Katz IT, Ware NC, Gray G, Haberer JE, Mellins CA, Bangsberg DR. Scaling up human papillomavirus vaccination: A conceptual framework of vaccine adherence. Sexual Health. 2010; 7(3):279-86. Access Abstract NPM: 1: Well-Woman Visit Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Access Intervention Description: This review article provides a conceptual framework for human papillomavirus (HPV) vaccine acceptance and adherence, with a focus on improving understanding of the sociocultural factors impacting vaccine adherence behaviour. We include a systematic review of the slowly expanding literature on HPV vaccine acceptability and uptake in developed nations, as well as the relatively few publications from poorer nations, where more than 80% of global cervical cancer related deaths occur and where the vaccine will probably have the largest impact. Primary Outcomes: N/A Conclusion: "By developing a conceptual framework for HPV vaccine adherence, we hope to inform future research on vaccine adherence among adolescents at high risk for STI acquisition. The analytic construct proposed here recognises forces such as structural and sociocultural factors effecting vaccine uptake and incorporates them into the model. This model also takes into account the target population and the role that caregiver involvement will play in acceptance of this vaccination. It is provides a future direction for research. We caution readers that most reviewed studies, when considered on their own, yield evidence of inadequate quality to direct future interventions. We do believe, however, that this work, taken in combination with other health behaviour theories and a body of empirical literature that continues to expand on HPV vaccine uptake and adherence, suggests that programs promoting vaccine uptake and adherence would benefit from optimising educational messaging (vaccine effectiveness) while addressing important sociocultural barriers for both adolescents and their caregivers. Ultimately, we believe our proposed conceptual model will aid in future research aimed at understanding barriers to vaccine uptake and adherence, and ultimately provide further information about means to overcome them, thus enabling millions to receive the benefits of vaccination." Study Design: Systematic Review Significant Findings: Yes Setting: Not specified Data Source: "For our literature review, the lead author searched PubMed/MEDLINE and other electronic databases from 1995 to 2009 (the approximate time frame during which HPV was known to cause cervical cancer), as well as electronic conference proceedings of the recent HPV-related conferences, for articles related to HPV vaccine uptake and adherence. The focus was on likely barriers and facilitators, identified from behavioural theory, among adolescents and their caregivers. Since federal approval of the vaccine was not granted until 2007, we were only able to examine actual uptake in the latter years of our search. Search terms included: human papillomavirus (and variants such as HPV); AND adherence* and attitude* and uptake* and barrier* and knowledge* and risk perception*; AND vaccine*. We also searched the reference sections of included articles." Sample Size: 400 studies Age Range: Not specified
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