Ellen M. Daley

An Observational Study of How Young People Search for Online Sexual Health Information

Abstract Little is known about the quality of online sexual health information, how young people access the Internet to answer their sexual health questions, or an individuals ability to sort through myriad sources for accurate information. Objective: The purpose of this study was to determine how college students search for online sexual health information and whether they retrieve accurate answers to sexual health questions. Participants: In fall 2007, the authors recruited 34 first-year, first-semester undergraduates to participate in an observational research study, using Camtasia Studio. Results: Most students found accurate answers to the 12 sexual health questions posed. Finding local information and resources online proved more difficult than finding answers to general sexual health questions. Conclusions: The Internet has become the leading source for sexual health information. Based on their findings, the authors argue that young people must be educated about how Web search engine results are prioritized/displayed and trained to evaluate Web sites for reliable information.

Conducting web-based survey research: a lesson in internet designs.

OBJECTIVES To examine the tacit knowledge resulting from designing a complex Web site to facilitate administration of an Internet-based survey. METHODS Formative methods guided studying the feasibility of conducting an online survey using versions of the Keirsey Temperament Sorter II and the National College Health Risk Behavior Survey. RESULTS Web-site design software and pilot testing were critical to success. Incorporating the target audience as consumers in both Web site development and formative evaluation simplified data collection and analysis. CONCLUSIONS Online instrumentation used in survey research is both practical and desirable. Future refinements are necessary, but improved designs can emanate from this particular effort.

Women's Reactions to HPV Diagnosis: Insights from In-Depth Interviews

ABSTRACT Research links certain types of the human papillomavirus (HPV) to subsequent development of cervical cancer. Women (n = 52) recently diagnosed with HPV following an abnormal Pap smear participated in in-depth interviews to explore their knowledge of HPV, their emotional responses to diagnosis, and the extent of their disclosure of their HPV diagnosis to others. Women had many knowledge deficits about HPV. Emotions related primarily to stigma, fear, self-blame, powerlessness, and anger. Most women disclosed their disease to significant others, usually to a sexual partner. Womens lack of accurate knowledge may contribute to the array of emotions they experience. Whereas education about HPV may reduce the potency of these emotions, information alone may be inadequate for achieving optimal patient care. Health care providers can be important in treating the emotional elements associated with diagnosis as well as the condition itself.

Influences on Human Papillomavirus Vaccination Status Among Female College Students

OBJECTIVE In 2006, the Food and Drug Administration (FDA) approved the human papillomavirus (HPV) vaccine Gardasil® (Merck) for girls and women aged 9-26 years. Although the vaccine is ideally administered to 11 and 12 year olds, college-aged women may be uniquely at risk for HPV due to high rates of sexual activity and, thus, serve as an important catch-up population for the HPV vaccine. The purpose of this study is to examine factors associated with HPV vaccination status among college women. METHODS In fall 2008, a convenience sample of 256 undergraduate women enrolled in an introductory social science course at a large, public, urban university in the southeastern United States was surveyed. The 30-item paper-and-pencil questionnaire asked for demographic information, HPV knowledge, HPV vaccine beliefs, and HPV vaccination status. The overall survey response rate was 89.6%. RESULTS Most women were unmarried/single (91.7%), with a mean age of 18.9 years (range 17-42). Race/ethnicity status included 73.0% white, 17.5% Hispanic, and 7.7% black/African American. One hundred eleven (40.5%) women reported receiving the vaccine. Nonvaccinated women were less likely to have heard of the vaccine through a healthcare provider (odds ratio [OR] 0.12, 95% confidence interval [CI] 0.04-0.35) or from a family member (OR 0.33, 95% CI 0.16-0.68) and more likely to consider a healthcare provider recommendation as being only somewhat important (OR 2.91, 95% CI 1.32-6.41) or not important at all (OR 5.61, 95% CI 0.44-71.87) vs. very important. CONCLUSIONS Findings suggest that healthcare providers have an important role in encouraging HPV vaccination. Continuing education for providers who see preadolescent girls in conjunction with a parent or who treat women of college age may be a worthwhile endeavor.

The Psychosocial Burden of HPV A Mixed-method Study of Knowledge, Attitudes and Behaviors among HPV+ Women

Despite an increased awareness and ‘normalization’ of Human Papillomavirus (HPV) following the release of the HPV vaccine, the psychosocial impact of an HPV infection, the most common sexually transmissible infection (STI), must not be overshadowed. This study employed in-depth interviews (N = 52) and quantitative surveys (N = 154) to assess the knowledge, emotional impact and behavioral consequences of an HPV-related diagnosis in women who had received abnormal Pap test results. Findings revealed confusion over test results and themes related to stigma, fear, self-blame, powerlessness and anger emerged. The promotion of the HPV vaccine should not obfuscate the psychosocial burden associated with an HPV diagnosis.

Quality and Accuracy of Sexual Health Information Web Sites Visited by Young People

We assessed online sexual health information quality and accuracy and the utility of web site quality indicators. In reviewing 177 sexual health web sites, we found below average quality but few inaccuracies. Web sites with the most technically complex information and/or controversial topics contained the most inaccuracies. We found no association between inaccurate information and web site quality.

Health beliefs and attitudes associated with HPV vaccine intention among young gay and bisexual men in the southeastern United States

Gay and bisexual men are at increased risk of anal cancer as a result of human papillomavirus (HPV) infection. Prophylactic vaccination is a potentially effective strategy for preventing anal cancer in this population. The purpose of this study was to identify factors associated with gay and bisexual mens intention to receive HPV vaccine. In the fall of 2010, 179 self-identified gay and bisexual men (mean age 22 years) completed an Internet-based questionnaire assessing beliefs and attitudes toward HPV vaccination. Men were recruited from college-based and Internet venues throughout the southeastern United States. The probability of intent to receive HPV vaccine was modeled using logistic regression. A majority of men (93%) had heard of HPV prior to participation but were generally unaware of the association of HPV with anal, penile, and oral cancers. Only 26% were aware of an HPV vaccine for males. Of the 179 participants, 64 (36%) were likely to be vaccinated. Men most likely to receive HPV vaccine perceived stronger physical and psychological benefits from vaccination and had more positive attitudes toward the vaccine. Conversely, intent to be vaccinated was negatively associated with concern over the financial cost of vaccination. Findings from this study can inform college-based health education programs aimed at increasing vaccine uptake among gay and bisexual men.

Intimate partner violence and contraception use among women in Sub-Saharan Africa

To determine the association between contraceptive use and intimate partner violence (IPV) in Sub‐Saharan African women.

HPV knowledge among HPV+ women.

OBJECTIVE To assess knowledge and information seeking among women recently receiving an HPV+ diagnosis. METHODS A 2-phase mixed methods design was used. In both phase I (qualitative) and phase II (quantitative), women with scheduled gynecological exams and Pap smears at clinic sites were approached to participate. RESULTS Women expressed confusion about HPV, and most could not correctly articulate the meaning of their diagnosis. Women do engage in further information seeking, especially through the Internet. CONCLUSION Identifying gaps in knowledge among HPV+ women who need clear messages to facilitate their comprehension of the diagnosis is an important public health activity.

State-Mandated School-Based BMI Screening and Parent Notification A Descriptive Case Study

To address childhood obesity, several states and local school districts across the United States have adopted body mass index (BMI) measurement initiatives. This descriptive case study explored psychosocial, environmental, and behavioral factors among parents of sixth-grade students who received BMI Health Letters (BMIHLs) in one Florida County. A nonexperimental postintervention design was employed to gather quantitative data via self-report Likert-type questionnaire. Participants were parents/guardians of sixth-grade students attending one Hillsborough County public middle school (n = 76). Results indicate three main findings: (a) most parents in this study (67.4%) who discussed the BMIHL with their child reported their child as “very” or “somewhat” uncomfortable with the discussion; (b) some parents of normal weight (NW) children responded by taking their child to a medical professional to control their weight; and (c) more parents of at risk of overweight/overweight (AR/OW) children (vs. NW) reported greater concern about their child’s weight, using food restriction and physical activity to control their child’s weight, and giving negative weight-related comments/behaviors. This case study illustrates the importance of adapting and tailoring state mandated BMIHLs for parents based on child’s BMI status.