First nations people's perspectives on barriers and supports for enhancing HPV vaccination: Foundations for sustainable, community-driven strategies (original) (raw)
Related papers
Systematic reviews, 2018
Despite the existence of human papilloma virus (HPV) vaccines with demonstrated safety and effectiveness and funded HPV vaccination programs, coverage rates are persistently lower and cervical cancer burden higher among Canadian Indigenous peoples. Barriers and supports to HPV vaccination in Indigenous peoples have not been systematically documented, nor have interventions to increase uptake in this population. This protocol aims to appraise the literature in Canadian and global Indigenous peoples, relating to documented barriers and supports to vaccination and interventions to increase acceptability/uptake or reduce hesitancy of vaccination. Although HPV vaccination is the primary focus, we anticipate only a small number of relevant studies to emerge from the search and will, therefore, employ a broad search strategy to capture literature related to both HPV vaccination and vaccination in general in global Indigenous peoples. Eligible studies will include global Indigenous peoples ...
Engaging Canadian First Nations women in cervical screening through education
Recognition of the need to decrease cervical cancer rates in Indigenous populations has been ongoing – yet few successful interventions have been reported. In addition, the literature addressing the challenges and barriers associated with designing screening programs aimed to specifically reach Indigenous women is limited. Here, we report findings from a mixed methods cervical cancer research project conducted in partner-ship with 10 First Nations communities in Northwest Ontario, Canada. Individual inter-views with community health professionals (the majority of whom identified as First Nation) stressed that awareness of cervical screening benefits is lacking. In contrast, focus group participants (women with no formal health education) emphasized the desire to learn more about the science of human papillomavirus (HPV) and that a posi-tive HPV or abnormal Papanicolaou test need not mean a woman will develop cervical cancer. Both the health professionals and the focus group participants highlighted that sexual health education must start early, in schools, preferably before girls are sexually active and that it has to continue throughout life to create a screening culture with a focus on women’s well-being. Health professionals elaborated mainly on special events for community women, whereas focus group participants also recognized the need to include community men in health education particularly for destigmatizing the sexually transmitted HPV infection.
IPVS Policy Statement addressing the burden of HPV disease for Indigenous peoples
Papillomavirus Research, 2019
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
2012
To describe the attitudes about and experiences with cervical cancer, Pap smear screenings and the HPV vaccine among a sample of Inuit women from Nunavik, Quebec, Canada. We also evaluated demographic and social predictors of maternal interest in HPV vaccination. Study design: A mixed method design was used with a cross-sectional survey and focus group interviews. Methods: Women were recruited through convenience sampling at 2 recruitment sites in Nunavik from March 2008 to June 2009. Differences in women's responses by age, education, and marital status were assessed. Unconditional logistic regression was used to determine predictors of women's interest in HPV vaccination for their children.
BMJ Open
IntroductionThe nine-valent human papillomavirus (HPV) vaccine could prevent an estimated 92% of the cancers attributable to HPV types targeted by the vaccine. However, uptake of the HPV vaccine among American Indian and Alaska Native (AI/AN) adolescents has been low. AI/ANs also bear a disproportionate burden of cervical and other HPV-associated cancers. Increasing HPV vaccination rates is a national priority, but reviews and national surveys on HPV vaccination factors are lacking for the AI/AN population. The objective of this systematic review is to assess factors associated with HPV vaccination among AI/ANs in the USA.Methods and analysisA systematic review is proposed to synthesise the current literature on HPV vaccination factors in AI/ANs from 1 July 2006 until 30 September 2019. As applicable, controlled vocabulary terms, keywords and special features (eg, limits, explode and focus) will be incorporated into database searches. To maximise the identification of relevant studi...
Awareness and Knowledge about Human Papillomavirus Among Inuit Women in Nunavik, Quebec
Journal of Community Health, 2011
Accurate knowledge about human Papillomavirus (HPV) and its link to cervical cancer is essential for women to understand and make use of cervical cancer prevention and detection opportunities. This study was the first to survey awareness and knowledge of HPV in a population of Canadian Inuit. The objectives of this study were to assess the level of awareness and knowledge of Inuit women in Nunavik, Quebec, Canada, about HPV infection and its relation to cervical cancer and to study correlates of this awareness. A cross-sectional survey design was used. Women were recruited through convenience sampling at two recruitment sites in Ungava Bay from March 2008 to June 2009. Questionnaires were completed by 175 women aged 18-63. Thirty one percentage reported that they had heard of HPV. Of the women who had heard of HPV, 53% knew that HPV causes cervical cancer. The level of HPV awareness was not found to vary with participants' age. Awareness of HPV was found to be associated with greater or equal to 13 years of education (OR = 4.4, 95%: 1.3-15.1) and knowing someone with cervical cancer (OR = 3.6, 95%: 1.4-8.9). Despite the high prevalence of HPV and incidence of cervical cancer in Inuit populations, there is a low level of knowledge in this population. The lack of awareness and knowledge and misconceptions found in this study has been consistently found in other non-Indigenous populations.
BMJ open, 2011
Background The incidence of cervical cancer is up to sixfold higher among First Nation women in Canada than in the general population. This is probably due to lower participation rates in cervical cancer prevention programmes. Objective To raise screening participation in this underserved population by launching an alternative approach to (Pap)anicolaou testing in a clinic-namely, vaginal self-sampling followed by human papillomavirus (HPV) diagnostics. Methods Good relationships were established with a First Nation community of the Northern Superior region in Northwest Ontario, and then 49 community women, aged 25-59, were recruited, who provided a vaginal self-sample and answered a questionnaire. Frequency distributions and cross-tabulations were used to summarise the data. Associations between categorical variables were assessed using the χ(2) test of association, or the Goodman-Kruskal γ if both variables had ordered categories. Self-collected samples were tested for integrity a...
Women's Health Issues, 2013
Objective-In Canada, opportunistic screening programs have successfully reduced mortality from cervical cancer; however, minority or disadvantaged groups, as well as women in northern and rural areas, are inadequately recruited by this approach. Hence, we set out to examine the structural barriers that prevent First Nations women's participation in cervical cancer screening. Methods-Using a participatory action research approach and semistructured interview guides, we conducted in-depth interviews with 18 experienced health care professionals, 12 of whom were also community members. These individuals included nurses, nurse practitioners, community health representatives, social workers and physicians who provide care to women in our First *
The Palgrave Handbook of Gender, Sexuality, and Canadian Politics
Using an intersectional lens, this chapter examines sexual and reproductive health with a focus on cervical cancer prevention policy. In Canada, the control of cervical cancer has been a public-health success due to the widespread effects of Papanicolaou (Pap) screening. Within the context of publicly funded universal health insurance, which aims to achieve equitable access to healthcare, the routinisation of Pap screening has significantly lowered cervical cancer incidence and mortality among women generally. Despite this success, the burden of cervical cancer incidence and mortality is disproportionately carried by marginalised women, and structural barriers to access persist for groups who remain under-screened (Indigenous women, rural women, immigrant women, sexual and gender minorities). This approach to cervical cancer prevention contrasts with the human papillomavirus (HPV) vaccination programme, which entailed a distinct shift in thinking about cervical cancer risk and constructed a new target group for cervical cancer prevention-sexually naïve girls. Promoted by both publichealth authorities and pharmaceutical companies, HPV vaccination framed