Barriers to the HPV Vaccination and Cervical Cancer Screening for BAME Women

Barriers to the HPV Vaccination and Cervical Cancer Screening for BAME Women What are the Barriers of Human Papillomavirus (HPV) Vaccination and Cervical Cancer Screening amongst Minority Women age 12-26? Abstract Background: Minority women systematically experience socio-economic disadvantages, which put them in the face of greater obstacles in attaining optimal health. Approximately 44 million women in the United States, nearly one third of all women in America, self-identify as women of a minority racial or ethnic group. Yet, minority women fare worse than non-Hispanic white women across a broad range of measures, with some of the largest disparities being that of HPV-related cervical cancer mortality. Objective: The objective is to emphasize the barriers of care in relation to cervical cancer screening and HPV vaccination, as well as examine patterns in barriers like demographic, cultural, and health belief factors amongst minority women.Methods: The data collection review and process was based on article review factors that were associated with HPV vaccine acceptability, initiation, and series completion among adolescent and young adult women of different racial, ethnic, and socioeconomic groups in the United States. Results: Selected characteristics of the included studies contended that an estimated 12,000 women are diagnosed with cervical cancer annually in the United States, and 4500,000 women worldwide develop cervical cancer each year. Higher rates of cervical cancer are found in US regions with large minority and impoverished populations. Conclusion: It is imperative for clinicians to progress minority women screening and early detection. Further intervention models need to reflect multifactorial determinants of screening utilization. Introduction Background While there have been strides in HPV and cervical cancer prevention efforts, many minority women across the board still experience significant barriers to care. For example, women from rural and poor communities tend to have health illiteracy in regard to their own self-care, which also includes their mistrust for the healthcare system. Additionally, many minority women simply lack financial access to care. Socio-economic disadvantages (i.e. race, class, gender, education, occupation, etc.) are the underlying issues. Though many health efforts are made by health professionals, and health ramifications like informative technologies and preventative care strategies have been achieved, there is a continual socio-economic and racial imbalance with both the diagnosis and treatment of cervical cancer, especially the strains directly influenced by HPV. Specific Aims Our specific aims are to first identify Health care barriers and challenges to cervical cancer screening and HPV vaccination within the population of minority women. We also want to uncover minority women, health care provider & health care system risk factors for cervical cancer screening & HPV vaccination, as well as, health care challenges and opportunities in improving cervical cancer screening rates amongst minority women. Lastly, we want to pinpoint the nurses’ roles in preventing cervical cancer in underserved racial and or ethnic populations. Methods Search Strategy In June 2017,we searched four electronic bibliographic databases (Google scholar, Medline, Pubmed and Cinahl) using the search terms ‘HPV’ ‘cervical cancer’ ‘pap smear’ ‘minority women’ ‘ethnic women’ and ‘health disparities’. All of the studies identified during the database search were assessed for relevance to the review based on the information provided in the title, abstract, and description of key words and terms. A full report was retrieved for all studies that met the inclusion criteria. Inclusion Criteria The data collection review and process was based on article review factors that were associated with HPV vaccine acceptability, initiation, and series completion among adolescent and young adult women of different racial, ethnic, and socioeconomic groups in the United States. We reviewed relevant peer-reviewed and evidence-based qualitative literature in order to identify current vaccination trends, rates and factors associated with HPV and cervical cancer. Study findings a related to race (black, Latina, Asian), and socio-economic disadvantages were summarized. Eligibility Criteria Understanding current vaccination trends and the barriers to series initiation and completion, the Centers for Disease Control and Prevention (CDC) recommends that 11 to 12 year old adolescents receive two doses of the HPV vaccine in order to protect against themselves against cancers that are caused by HPV. The HPV vaccine series can be given to girls beginning at age 9 years old, but many parents believe this age is too immature for a sexually transmitted disease vaccination. Additionally, it is recommended by the CDC that girls and women age 13 through 26 years of age who have not yet been vaccinated or completed the vaccine series to be given the HPV vaccination immediately to provide HPV-cancer related protection. In understanding HPV vaccination parameters, it is essential that we too recognize gaps in knowledge and all the misconceptions surrounding HPV vaccination and cervical cancer. When the vaccine is given prior to HPV exposure, it is highly effective in preventing infection from two high-risk genotypes (HPV-16/HPV-18) of HPV, which causes approximately 70 percent of cervical cancers, and two low-risk (HPV-6/HPV-11) genotypes that are responsible for over 90 percent of all genital warts. As we assessed the appropriateness of our criteria interests, we focused on Black/African-American, Latina and non-white adolescent women age 12-26, minority teen women reported having sexual intercourse, adolescent women who have completed puberty, and low income and health care illiterate young women, who are too uninsured or have limited access. Quality Assessment The methodological quality is significant to our study. It was organized and detailed oriented. It presented evidence that there is a need for increasing HPV vaccination among young minority women. The failure to achieve equitable vaccination has exacerbated health disparities in HPV and cervical cancer incidence and mortality. Research suggests that low- income and minority women are disadvantaged due to the difference in cervical cancer screening, practices and beliefs, as well as healthcare access barriers and systemic risk factors. We used the ‘Research and Quality Scoring Method’ by Sackett and Haynes, the Jadad scale, and the items published by Cho and Bero to rate the quality of each study (Table 1). The range of total quality scores was from 0 to 9. Studies that ranged from 0 to 5 were considered low quality, whereas studies that ranged from 6-9 were considered high quality. Two raters independently coded variables using Microsoft Excel. Discrepancies were identified and resolved amongst our team members. Table 1. Study quality ratings Statistical Analysis Race/ethnicity and low socio-economic status are known predictors of late-stage diagnosis of cervical cancer and are important predictors of cancer mortality. In the United States, approximately 12,000 women develop cervical cancer and 44000 die of the disease each year, with higher incidence and mortality rates reported in low-income minority populations. HPV vaccination has been shown to reduce the prevalence of high-risk HPV infection among teen women and thus, has the potential to decrease the risks of cervical cancer among vaccinated young women. According to preceding surveillance and qualitative studies, it is indicated that a decline in the annual rate of high-grade cervical cancer, from 834 per 100,000 in 2008 to 688 per 100,000 in 2014, among women aged 21 to 24 years, which reflects the impact of HPV vaccination. However, declines were not significant in areas with high proportions of minority women (i.e blacks, Latinas) and/or people living in low-income areas. Results Included Studies The search yielded nearly 500 potential article titles for review, yet less than 70 were relevant to our interests. And of that 70, about 20 were dated within the last 10 years. Accordingly, less than 20 seemed more characteristic of our research interests and provided adequate information to our research question. Description of Studies Selected characteristics of the included studies contended that an estimated 12,000 women are diagnosed with cervical cancer annually in the United States, and 4500,000 women worldwide develop cervical cancer each year. In the United States, cervical cancer incidence is nearly twice as high in counties with poverty levels > 20% compared with those with poverty levels