Indiana Parental Perceptions of the Acceptability of General and HPV-Specific State Vaccine Requirements.

State vaccine requirements are a tool for improving child and adolescent vaccination immunization coverage, but to be effective, parental buy-in is needed. The objective of this study was to assess the demographic, healthcare characteristics, and health beliefs associated with parental acceptance of general and HPV-specific state vaccine requirements. Indiana parents (N = 601) with children ages 11-17 years old completed a survey during March 2020.Results showed that 47.2% and 43.1% of parents believed there should always be general and HPV-specific state vaccine requirements, respectively. In multivariable analysis, higher odds of parental support for general state vaccine requirements were associated with being unsure whether HPV-associated cancer is a problem in the participant's county and having higher perceived benefits of HPV vaccines. Lower odds were associated with private insurance, having less than a bachelor's degree, and having less confidence in vaccines. In comparison, parents had higher odds of agreeing with HPV-specific state vaccine requirements if they reported higher interpersonal altruism and higher perceived benefits of HPV vaccines; they had lower odds if they were non-Hispanic White. Findings indicate that while similar percentages of parents agreed with general and HPV-specific state vaccine requirements, there were different characteristics associated with acceptance of each. Results can inform the development of tailored interventions for improving parental support for general and HPV-specific state vaccine requirements.

Shining the Light on Altruism and Its Potential Impact for Behavior Change Strategies Related to the COVID-19 Pandemic and Beyond.

The COVID-19 pandemic is shining a light on altruistic behaviors needed to prevent the spread of the virus. This short essay presents a personal experience of altruism during the COVID-19 pandemic and its resulting motivation to leverage it in health behavior change strategies for vaccination and other pandemic protective behaviors.

The role of the media on maternal confidence in provider HPV recommendation.

BACKGROUND: Despite a growing understanding of the importance of provider HPV recommendation on parental acceptance, U.S. HPV vaccination rates remain suboptimal. Given the prevalence and use of the media for health decisions, this study examined the relationship between the media and provider HPV recommendation on maternal HPV vaccine hesitancy. METHODS: Thirty individual interviews with HPV vaccine-accepting mothers in the Midwest U.S. were conducted to examine their feelings of hesitancy around the decision to accept HPV vaccination at the time of provider recommendation and their suggestions for improving the recommendation experience by addressing media concerns. RESULTS: Media exposure was an antecedent to hesitancy for three main vaccination concerns: safety, protection/efficacy and sexual stigma. Although mothers accepted vaccination, they continued to feel confused and hesitant about HPV vaccination. They had several recommendations for how providers could combat hesitancy to improve confidence in HPV vaccine acceptance. CONCLUSIONS: Providers' approach to HPV vaccination recommendation must consider concerns reported in the media with delivery techniques modified to adjust to maternal fears absorbed from adverse media information.

#13ReasonsWhy Health Professionals and Educators are Tweeting: A Systematic Analysis of Uses and Perceptions of Show Content and Learning Outcomes.

This study is a content analysis of health professionals' and educators' tweets about a popular Netflix show that depicts teen suicide: 13 Reasons Why. A content analysis of 740 tweets was conducted to determine the main themes associated with professionals' and educators' tweets about the show, as well as the valence of the tweets. Additionally, a thematic analysis of linked content in tweets (n = 178) was conducted to explore additional content shared about the show and modeling outcomes. Results indicated the largest percentage of tweets was related to social learning, particularly about outcomes that could occur from viewing the show. The valence of the tweets about outcomes was more positive than negative. However, linked materials commonly circulated in tweets signified greater concern with unintended learning outcomes. Some of the linked content included media guidelines for reporting on suicide with recommendations that entertainment producers follow the guidelines. This study emphasizes the importance of including social learning objectives in future typologies of Twitter uses and demonstrates the importance of examining linked content in Twitter studies.

Midwestern Latino caregivers' knowledge, attitudes and sense making of the oral health etiology, prevention and barriers that inhibit their children's oral health: a CBPR approach.

BACKGROUND: Using community-based participatory research, the Health Protection Model was used to understand the cultural experiences, attitudes, knowledge and behaviors surrounding caries etiology, its prevention and barriers to accessing oral health care for children of Latino parents residing in Central Indiana. METHODS: A community reference group (CBPR) was established and bi-lingual community research associates were used to conduct focus groups comprised of Latino caregivers. Transcripts were analyzed for thematic content using inductive thematic analysis. RESULTS: Results indicated significant gaps in parental knowledge regarding caries etiology and prevention, with cultural underlays. Most parents believed the etiology of caries was related to the child's ingestion of certain foods containing high amounts of carbohydrates. Fewer parents believed either genetics/biological inheritance or bacteria was the primary causative factor. Fatalism negatively impacted preventive practices, and a clear separation existed concerning the perceived responsibilities of mothers and fathers to provide for the oral needs of their children. Females were more likely to report they were primarily responsible for brushing their children's teeth, overseeing the child's diet and seeking dental care for the child. Fathers believed they were primarily responsible for providing the means to pay for professional care. Perceived barriers to care were related to finances and communication difficulties, especially communicating with providers and completing insurance forms. CONCLUSION: The main study implication is the demonstration of how the CBPR model provided enhanced understanding of Latino caregivers' experiences to inform improvements in oral prevention and treatment of their children. Current efforts continue to employ CBPR to implement programs to address the needs of this vulnerable population.

A content analysis of cognitive and affective uses of patient support groups for rare and uncommon vascular diseases: comparisons of may thurner, thoracic outlet, and superior mesenteric artery syndrome.

Rare disease patients are the predominant group of patients who are now connecting online to patient support groups, yet research on their uses of support groups has received little attention. This is a content analysis of three vascular diseases of differing degrees of rarity. Wall posts from Facebook patient support groups for May Thurner syndrome, thoracic outlet syndrome, and superior mesenteric artery syndrome were analyzed over a period of two years. Using Uses and Gratifications as the theoretical framework, the study purpose was to assess how variations in health condition and rarity of condition affect online support group user needs. Results indicated common main cognitive and affective uses across conditions, indicating a consistent pattern of needs communicated by all patients. However, there were nuanced differences in subcategories of cognitive and affective uses between the most and least rare disorders, which inform areas for tailored support mechanisms. Additionally, these vascular patients used their respective support groups primarily for cognitive reasons, especially for the rarest conditions, which informs of basic medical informational needs these patients face related to tests, treatment, surgery, and diagnoses.

Cues to Action as Motivators for Children's Brushing.

Dental caries is the most common chronic childhood disease. Home self-care procedures are the most important strategies to prevent tooth decay. Brushing is the most important single intervention for the prevention of tooth decay, yet compliance is not practiced and there is limited understanding of children's behavioral decisions. Guided by the Health Belief Model, this study consisted of eight focus groups with children in the second through fifth grades at three different socioeconomic-level school districts to determine the cues to action that are motivating or can motivate their brushing behavior. Results indicated children are primarily motivated to brush for aesthetic reasons, mainly due to viewed media pictures of "perfect" teeth. Other less commonly expressed motivations for brushing stemmed from interpersonal connections, such as relatives with dentures. Social media, on the other hand, played a key role in some children's understanding of more advanced oral health connections such as links between cardiovascular and oral disease, and smoking and oral cancer. These links were viewed as threatening to children to motivate better brushing. Additionally, the study found that home computers can be used as an external motivator to deliver tailored messages to encourage better brushing.

Cognitive and Affective Uses of a Thoracic Outlet Syndrome Facebook Support Group.

There are currently many disease-specific groups on Facebook in which patients may take an active part (Greene, Choudhry, Kilabuk, & Shrank, 2011). Although uses and gratifications of patient-disease groups have begun to be identified for chronic diseases, rare diseases have been omitted, even though they collectively affect roughly 30 million people in the United States and 350 million people worldwide. This study is a content analysis of one Facebook rare disease patient group, the Thoracic Outlet Syndrome (TOS) Awareness group. All wall posts were recorded and content analyzed for cognitive and affective categories and subcategories between October 9, 2011 (date of site origin), and May 1, 2012. Analysis of cognitive needs indicated TOS patients used the site more to share information about their own TOS symptoms and journey with diagnosis than to seek information. Analysis of affective needs found patients were more likely to use the site to give support and encouragement to others than to express concerns and complaints. The complaints they did express were primarily related to their frustration with the general medical community's perceived inability to diagnose and understand their disease or to question a specific doctor's diagnosis/recommendation. Results point to needs specific to TOS patients that uses and gratifications research can help clarify.

A qualitative study exploring the relationship between mothers' vaccine hesitancy and health beliefs with COVID-19 vaccination intention and prevention during the early pandemic months.

Vaccine hesitancy is a top ten global health threat that can negatively impact COVID-19 vaccine uptake. It is assumed that vaccine refusers hold deep, negative beliefs, while acceptors hold strong, positive beliefs. However, vaccine hesitancy exists along a continuum and is multidimensional, varying by time, place, vaccine, subgroup, and person. Guided by the Health Belief Model and vaccine hesitancy frameworks, the study purpose was to qualitatively explore maternal COVID-19 threat perceptions and willingness to accept a COVID-19 vaccine in light of their expressed vaccine hesitancy toward past school required and routinely recommended vaccines and the HPV vaccine for their children. Researchers conducted twenty-five interviews with US Midwestern mothers during the early COVID-19 pandemic months. Mothers were grouped by vaccine hesitancy categories and thematic analysis was used to analyze the data within and across categories. Results showed that prior vaccine hesitancy attitudes and behavior did not fully capture maternal acceptance of COVID-19 vaccine or perception of COVID-19 threat. Perceptions of COVID-19 threat did influence mothers' decisions about COVID-19 protective behaviors (e.g., handwashing, mask wearing, and distancing). However, mothers were hesitant to accept the COVID-19 vaccine across vaccine hesitancy categories, primarily citing concerns about safety, efficacy, and confusion over conflicting information as barriers to immediate COVID-19 vaccine acceptance. Findings indicate that mothers cannot be grouped together based on hesitancy about, or acceptance of, other vaccines for purposes of assuming COVID-19 preventive behavior adherence or anticipated COVID-19 vaccine acceptance.

"We fear the unknown": Emergence, route and transfer of hesitancy and misinformation among HPV vaccine accepting mothers.

Although licensed since 2006, US HPV vaccination rates remain suboptimal. Since mothers are decision-makers for young adults' vaccination, assessing ongoing knowledge deficits and misunderstanding among parents is important for determining the content and mode of interventions to reach parents. Guided by the social-ecological model and health belief model, 30 interviews with vaccine accepting mothers in the U.S. Midwest were conducted from January through June 2020. Researchers examined ecological determinants of acceptance, perceptions of vaccination barriers, and perceived cues to action for empowering other mothers to vaccinate their children. Data were analyzed using thematic analysis. Results found vaccine accepting mothers exhibited ongoing misconceptions and negative attitudes toward HPV vaccine. Physicians, peers and the media were identified as primary pro-HPV vaccine sources, yet hesitancy and misinformation occurred with each source. Trust in provider recommendation was the primary source for decision-making, yet trust was still lacking. While mothers looked to the media for HPV information, the media were identified as the main source of confusion and distrust. Results show that parents who accept the HPV vaccine can still be hesitant. Thus, mothers who have vaccinated their children for HPV may still need attitudinal and educational training prior to establishing them as role models in interventions for empowering other parents to vaccinate their children. Results showing that the media sow confusion and hesitancy also call for more attention to social media policies to guard against misinformation about the HPV vaccine.

USA dental health providers' role in HPV vaccine communication and HPV-OPC protection: a systematic review.

Background. Improving human papilloma virus (HPV) vaccination coverage in the US will require healthcare providers to recommend the vaccine more effectively. To inform quality improvement efforts, we systematically reviewed studies of dental provider communication about HPV vaccination. Methods. We searched MEDLINE, CINAHL, ScienceDirect, PsycINFO and JSTOR in August 2018 to identify studies of dental provider knowledge, perceived role and communication about HPV, HPV vaccination and HPV-associated oropharyngeal cancer (HPV-OPC). Results. We identified 10 qualitative and quantitative studies. Results of the primarily descriptive studies showed that although there were some deficiencies in knowledge about HPV-related outcomes and its effect on the male population, most providers understand HPV as a sexually transmitted infection and know the HPV vaccine is available, yet many are not discussing the HPV-OPC link or recommending vaccination. Providers were less often to recommend HPV vaccination if they were uncomfortable discussing sex, perceived parents as hesitant, or believed patients to be low risk. Studies reported mixed results on providers' perceived role in expanded HPV vaccination and HPV-OPC education, but indicated support for the role of professional organizations in promoting awareness. Conclusion. Interventions are needed to help dental providers perceive their role to deliver effective recommendations within the complex communication environment surrounding HPV vaccination and HPV-OPC education.

The Importance of Developing Communication Skills: Perceptions of Dental Hygiene Students.

Purpose: The purpose of this study was to gather data from first- and second-year dental hygiene students concerning their perceptions of the benefits and possible impediments to effective patient communication. Additionally, the students were asked to theorize as to the impact emerging communication technologies could have on oral health promotion, practice administration and patient/provider communication.Methods: A self-administered questionnaire of 6 open-ended queries was employed. Thematic analysis was conducted to reveal themes related to their perceived ability to effectively communicate, perceived barriers to communication, possible solutions to lessen or eliminate these barriers, and the impact of emerging technologies on interpersonal communication.Results: The questionnaire was completed by 63 of 68 students (93%). Patient apathy and patient unwillingness to change detrimental health-related habits were the most frequently cited barriers to effective communication. Of the students having patient contact, many stated that they were less sure of their ability to communicate effectively if the patient differed from themselves, such as being elderly or being from another culture. While most of the students believed their fundamental communication skills were good, many noted that improving their higher-order skills, such as conveying empathy or displaying a nonjudgmental attitude, were essential to being more effective communicators. Many students felt emerging technologies such as universal translators could potentially assist them in overcoming some of their perceived deficiencies.Conclusion: While perceived inadequacies will likely diminish as the students gain more experience in school and later in private practice, dental hygiene programs may wish to consider implementing additional structured educational experiences to better prepare students to address patient apathy and to effectively convey a sense of personal compassion. Promoting student involvement in community outreach activities and providing a variety of service learning opportunities, including foreign travel, may broaden student experiences and deepen their awareness and appreciation of verbal and nonverbal communications displayed by differing cultures.