Trends in HPV Vaccine Initiation and Completion among Girls in Texas: Behavioral Risk Factor Surveillance System Data, 2008-2010.

OBJECTIVE: The objective of this study was to evaluate the trend of HPV vaccine initiation and completion among girls in Texas from 2008 to 2010. METHODS: Data were obtained from the Behavioral Risk Factors Surveillance System (BRFSS) over 3 years (2008-2010). The information regarding HPV vaccination was gathered from the parents of 9- to 17-year-old daughters (choosing only 1 per household) in randomly selected households in the sample area. RESULTS: The highest prevalence of vaccine initiation and completion were detected in 2010 (20.9% and 9.7%, respectively). Over the study period, HPV vaccine initiation statistically significantly increased (2008, 14.9%; 2009, 20.7%; 2010, 24.3%; p = 0.002), corresponding to an annual increase in coverage of 33.5% (odds ratio [OR] = 1.33; 95% confidence interval [CI]: 1.11-1.60). Similarly, HPV vaccination completion increased (2008, 6.3%; 2009, 9.6%; 2010, 11.6%; p = 0.021), corresponding to an annual increase in coverage of 37.1% (OR = 1.37; 95% CI: 1.05-1.79). Increasing trends in HPV vaccination initiation and completion were observed in mothers, white, non-Hispanic parents, parents who had attended some college or were college graduates, parents who were married/partnered, and parents who lived in urban areas. CONCLUSION: Although HPV vaccination coverage in Texas is lower than recommended, there have been increases in the trends of vaccine initiation and completion. The campaigns promoting HPV vaccination should target specific population groups in which HPV immunization rates did not increase over time.

Cancer beliefs and patient activation in a diverse, multilingual primary care sample.

OBJECTIVES: Greater patient activation, defined as having the knowledge, skills, and confidence to manage one's health, is associated with cancer control behaviors. Cancer risk beliefs may be associated with patient activation, and delineating this relationship could inform cancer control interventions across diverse patient subgroups. This study examines associations between cancer risk beliefs, language preference, and patient activation within a multilingual urban primary care setting. DESIGN: Patients 18 years and older within a New York City public hospital serving a large proportion of non-native-born Americans were surveyed regarding their cancer risk beliefs and patient activation in Haitian Creole, Spanish, or English based on language preference during a health care visit. RESULTS: The sample (N = 460) included 150 Haitian Creole speakers, 159 Spanish speakers, and 151 English speakers and was primarily non-White (92%). Most participants (84%) had not been born in the United States. Cancer risk beliefs differed across language preference. Beliefs that cancer could be avoided by minimizing thoughts about cancer risk were significantly higher in Haitian Creole speakers than in others; reported negative emotion when thinking about cancer risk was higher in Spanish and English than in Haitian Creole speakers. These cancer risk beliefs were positively related to patient activation, even when controlling for language preference. CONCLUSION: Cancer risk beliefs differ across language preference and are related to patient activation, making them potentially important in cancer control. Consideration of language represents important demographic stratification for understanding the frequency and relevance of different beliefs about cancer and patient activation.

Examining Intuitive Cancer Risk Perceptions in Haitian-Creole and Spanish-Speaking Populations.

BACKGROUND: There is a developing emphasis on intuition and affect in the illness risk perception process, yet there have been no available strategies to measure these constructs in non-English speakers. This study examined the comprehensibility and acceptability of translations of cancer risk beliefs in Haitian-Creole and Spanish. METHOD: An established, iterative, team-based translation process was employed. Cognitive interviews (n = 20 in Haitian-Creole speakers; n = 23 in Spanish speakers) were conducted in an inner-city primary care clinic by trained interviewers who were native speakers of each language. Use of an established coding scheme for problematic terms and ambiguous concepts resulted in rewording and dropping items. RESULTS: Most items (90% in the Haitian-Creole version; 87% in the Spanish version) were highly comprehensible. DISCUSSION: This work will allow for further research examining health outcomes associated with risk perceptions across diverse, non-English language subgroups, paving the way for targeted risk communication with these populations.

Health literacy, information seeking, and trust in information in Haitians.

OBJECTIVES: To assess heath literacy, health information seeking, and trust in health-related information among Haitian immigrants seen in primary care. METHODS: Health literacy was measured by the Brief Health Literacy Screen (BHLS); items on health information use were from the 2007 Health Information National Trends Survey. RESULTS: BHLS scores differed according to age, education, and survey language. Participants with lower levels of health literacy tended to be more likely to place "a lot" or "some" trust in family and friends and religious organizations and leaders as sources of information about health or medical topics. CONCLUSIONS: Constructing a culturally-tailored and appropriate intervention regarding health promotion requires understanding how the population accesses and conveys health information.

Promoting colorectal cancer screening among Haitian Americans.

BACKGROUND: Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns. METHODS: In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research. RESULTS: Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of the curability of colorectal cancer, preventive practices, and preferred sources of information among Haitian Americans and other ethnic subgroups of U.S. Blacks. Awareness of colorectal cancer screening tests, risk perception, healthcare provider recommendation, and self-reported use of screening are suboptimal among Haitian Americans and other subgroups. In preliminary quantitative studies, Haitian immigrants have been found to have lower colorectal cancer screening rates than other groups such as African Americans. CONCLUSIONS: Culturally appropriate educational interventions are needed to encourage Haitian American adults aged ≥ 50 years to undergo screening for colorectal cancer and to ensure that they are well informed about the value of healthy eating and physical activity.