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Knowledge and Acceptability of Human Papillomavirus Vaccination and Text Message Reminders for Adolescents in Urban Emergency Departments: A Pilot Study

Authors Allison WE, Rubin A, Melhado TV, Choi A, Levine DA

Received 8 January 2020

Accepted for publication 25 March 2020

Published 2 June 2020 Volume 2020:12 Pages 145—153


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Hans-Christoph Pape

Waridibo E Allison,1 Ada Rubin,2 Trisha V Melhado,1 Aro Choi,1 Deborah A Levine2

1University of Texas Health Science Center San Antonio, Department of Medicine, Division of Infectious Disease, San Antonio, TX, USA; 2New York University, Ronald O. Perelman Department of Emergency Services, New York, NY, USA

Correspondence: Waridibo E Allison
Department of Medicine, Division of Infectious Disease, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, Mail Code 7881, San Antonio, TX 78229, USA
Tel +1 210 567 0939
Fax +1 210 567 4670

Purpose: Cervical, oropharyngeal and anogenital cancers are vaccine-preventable diseases, but human papillomavirus (HPV) vaccination coverage in the US remains poor overall with regional variations in vaccination rates. We explore the acceptability by adolescents and their parents of HPV vaccination and text message reminders in the non-traditional setting of the emergency department (ED).
Patients and Methods: The modified validated Carolina HPV Attitudes and Beliefs Scale (CHIAS) survey was administered at two urban EDs to adolescents aged 13– 18 years and their parents. Demographic information was collected for each participating adolescent. Recruitment occurred with consecutive eligible participants on the ED census list approached within 4-hour blocks from 8am to 8pm.
Results: Ninety-six adolescents completed the survey. The mean adolescent and parental knowledge scores were 63% (SD=29.7) and 60% (SD=22.1), respectively. The higher the HPV knowledge score among both adolescents and parents, the more likely they were to accept HPV vaccine in ED. Among the 10 cases where the parents disagreed to the HPV vaccine and the adolescents agreed to the HPV vaccine, the mean knowledge score among parents disagreeing was 47 compared to 62 among the remaining parents (p=0.04). Sixty-seven percent of adolescents and 68% of parents were agreeable to the adolescent receiving vaccination in the ED (kappa = 0.24). Seventy-five percent of adolescents and 71% of parents reported being agreeable to receiving text reminders for HPV vaccines (kappa = 0.20). Adolescent agreement with receiving a text message reminder corresponded with an increased willingness to be vaccinated (OR=3.21, 95% CI=1.07– 9.57, p-value=0.0368). Sexually active adolescents were older (mean age,  17 years) than those who reported no sexual activity (mean age, 15 years) (p< 0.0001).
Conclusion: Increased knowledge about HPV influences vaccine acceptance. Parents and adolescents may disagree in accepting HPV vaccination. A majority of adolescents and their parents were agreeable to receiving HPV vaccination in the ED and subsequent text message reminders. The ED should be explored further as a non-traditional healthcare setting for HPV vaccination of adolescents.

Keywords: adolescent, vaccination, vaccine, prevention, public health

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