Julia Bodson

Geography and the Burden of Care in Pediatric Cancers

Childhood cancers typically require rigorous treatment at specialized centers in urban areas, which can create substantial challenges for families residing in remote communities. We evaluated the impact of residence and travel time on the burden of care for families of childhood cancer patients.

Diverse Families’ Experiences with HPV Vaccine Information Sources: A Community-Based Participatory Approach

Current sources of publicly available human papillomavirus (HPV) information may not adequately meet the needs of diverse families. This study sought to describe associations between sociodemographic and acculturation factors, and sources of HPV information among diverse parents and caregivers. Community organizations purposively recruited participants from African American, African refugee, Hispanic/Latino, American Indian, and Native Hawaiian and Pacific Islander communities for a 21-item survey (N = 228). Ninenty-three of these participants also participated in ten focus groups conducted in three languages. Descriptive statistics and Fishers’ Exact Test for Count Data were produced and triangulated with focus group data to provide additional context. Overall, HPV vaccine awareness and knowledge in the five communities was low. This study found that a greater proportion of lower-acculturated participants had heard of HPV through personal networks (foreign-born = 50 % vs US-born = 30 %, p < 0.05; medium acculturation = 60 % vs high acculturation = 26 %, p = 0.01), while greater proportions of US-born participants reported media sources (49 % vs foreign-born = 29 %, p < 0.05). Across communities, healthcare system sources were described as important and preferred sources of HPV information. Hearing about the HPV vaccine from healthcare settings was significantly associated with increased accuracy in HPV vaccine knowledge (p < 0.05). Communities described a need for more in-depth information about the HPV vaccine, and culturally and linguistically appropriate educational materials. Culturally-competent delivery of HPV information through the healthcare system sources may be important in improving knowledge and acceptability of the HPV vaccine among diverse families.

Moderate Awareness and Limited Knowledge Relating to Cervical Cancer, HPV, and the HPV Vaccine Among Hispanics/Latinos in Utah

Background. We investigate the demographic factors associated with human papillomavirus (HPV) vaccine–related awareness and knowledge in an emerging (rather than established) Hispanic/Latino population. Method. We surveyed 119 Spanish-speaking, mostly low-income and immigrant, Hispanic/Latino parents and guardians of adolescents 11 to 17 years old (i.e., eligible to receive the HPV vaccine) about their HPV vaccine–related awareness and knowledge. Data collection took place between August 2013 and October 2013 in Salt Lake City, Utah. Results. Participants had moderately high awareness scores, with more than half the participants reporting having heard of cervical cancer (84.5%), HPV (76.4%), and the HPV vaccine (67.3%). HPV vaccine–related knowledge was low, with fewer than half the participants reporting they knew that most people are infected with HPV (32.7%), that HPV is asymptomatic among women (16.4%), that the HPV vaccine requires more than one dose (33.6%), and that the HPV vaccine is recommended for adolescent girls (47.3%) and boys (35.5%). Combined awareness and knowledge was significantly associated with educational attainment (p = .02) and country of origin (p = .03). Conclusion. Results demonstrate moderate to high HPV vaccine–related awareness and limited HPV vaccine–related knowledge among Hispanic/Latino parents living in Utah. These findings will inform educational interventions to improve the HPV vaccine–related awareness and knowledge in this vulnerable population.

Latinas’ Colorectal Cancer Screening Knowledge, Barriers to Receipt, and Feasibility of Home-Based Fecal Immunochemical Testing

Latinas’ high colorectal cancer (CRC) mortality makes them a priority population for CRC screening. CRC screening knowledge, perceived barriers, and feasibility of using the Fecal Immunochemical Test (FIT) was assessed among Latinas in Utah. Participants aged ≥50 (n = 95) were surveyed about knowledge and barriers to CRC screening. 27 participants completed a FIT and evaluation survey. Fisher’s exact tests assessed sociodemographic correlates of CRC screening outcomes. Most participants were overdue for CRC screening (n = 81, 85%). Age, acculturation, education, and employment were significantly associated with CRC screening status and/or reasons for being overdue (e.g., not knowing about the test, cost). All participants who received a FIT completed it, felt it was easy to use, and reported they would use it again. Latinas had limited awareness of CRC, CRC screenings, and experienced barriers to CRC screening (e.g., limited access, cost), but were willing to utilize a low-cost home-based FIT.

Religion and HPV vaccine-related awareness, knowledge, and receipt among insured women aged 18-26 in Utah

Introduction We investigate the associations between religious practice and human papillomavirus (HPV) vaccine-related awareness, knowledge, and receipt among young women in Utah. Methods We surveyed 326 insured women aged 18–26 by mail. Fishers Exact Tests and multivariable logistic regression models were used to evaluate the relations between religious practice and HPV vaccine-related outcomes. Data collection occurred January-December 2013; analyses were conducted June-September 2015. Results Multivariable analyses reveal that when controlling for age, educational attainment, and marital status, participants who practiced an organized religion were significantly less likely to have heard of HPV (aOR = 0.25, p = 0.0123), to have heard of the HPV vaccine (aOR = 0.41, p = 0.0368), to know how HPV is spread (aOR = 0.45, p = 0.0074), to have received a provider recommendation for the HPV vaccine (aOR = 0.36, p = 0.0332), and to have received at least one (aOR = 0.50, p = 0.0073) or all three (aOR = 0.47, p = 0.0026) doses of the HPV vaccine. Bivariate analyses produce parallel results. Conclusions Results indicate that religious young women in Utah are not only under-vaccinated, but are also under-informed about HPV and the HPV vaccine. These results suggest that suboptimal vaccine coverage among religious young women may present a serious health risk for the community. Strategies for educational interventions targeted to this population are discussed.

Sub-Regional Assessment of HPV Vaccination Among Female Adolescents in the Intermountain West and Implications for Intervention Opportunities

Objectives We investigated the similarities and differences in the factors related to human papillomavirus (HPV) vaccination of female adolescents in three sub-regions of the Intermountain West (IW). Methods We analyzed 2011–2012 National Immunization Survey-Teen data. Respondents (parents) who were living in the IW and who had daughters aged 13–17 years old with provider-verified immunization records were included in our analyses. East, Central, and West sub-regions were defined based on geographic contiguity and similarity in HPV vaccination rates and sociodemographic characteristics. Survey-weighted Chi square tests and multivariable Poisson regressions were performed. Results In all three sub-regions, older teen age and receipt of other recommended adolescent vaccinations were significantly associated with HPV vaccination. In the East sub-region, providers’ facility type and source of vaccines were significantly related to HPV vaccination. In the Central sub-region, teens with married parents were significantly less likely to be vaccinated than were those with unmarried parents. In the West sub-region, non-Hispanic teens were significantly less likely to be vaccinated than were Hispanic teens. Conclusionsfor Practice In order to improve HPV vaccine coverage in the IW, region-wide efforts to target younger teens and to promote the HPV vaccine with other recommended adolescent vaccinations should be supplemented with sub-regional attention to the health care system (East sub-region), to married parents (Central sub-region), and to non-Hispanic teens (West sub-region).

Younger Age and Health Beliefs Associated with Being Overdue for Pap Testing among Utah Latinas who were Non-Adherent to Cancer Screening Guidelines

Factors associated with being overdue for Papanicoloau (Pap) testing in a Latina community were examined. Female participants aged ≥ 21 years, who were overdue for one or more cancer screenings (N = 206), were purposively recruited. Descriptive statistics, Fisher’s Exact Tests for count data, and multivariable logistic regressions were conducted. Participants overdue for cancer screening, aged 38–47 years demonstrated lower odds of being overdue for Pap testing compared with those 21–37 years old (OR = 0.11, 95% CI = 0.01–0.49, p = 0.01). Lower perceived susceptibility to cervical cancer (OR = 3.21, p = 0.02), and poorer perceived health (OR = 3.74, p < 0.01) was associated with being overdue for Pap testing. Cost/lack of insurance was the most common barrier reported among those overdue for Pap testing. Among an underserved population of Latinas, cost or a lack of health insurance persist as barriers to Pap testing. Evaluation of systematic barriers to accessing Pap testing for lower-income, uninsured individuals is recommended.