A Narrative Engagement Framework to Understand HPV Vaccination Among Latina and Vietnamese Women in a Planned Parenthood Setting

Suellen Hopfer, Samantha Garcia, Huong T Duong, Jennefer A Russo, Sora P Tanjasiri, Suellen Hopfer, Samantha Garcia, Huong T Duong, Jennefer A Russo, Sora P Tanjasiri

Abstract

Disparities in cervical cancer and human papillomavirus (HPV) vaccination persist among Vietnamese and Latina women. Through a partnership with Planned Parenthood of Orange and San Bernardino Counties (PPOSBC) in Southern California, we conducted in-depth interviews with young adult Latina ( n = 24) and Vietnamese ( n = 24) women, and PPOSBC staff ( n = 2). We purposively sampled vaccinated women to elicit HPV vaccine decision narratives to uncover rich data on motivators, cultural values, and implicit vaccine attitudes. Unvaccinated women were interviewed to identify barriers. Women were also asked to discuss their observations of men's HPV vaccine attitudes. Narrative engagement theory guided the study privileging the meaning women ascribed to their experiences and conversations related to vaccine decision making. Vaccine decision narratives included (a) mother-daughter narratives, (b) practitioner recommendation of HPV vaccination, (c) independence narratives among Vietnamese women, (d) HPV (un)awareness narratives, and (d) school exposure to HPV knowledge. Barriers to vaccinating included trust in partner HPV status, and family silence and stigma about sexual health. Participants conveyed the importance of including messages aimed at reaching men. Practitioners described insurance barriers to offering same day vaccination at PPOSBC health center visits. Narrative communication theory and methodology address health equity by privileging how Vietnamese and Latina women ascribe meaning to their lived experiences and conversations about HPV vaccination. Identifying authentic and relatable vaccine decision narratives will be necessary to effectively engage Vietnamese and Latina women. These findings will guide the process of adapting an existing National Cancer Institute research-tested HPV vaccine intervention.

Keywords: HPV vaccine; Latina cancer disparities; Vietnamese cancer disparities; health equity; narrative engagement; planned parenthood.

Conflict of interest statement

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. American Cancer Society. Cancer facts & figures for Hispanics/Latinos 2015–2017. Atlanta, GA: Author; 2015.
    1. Are immunizations free under Obamacare? 2015 Retrieved from .
    1. Babtiste I. Qualitative data analysis: Common phases, strategic differences. Forum: Qualitative Social Research. 2001;2(3) doi: 10.17169/fqs-2.3.917.
    1. Banks J. Storytelling to access social context and advance health equity research. Preventive Medicine. 2012;55:394–397.
    1. Braveman P. What are health disparities and health equity? We need to be clear. Public Health Reports. 2014;129(Suppl 2):5–8.
    1. Braveman PA, Kumanyika S, Fielding J, LaVeist T, Borrell LN, Manderscheid R, Troutman A. Health disparities and health equity: The issue is justice. American Journal of Public Health. 2011;101(Suppl 1):S149–S155.
    1. Burlingame P. New bill will strengthen sex education in California. 2015 May 29; Retrieved from .

    1. CA Assembly Bill (AB) 329, 329 (2015).

    1. Calo WA, Gilkey MB, Shah PD, Moss JL, Brewer NT. Parent’s support for school-entry requirements for human papillomavirus vaccination: A national study. Cancer Epidemiology, Biomarkers & Prevention. 2016;25:1317–1325.
    1. Cappella J, Hornik RC. The importance of communication science in addressing core problems in public health. In: Carbaugh D, Buzzanell PM, editors. Distinctive qualities in communication research. New York, NY: Routledge; 2009. pp. 73–86.
    1. Charmaz K. Constructing grounded theory. Thousand Oaks, CA: Sage; 2012.
    1. Clandinin DJ. Narrative inquiry: A methodology for studying lived experience. Research Studies in Music Education. 2006;27(1):44–54.
    1. Dempsey A, Cohn L, Vanessa D, Mack R. Worsening disparities in HPV vaccine utilization among 19–26 year old women. Vaccine. 2011;29:528–534. doi: 10.1016/j.vac-cine/2010.10.051.
    1. Facts and figures: Santa Ana history and population. Santa Ana, CA: Santa Ana Public Library; 2017.
    1. Fang CY, Ma GX, Tan Y. Overcoming barriers to cervical cancer screening among Asian American women. North American Journal of Medical Sciences. 2011;4:77–83.
    1. Fisher WR. Human communication as narration: Toward a philosphy of reason, value, and action. Columbia: University of South Carolina Press; 1987.
    1. Getrich CM, Sussman AL, Helitzer DL, Hoffman RM, Warner TD, Sanchez V, … Rhyne R. Expressions of machismo in colorectal cancer screening among new Mexico Hispanic subpopulations. Qualitative Health Research. 2012;22:546–559.
    1. Gilkey MB, Malo TL, Shah PD, Hall ME, Brewer NT. Quality of physician communication about human pap-illomavirus vaccine: Findings from a national survey. Cancer Epidemiology, Biomarkers & Prevention. 2015;24:1673–1679.
    1. Gomez SL, Noone AM, Lichtensztajn DY, Scoppa S, Gibson JT, Liu L, … Miller BA. Cancer incidence trends among Asian American populations in the United States, 1990–2008. Journal of National Cancer Institute. 2013;105:1096–1110.
    1. Grose RG, Grabe S, Kohlfeldt D. Sexual education, gender ideology, and youth sexual empowerment. Journal of Sex Research. 2014;51:742–753.
    1. Hall M, Graffunder C, Metzler M. Policy approaches to advancing health equity. Journal of Public Health Management Practice. 2016;22(Suppl 1):S50–S59.
    1. Hecht ML, Miller-Day M. Drug resistance strategies project: Using narrative theory to enhance adolescents’ communication competence. In: Cissna K, Frey L, editors. Handbook of applied communication: Exemplary programs. New York, NY: Routledge; 2009. pp. 535–557.
    1. Hinyard LJ, Kreuter MW. Using narrative communication as a tool for health behavior change: A conceptual, theoretical, and empirical overview. Health Education & Behavior. 2007;34:777–792.
    1. Hopfer S. Effects of a narrative HPV vaccine intervention aimed at reaching college women: A randomized controlled trial. Prevention Science. 2012;13:173–182. doi: 10.1007/s11121-011-0254-1.
    1. Hopfer S, Clippard JR. College women’s HPV vaccine decision narratives. Qualitative Health Research. 2011;21:262–277. doi: 10.1177/1049732310383868.
    1. Hopfer S, Ray AE, Hecht ML, Miller-Day M, Belue R, Zimet G. Taking an HPV vaccine research tested intervention to scale in a clinical setting. Translational Behavioral Medicine (in press)
    1. Jin H, Pinheiro PS, Xu J, Amei A. Cancer incidence among Asian American populations in the United States, 2009–2011. Cancer Epidemiology. 2016;138:2136–2145. doi: 10.1002/ijc.29958.
    1. Kim JL, Ward LM. Silence speaks volumes: Parental sexual communication among Asian American emerging adults. Journal of Adolescent Research. 2007;22:3–31.
    1. Kreuter MW, Green MC, Cappella JN, Slater MD, Wise ME, Storey D, … Woolley S. Narrative communication in cancer prevention and control: A framework to guide research and application. Annals of Behavioral Medicine. 2007;33:221–235. doi: 10.1007/BF02879904.
    1. Larkey LK, Hecht ML, Slater MD, Helitzer D, Kreuter MW, Lopez AM. A model of narrative as culture-centric health promotion. Paper presented at the Society for Behavioral Medicine; San Diego, CA. 2008. Mar,
    1. Miller-Day M, Hecht ML. Narrative means to preventive ends: A narrative engagement approach to adolescent substance use prevention. Health Communication. 2013;28:657–670.
    1. Moran MB, Murphy ST, Chatterjee JS, Amezola de Herrera P, Baezconde-Garbanati L. Mexican-American mother’s perceptions regarding vaccinating their daughters against HPV and recommended strategies to promote vaccine uptake. Women’s Reproductive Health. 2014;1:106–119. doi: 10.1080/2393691.2014.966033.
    1. Morse JM. Critical analysis of strategies for determining rigor in qualitative inquiry. Qualitative Health Research. 2015a;25:1212–1222.
    1. Morse JM. Data were saturated …. Qualitative Health Research. 2015b;25:587–588.
    1. National Cancer Institute. Fast Stats interactive tool US cancer statistics: SEER. 2014 Retrieved from .
    1. National Cancer Institute. HPV vaccine decision narratives: Encouraging informed HPV vaccine decision-making. 2015 Retrieved from .
    1. Niccolai LM, Hansen CE, Credle M, Shapiro ED. Parents’ recall and reflections on experiences related to HPV vaccination for their children. Qualitative Health Research. 2016;26:842–850.
    1. Parker JM, Wiltshire J. Research story and narrative in nursing: An object-relations approach. In: Latimer J, editor. Advanced qualitative research for nursing. Oxford, England: Oxford Blackwell Science; 2003. pp. 97–114.
    1. Petraglia J. The importance of being authentic: Persuasion, narration, and dialogue in health communication and education. Health Communication. 2009;24:176–185.
    1. Rendle KA, Leskinen EA. Timing is everything: Exploring parental decisions to delay HPV vaccination. Qualitative Health Research. 2016;27:1380–1390.
    1. Strauss A, Corbin J. Basics of qualitative research. Thousand Oaks, CA: Sage; 1998.
    1. U.S. Census Bureau. Orange County, California community facts. 2010a Retrieved from .
    1. U.S. Census Bureau. Westminster, California Vietnamese demographics. Suitland, MD: Author; 2010b.
    1. Vo LT. The formation of post-suburban communities: Koreatown and Little Saigon, Orange County. International Journal of Sociology and Social Policy. 2004;24:15–45.
    1. Williams WW, Lu PJ, O’Halloran A, Kim DK, Grohskopf LA, Pilishvili T, … Bridges CB. Surveillance of vaccination coverage among adult populations—United States, 2014. Morbidity and Mortality Weekly Report. 2016;65:1–36.
    1. Yi JK, Lackey SC, Zahn MP, Castaneda J, Hwang JP. Human papillomavirus knowledge and awareness among Vietnamese mothers. Journal of Community Health. 2013;38:1003–1009.

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