A Regional Comparison of Barriers to Communication between Caregivers and Healthcare Providers Regarding the HPV Vaccine in Georgia Open Access
Davidson, Kaliane (Spring 2020)
Abstract
Background: HPV vaccination rates in Georgia among adolescents remain low despite the availability of the HPV vaccine since 2006. Little research into barriers to communication between healthcare providers and caregivers of adolescents regarding the vaccine has been conducted in Georgia. This research seeks to identify and regionally compare barriers to communication across East, Northwest, and South Georgia.
Methods: We conducted FGDs (n=12) with healthcare providers (n=6) and caregivers of adolescents (n=6) that could be comparatively analyzed across similar regions of the state of Georgia (East, Northwest, and South). Thematic analysis was utilized to identify, analyze, and interpret common themes present across both the healthcare provider and caregiver FGDs. These themes were then compared regionally to identify similarities and differences across Georgia regions.
Results: Our examination finds that across different regions, participants discussed similar themes, however, there were critical contextual differences when identifying barriers to communication. Findings were categorized into three themes: (1) health literacy, (2) lack of trust, (3) sex as a taboo topic. To improve communication between healthcare providers and caregivers across the state, regional needs must be addressed to facilitate the development of community-specific initiatives.
Conclusion: Georgia is a highly diverse state. This diversity is reflected in the variation of HPV vaccination coverage across the state. An understanding of Georgia’s regional context is integral to the development of targeted communication and intervention strategies aimed at increasing HPV vaccination uptake and series completion. Improving communication between healthcare providers and caregivers is critical to addressing low HPV vaccination completion in Georgia.
Table of Contents
CHAPTER 1: INTRODUCTION 1
1.1 Overview 1
1.2 Problem Statement 3
1.3 Purpose Statement 4
1.4 Research Questions 5
1.5 Significance Statement 5
1.6 Definition of Terms 6
1.7 List of Acronyms 6
CHAPTER 2: BACKGROUND 8
2.1 Literature Review 8
Introduction 8
HPV Vaccination Recommendation 9
HPV Vaccination Rates: U.S. and Georgia 11
HPV-Related Policies/Legislation: U.S. and Georgia 13
Perceived Motivators to HPV Vaccination Among Caregivers: U.S. and Georgia 15
Perceived Barriers to HPV Vaccination Among Caregivers: U.S. and Georgia 16
Identified Strategies for Increasing HPV Vaccine Uptake 19
Perceived Motivators to HPV Vaccination Among Healthcare Providers: U.S. and Georgia 21
Perceived Barriers to HPV Vaccination Among Healthcare Providers: U.S. and Georgia 21
Identified Strategies for Increasing HPV Vaccine Uptake 22
Knowledge Gap 24
What is needed to address the knowledge gap 24
CHAPTER 3: MANUSCRIPT 25
3.1 Contribution of the Student 25
3.2 Background 25
3.3 Methodology 26
IRB Approval 26
Methods 26
Participant Eligibility Criteria 27
Participant Recruitment 27
Informed Consent Process 28
Focus Group Facilitation 28
Analysis 29
3.4 Results 30
Overview 31
Health Literacy 31
Lack of Trust 38
Sex as a Taboo Topic 43
3.5 Discussion 47
Introduction 47
Health Literacy 48
Lack of Trust 53
Sex as a Taboo Topic 55
3.6 Limitations 56
3.7 Conclusion 57
CHAPTER 4: PUBLIC HEALTH IMPLICATIONS 58
REFERENCES 59
APPENDIX 73
Table 1: Participant Demographic Characteristics 73
Table 2: Representative Participant Quotes 74
About this Master's Thesis
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