Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 2/2016

01-02-2016

Differences in Human Papillomavirus Vaccination Among Adolescent Girls in Metropolitan Versus Non-metropolitan Areas: Considering the Moderating Roles of Maternal Socioeconomic Status and Health Care Access

Authors: Shannon M. Monnat, Danielle C. Rhubart, Sherrie Flynt Wallington

Published in: Maternal and Child Health Journal | Issue 2/2016

Login to get access

Abstract

Objectives This study is among the first to examine metropolitan status differences in human papillomavirus (HPV) vaccine initiation and completion among United States adolescent girls and is unique in its focus on how maternal socioeconomic status and health care access moderate metropolitan status differences in HPV vaccination. Methods Using cross-sectional data from 3573 girls aged 12–17 in the U.S. from the 2008–2010 Behavioral Risk Factor Surveillance System, we estimate main and interaction effects from binary logistic regression models to identify subgroups of girls for which there are metropolitan versus non-metropolitan differences in HPV vaccination. Results Overall 34 % of girls initiated vaccination, and 19 % completed all three shots. On average, there were no metropolitan status differences in vaccination odds. However, there were important subgroup differences. Among low-income girls and girls whose mothers did not complete high school, those in non-metropolitan areas had significantly higher probability of vaccine initiation than those in metropolitan areas. Among high-income girls and girls whose mothers completed college, those in metropolitan areas had significantly higher odds of vaccine initiation than those in non-metropolitan areas. Moreover, among girls whose mothers experienced a medical cost barrier, non-metropolitan girls were less likely to initiate vaccination compared to metropolitan girls. Conclusions Mothers remain essential targets for public health efforts to increase HPV vaccination and combat cervical cancer. Public health experts who study barriers to HPV vaccination and physicians who come into contact with mothers should be aware of group-specific barriers to vaccination and employ more tailored efforts to increase vaccination.
Appendix
Available only for authorised users
Footnotes
1
We excluded respondents from NY because NY excluded the question about number of HPV shots received, disabling us from identifying which girls completed the series.
 
2
Rather than excluding respondents who were missing on income (N = 301), we created a dummy variable in order to keep them in our analyses. Excluding these respondents would introduce systematic bias into the results because girls of respondents missing on income were significantly less likely to be vaccinated than those not missing income.
 
3
Data limitations prevent us from explaining why there are metropolitan status differences in vaccine initiation for Oklahoma but not for other states. We ran the vaccine initiation model on Oklahoma respondents (N = 233) using all covariates discussed in the methods section. None of those variables explained away the significantly higher odds of vaccine initiation for non-metropolitan respondents in Oklahoma.
 
4
In the unadjusted model for vaccine completion, girls whose mothers had a high school degree had significantly lower odds (p < 0.05) of vaccine completion versus girls whose mothers had a college degree. In the adjusted model, that significant difference was eliminated. We found that income alone resulted in the elimination of significance of the high school versus college difference.
 
Literature
1.
2.
Armstrong, K., Ravenell, K. L., McMurphy, S., & Putt, M. (2007). Racial/ethnic differences in physician distrust in the United States. American Journal of Public Health, 97(7), 1283–1289.PubMedCentralCrossRefPubMed
3.
Atav, Serdar, & Spencer, G. A. (2002). Health risk behaviors among adolescents attending rural, suburban, and urban schools: A comparative study. Family & Community Health, 25(2), 53–64.CrossRef
4.
Bernard, V. B., Johnson, C. J., Thomas, T. D., et al. (2008). Examining the association between socioeconomic status and potential human papillomavirus associated cancers. Cancer, 113, 2910–2918.CrossRef
5.
Brewer, N. T., & Fazekas, K. I. (2007). Predictors of HPV vaccine acceptability: A theory-informed, systematic review. Preventative Medicine, 45(2–3), 107–114.CrossRef
6.
Centers for Disease Control and Prevention. (2008). Vaccination coverage among adolescents aged 13–17 years- United States. MMWR. Morbidity and Mortality Weekly Report, 57, 1100–1103.
7.
8.
9.
Chao, C., Slezak, J. M., Coleman, K. J., & Jacobsen, S. J. (2009). Papanicolaou screening behavior in mothers and human papillomavirus vaccine uptake in adolescent girls. American Journal of Public Health, 99(6), 1137–1142.PubMedCentralCrossRefPubMed
10.
Chao, C., Velicer, C., Slezak, J. M., & Jacobsen, S. J. (2010). Correlates for human papillomavirus vaccination of adolescent girls and young women in a managed care organization. American Journal of Epidemiology, 171, 357–367.PubMedCentralCrossRefPubMed
11.
Desjarlais-deKlerk, K., & Wallace, J. E. (2013). Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics. BMC Health Services Research, 13, 261.PubMedCentralCrossRefPubMed
12.
Farmer, J., Iversen, L., Campbell, N. C., et al. (2006). Rural/urban differences in accounts of patients’ initial decisions to consult primary care. Health & Place, 12(2), 210–221.CrossRef
13.
Kester, L. M., Zimet, G. D., Fortenberry, J. D., Kahn, J. A., & Shew, M. L. (2013). A national study of HPV vaccination of adolescent girls: Rates, predictors, and reasons for non-vaccination. Maternal and Child Health Journal, 17(5), 879–885.PubMedCentralCrossRefPubMed
14.
Krieger, N., Quesenberry, C., Peng, T., et al. (1999). Social class, race/ethnicity, and incidence of breast, cervix, colon, lung, and prostate cancer among Asian, Black, Hispanic, and White residents of the San Francisco Bay Area, 1988–1992 (United States). Cancer Causes and Control, 10, 525–537.CrossRefPubMed
15.
16.
Markowitz, L. E., Dunne, E. F., Saraiya, M., Lawson, H. W., Chesson, H., Under, E. R., et al. (2007). Quadrivalent human papillomavirus vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and Reports, 56(RR-2), 1–24.PubMed
17.
Monnat, S. M., & Wallington, S. F. (2013). Is there an association between maternal pap test use and adolescent human papillomavairus vaccination? Journal of Adolescent Health, 52(2), 212–218.PubMedCentralCrossRefPubMed
18.
Moss, J. L., Gilkey, M. B., Reiter, P. L., & Brewer, N. T. (2012). Trends in HPV vaccine initiation among adolescent females in North Carolina, 2008–2010. Cancer Epidemiology, Biomarkers and Prevention, 21, 1913–1922.PubMedCentralCrossRefPubMed
19.
Nan, X., Zhao, X., & Briones, R. (2014). Parental cancer beliefs and trust in health information from medical authorities as predictors of HPV vaccine acceptability. Journal of Health Communication, 19(1), 100–114.CrossRefPubMed
20.
21.
Newmann, S. J., & Garner, E. O. (2005). Social inequities along the cervical cancer continuum: a structured review. Cancer Causes and Control, 16(1), 63–70.CrossRefPubMed
22.
Peters, S. J., Hansen, K. A., & Quevillon, R. P. (2013). Adolescent human papillomavirus vaccination and contraception in medically rural compared with urban environments. Obstetrics and Gynecology, 123, 30S–31S.CrossRef
23.
Regan, J., Schempf, A. H., Yoon, J., & Politzer, R. M. (2003). The role of federally funded health centers in serving the rural population. The Journal of Rural Health, 19(2), 115–124.CrossRef
24.
Reiter, P. L., Brewer, N. T., Gottlieb, S. L., McRee, A., & Smith, J. S. (2009). Parents’ health beliefs and HPV vaccination of their adolescent daughters. Social Science and Medicine, 69(3), 475–480.CrossRefPubMed
25.
Roberts, M. E., Gerrard, M., Reimer, R., & Gibbons, F. X. (2010). Mother-daughter communication and human papillomavirus vaccination. Pediatrics, 125, 982–989.CrossRefPubMed
26.
Rosenthal, S. L., Rupp, R., Zimet, G. D., Meza, H. M., Loza, M. L., Short, M. B., et al. (2008). Uptake of HPV vaccine: Demographics, sexual history and values, parenting style, and vaccine attitudes. Journal of Adolescent Health, 43(3), 239–245.CrossRefPubMed
27.
Sandri, K. J., Verdenius, I., Bartley, M. J., Else, B. M., Paynter, C. A., Rosemergey, B. E., et al. (2014). Urban and rural safety net health care system clinics: no disparity in HPV4 vaccine completion rates. PLoS One, 9(5). doi:10.​1371/​journal.​pone.​0096277.
28.
Singh, G. K. (2012). Rural-urban trends and patterns in cervical cancer mortality, incidence, stage, and survival in the United States, 1950–2008. Journal of Community Health, 37, 217–223.CrossRefPubMed
29.
Smith, P. J., Chu, S. Y., & Barker, L. E. (2004). Children who have received no vaccines: Who are they and where do they live? Pediatrics, 114(1), 187–195.CrossRefPubMed
30.
31.
Van Kriekinge, G., Castellsague, X., Cibula, D., & Demarteau, N. (2014). Estimation of the potential overall impact of human papillomavirus vaccination on cervical cancer cases and deaths. Vaccine, 32(6), 733–739.CrossRefPubMed
32.
Widdice, L. E., Bernstein, D. I., Leonard, A. C., et al. (2011). Adherence of the HPV vaccine dosing intervals and factors associated with completion of 3 doses. Pediatrics, 127, 77–84.PubMedCentralCrossRefPubMed
33.
Wong, C. A., Berkowtiz, Z., Dorell, C. G., et al. (2011). Human papillomavirus vaccine uptake among 9- to 17-year old girls: National Health Interview Survey, 2008. Cancer, 117(24), 5612–5620.PubMedCentralCrossRefPubMed
34.
Yabroff, K. R., Lawrence, W. F., King, J. C., Mangan, P., Washington, K. S., Yi, B., et al. (2005). Geographic disparities in cervical cancer mortality: What are the roles of risk factor prevalence, screening, and use of recommended treatment? The Journal of Rural Health, 21(2), 149–157.CrossRefPubMed
Metadata
Title
Differences in Human Papillomavirus Vaccination Among Adolescent Girls in Metropolitan Versus Non-metropolitan Areas: Considering the Moderating Roles of Maternal Socioeconomic Status and Health Care Access
Authors
Shannon M. Monnat
Danielle C. Rhubart
Sherrie Flynt Wallington
Publication date
01-02-2016
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 2/2016
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-015-1831-x

Other articles of this Issue 2/2016

Maternal and Child Health Journal 2/2016 Go to the issue

OriginalPaper

Reflections of Black Women Who Choose to Breastfeed: Influences, Challenges and Supports

OriginalPaper

Factors Influencing Exclusive Breastfeeding in Early Infancy: A Prospective Study in North Central Nigeria

OriginalPaper

Life Course Factors Associated with Initiation and Continuation of Exclusive Breastfeeding

OriginalPaper

Perinatal Preparation for Effective Parenting Behaviors: A Nationally Representative Survey of Patient Attitudes and Preferences

OriginalPaper

Maternal Alcohol Consumption During the Perinatal and Early Parenting Period: A Longitudinal Analysis

OriginalPaper

Childbearing and Economic Work: The Health Balance of Women in Accra, Ghana