A Regional Comparison of Barriers to Communication between Caregivers and Healthcare Providers Regarding the HPV Vaccine in Georgia Public

Davidson, Kaliane (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/12579t45h?locale=fr
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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

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