Knowledge, Attitudes and Barriers to Human Papillomavirus (HPV) Vaccine Uptake Among an Immigrant and Refugee Catch-Up Group in a Western Canadian Province

  • Erin McComb
  • Vivian Ramsden
  • Olufemi Olatunbosun
  • Hazel Williams-Roberts
Original Paper

Abstract

Vaccination is a key strategy to prevent cervical cancer in developed countries. Lower uptake of human papillomavirus (HPV) vaccine among new immigrants and refugees has been documented, although exploration of underlying reasons remains an understudied area. Semi-structured interviews with eleven immigrant women (ages 18–26 years) were conducted to understand their knowledge, attitudes and barriers regarding HPV vaccination in a western Canadian province. Participants had limited knowledge about HPV and the vaccine. Most women perceived that their risk of HPV was low, however expressed willingness to receive the vaccine if it were recommended by their physician. Greater efforts are needed to increase knowledge about HPV among immigrant and refugee women and support for physicians to discuss and offer vaccination to this underserved population.

Keywords

Human papillomavirus (HPV) Vaccine Immigrants Refugees Canada 

References

  1. 1.
    Campari C, Fedato C, Iossa A, Petrelli A, Zorzi M, Anghinoni E. GISCI Migrant Working Group, et al. Cervical cancer screening in immigrant women in Italy: a survey on participation, cytology and histology results. Eur J Cancer Prev. 2016; 25(4):321–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Pottie K, Nolen A, Topp P, Torres S, Welch V, Durand N. Evidence-based clinical guidelines for immigrants and refugees. Appendix 19: Cervical Cancer: evidence review for newly arriving immigrants and refugees. CMAJ. 2011;183(12):E824–925.CrossRefPubMedGoogle Scholar
  3. 3.
    Hamlish T, Clarke L, Alexander KA. Barriers to HPV immunization for African American adolescent females. Vaccine. 2012;30(45):6472–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Javanbakht M, Stahlman S, Walker S, Gottlieb S, Liddon N, Plant A, Guerry S. Provider perceptions of barriers and facilitators of HPV vaccination in a high-risk community. Vaccine. 2012;30(30):4511–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Crawford J, Ahmad F, Beaton D, Bierman AS. Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study. Health Soc Care Community. 2016;24(2):123–53.CrossRefPubMedGoogle Scholar
  6. 6.
    McDonald J. Kennedy S. Cervical cancer screening by immigrant and minority women in Canada. J Immigr Minor Health. 2007;9(4):323–34.CrossRefPubMedGoogle Scholar
  7. 7.
    Abboud S, De Penning E, Brawner BM, Menon U, Glanz K, Sommers MS. Cervical cancer screening among Arab women in the United States: an integrative review. Oncol Nurs Forum. 2017;44(1):E20–E33.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Bamack-Taylaris JL, Garcini LM, Macera CA, Brodine S, Klonoff EA. Human Papillomavirus vaccination awareness and acceptability among US-born and US foreign-born women living in California. Health Care Women Int. 2016;37(4):444–62.CrossRefGoogle Scholar
  9. 9.
    Pomfret T, Gagnon J, Gilchrist A. Quadrivalent human papillomavirus (HPV) vaccine: a review of safety, efficacy, and pharmacoeconomics. J Clin Pharm Ther. 2011;36(1):1–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Government of Saskatchewan. Saskatchewan Immunization Manual. 2016. https://www.ehealthsask.ca/services/manuals/Documents/sim-chapter10.pdf.
  11. 11.
    Glanz K. Health behavior and health education: theory, research and practice. San Francisco: Jossey-Bass; 2008.Google Scholar
  12. 12.
    Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRefGoogle Scholar
  13. 13.
    Donadiki EM, Jimenez-Garcia R, Hernandez-Barrera V. Health belief model applied to non-compliance with HPV vaccine among female university students. Public Health. 2014;128(3):268–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Chu H. The use of the health belief model to understand HPV vaccine behavior in female undergraduates [Master’s of Science thesis]. Eastern Michigan University; 2015.Google Scholar
  15. 15.
    Yacobi E, Tennat C, Ferrante J, Pai N, Roetzheim R. University student’s knowledge and awareness of HPV. Prev Med. 1999;28(6):535–41.CrossRefPubMedGoogle Scholar
  16. 16.
    Giede C, McFadden LL, Komonoski P, Agrawal A, Stauffer A, Pierson R. The acceptability of HPV vaccination among women attending the Unversity of Saskatchewan Student Health Services. J Obstet Gynaecol Can. 2010;32(7):679–86.CrossRefPubMedGoogle Scholar
  17. 17.
    Bendik M, Mayo RM, Parker VG. Knowledge, perceptions and motivations related to HPV vaccination among college women. J Can Educ 2011;26(3):459–64.CrossRefGoogle Scholar
  18. 18.
    Brewer NT, Fazekas KI. Predictors of HPV vaccine acceptability: a theory informed, systematic review. Prev Med 2007;45(2):107–14.CrossRefPubMedGoogle Scholar
  19. 19.
    Chan Z, Chan T, Ng K, Wong M. A systematic review of literature about women’s knowledge and attitudes toward Human Papillomavirs (HPV) vaccination. Public Health Nurs. 2012;29(6):481–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Wilson R, Brown DR, Boothe MA, Harris CE. Knowledge and acceptability of the HPV vaccine among ethnically diverse black women. J Immigr Minor Health. 2013;15(4):747–57.CrossRefPubMedGoogle Scholar
  21. 21.
    Beckett M. The borders that remain: prevention of cervical cancer in refugee and immigrant women in Canada. UOJM. 2016;6(2):61–6.CrossRefGoogle Scholar
  22. 22.
    Dailey PM. Communication, Somali culture and decision making about adult HPV vaccine [Master of Arts thesis]. Ohio State Univeristy; 2013.Google Scholar
  23. 23.
    Salad J, Verdonk P, de Boer F, Adma TA. A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary? A qualitative study into the perceptions of Somali women in the Netherlands about prevention of cervical cancer. Int J Equity Health. 2015;14:68.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Marlow LA, Wardle J, Forster AS, Waller J. Ethnic differences in human papillomavirus awareness and acceptability. J Epidemiol Community Health. 2009;68:1010–3.CrossRefGoogle Scholar
  25. 25.
    Bastani R, Glenn BA, Tsui J, Chang C, Marchand E, Taylor VM, Singhai R. Understanding suboptimal HPV vaccine uptake among ethnic minority girls. Cancer Epidemiol Biomarkers Prev. 2011;20(7):1463–72.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Sadry SA, De Souza LR, Yudin MH. The impact of ethnicity on awareness and knowledge of and attitudes towards the human papillomavirus and vacine among adult women. J Obstet Gynaecol Can. 2013;35(11):995–1003.CrossRefPubMedGoogle Scholar
  27. 27.
    Rosenthal SL, Weiss TW, Zimet GD, Ma L, Good MB, Vichin MD. Predictors of HPV vaccine uptake among women aged 19–26: importance of a physician’s recommendation. Vaccine. 2011;29(5):890–95.CrossRefPubMedGoogle Scholar
  28. 28.
    Hendry M, Lewis R, Clements A, Damery S, Wilkinson C. ‘HPV’ Never heard of it: a systematic review of girls and parents information needs, views and preferences about human papillomavirus vaccination. Vaccine. 2013;31(45):5152–67.CrossRefPubMedGoogle Scholar
  29. 29.
    Joseph N, Clark J, Bauchner H, Walsh J, Mercilus G, Bibbo C, Perkins R. Knowledge, attitudes and beliefs regarding HPV vaccination: ethnic and cultural difference between African-American and Haitian immigrant women. Womens Health Issues. 2012;22(6):571–9.CrossRefGoogle Scholar
  30. 30.
    Grandahl M, Tyden T, Gottvall M, Westerling R, Oscarsson M. Immigrant women’s experiences and views on prevention of cervical cancer: a qualitative study. Health Expect. 2015;18(3):344–54.CrossRefPubMedGoogle Scholar
  31. 31.
    Kiely M, Sauvageau C, Dube E, Deceuninck G, De Wals P. Factors associated with HPV vaccine among adult women in Quebec. Hum Vaccin Immunother. 2013;9(7):1421–24.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics, Gynecology and Reproductive Sciences, College of MedicineUniversity of SaskatchewanSaskatoonCanada
  2. 2.Department of Academic Family MedicineUniversity of SaskatchewanSaskatoonCanada
  3. 3.Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of SaskatchewanSaskatoonCanada
  4. 4.Department of Community Health and EpidemiologyUniversity of SaskatchewanSaskatoonCanada

Personalised recommendations