Multi-level determinants to HPV vaccination among Hispanic farmworker families in Florida. Issue 3 (3rd April 2021)

• Record Type: Journal Article
• Authors: Vamos, Cheryl A.; Vázquez-Otero, Coralia; Kline, Nolan; Lockhart, Elizabeth A.; Wells, Kristen J.; Proctor, Sara; Meade, Cathy D.; Daley, Ellen M.
• Is Part Of: Ethnicity & health. Volume 26:Issue 3(2021)
• Page Start: 319
• Page End: 336
• Publication Date: 2021-04-03
• Subjects: HPV vaccination -- Hispanic migrant farmworkers -- multi-level determinants -- cancer -- health disparities -- community-based; Ethnic groups -- Health and hygiene -- Periodicals; Ethnic groups -- Medical care -- Periodicals; Medical care -- Cross-cultural studies -- Periodicals; Ethnic Groups -- periodicals; Delivery of Health Care -- periodicals; Social Sciences -- periodicals; 362.1089
• DOI: 10.1080/13557858.2018.1514454
• Languages: English
• ISSNs: 1355-7858

Abstract

ABSTRACT: Background: HPV vaccination is the primary prevention method for HPV-related cancers, although among Hispanic populations, migrant farmworkers may experience exacerbated challenges to HPV vaccination due to intersecting political, social, and personal contexts. This study explored multi-level determinants of HPV vaccination among Hispanic migrant farmworker families. Methods: Using a community-engaged approach and guided by the socio-ecological model, Intervention Mapping, and PRECEDE-PROCEED constructs, we recruited parents who had a daughter and/or son age 9-15 years from a rural, faith-based, community organization in Florida. Three focus groups ( n = 13) were conducted in Spanish and constant comparison methods were used to analyze qualitative data. Results: Micro-level determinants included moderate HPV vaccine knowledge, desire for more HPV vaccine information, concerns about HPV vaccine completion, health/preventive motivations, past experiences with the healthcare system, and parental gender roles related to health care. Macro-level determinants included facilitators (e.g. transportation services, clinics open after work hours, governmental programs) and barriers (e.g. supervisor/employment inflexibility, long clinic wait times) to accessing health care and vaccination in general (including HPV vaccination). Participants shared their preferences for future interventions that would meet the needs of this community, and discussed potential content and mechanisms for receiving HPV information, as well as what might facilitate their overall access, uptake, and completion of the HPV vaccine series. Discussion: Determinants to HPV vaccination emerged and underscore the importance of addressing the multi-level factors when designing and delivering an HPV vaccine intervention for this Hispanic migrant farmworker population. Improving HPV vaccination rates requires responding to situational and structural hardships that disproportionately impact this group. Thus, community-tailored and culturally appropriate multi-level interventions are needed, while emphasizing existing knowledge assets and preferences favorable towards HPV vaccination, with the ultimate goal of the decreasing HPV-related disparities. Findings suggest interventions must reach beyond the individual level to account for this unique population's lived experiences.