one. The PRISMA statement is used to guide the methodology and reporting of the studies. Results: Nine eligible studies were finally identified. The studies reviewed found that the reasons behind low seasonal influenza vaccination uptake rate among health care workers are complex and made up by both perceptual and organizational factors. For factors of influenza vaccination acceptance, self protection, risk perception, and protection of patients were identified as the most important. For factors of influenza declination, concern of vaccine side effects, lack of concern, and doubts of vaccine safety and efficacy showed the greatest influence. Convenient vaccination location and time was suggested to be the strongest predictive factor which positively associated with future vaccination uptake. Conclusion: As influenza vaccination is an effective measure to prevent infection among health care workers and nosocomial infection of their patients, annual seasonal influenza vaccination program is essential in health care settings. In order to promote annual seasonal influenza vaccination among health care worker, multipronged approach is recommended. Targeted educational intervention can be used to overcome the perceptual barriers on misconception about influenza and influenza vaccines. The organizational barriers can be fixed by introducing mobile vaccination team which provide services in flexible period of time around the workplace. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (M.S.)--University of Wisconsin. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.P.H.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 52-57).

Thesis (M.P.H.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 60-69).

Thesis (M.S.)--University of Wisconsin--Madison, 1964. / eContent provider-neutral record in process. Description based on print version record. Bibliography: l. 47-52.

Thesis--University of Wisconsin--Madison. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 90-96).

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