Strategies for Improving Participation in Human Papillomavirus Vaccination Among Young Adults in the Capital of Iran: A Qualitative–Exploratory Study

Soudabeh Yarmohammadi, Mohtasham Ghaffari, Parisa Mashayekhi, Ali Ramezankhani, Jamal Mirzaei

Abstract


Background: Different strategies can promote healthy behaviors. Although the human papillomavirus (HPV) vaccine is very important due to its effect in reducing cervical cancer, the behavior of HPV vaccination is low among young adults in Iran. Therefore, this study aimed to determine strategies for improving HPV vaccination among young adults.

Methods: The present study was conducted with a qualitative content analysis method. The participants were 30 health professionals and young adults in Tehran city who were selected using purposive and snowball sampling. The data were collected through semistructured interviews and analyzed by Graneheim and Lundman’s approach.

Results: In total, two categories were identified: (1) access to services: access to the vaccine, vaccine insurance coverage; (2) educational coverage: subgroup training, educational content, time for training, educational channels, education strategies, and educational conditions.

Conclusions: This is the first study conducted to determine strategies for improving HPV vaccination in Iran. The policymakers and planners, schools, and health centers are recommended to use the strategies obtained from this study to increase HPV vaccine imports, as well as increase the community members’ knowledge and acceptance of the HPV vaccine.


Keywords


Human papillomavirus vaccine; qualitative research; strategy

Full Text:

PDF

References


Human papillomavirus vaccines: WHO position paper, October

Wkly Epidemiol Rec. 2014;89:465-91.

Markowitz LE, Dunne EF, Saraiya M, Chesson HW,

Curtis CR, Gee J, et al. Human papillomavirus vaccination:

Recommendations of the Advisory Committee on Immunization

Practices (ACIP). MMWR Recomm Rep 2014;63:1‑30.

Centers for Disease Control and Prevention (CDC). National

and state vaccination coverage among adolescents aged

‑17 years‑‑United States, 2012. MMWR Morb Mortal Wkly

Rep 2013;62:685‑93.

Rashwan HH, Saat NZNM, Manan DNA. Knowledge, attitude

and practice of Malaysian medical and pharmacy students

towards human papillomavirus vaccination. Asian Pac J Cancer

Prev 2012;13:2279‑83.

Fontenot HB, Fantasia HC, Vetters R, Zimet GD. Increasing HPV

vaccination and eliminating barriers: Recommendations from

young men who have sex with men. Vaccine 2016;34:6209‑16.

Malakouti J, Mirghafourvand M, Gorbani M, Salehi Poormehr H,

Pourasad Shahrak S, Jafari Shabiri M. Incidence of Human

Papilloma Virus (HPV) infection and its relevant factors among

women referring to Alzahra Therapeutic‑Educational Center of

Tabriz, September 2013 to March 2014. Iran J Obstet Gynecol

Infertil 2016;18:16‑22.

Khatibi M, Rasekh HR, Shahverdi Z. Cost‑effectiveness

evaluation of quadrivalent human papilloma virus vaccine

for HPV‑related disease in Iran. Iran J Pharm Res

;13(Suppl):225‑34.

Brabin L, Roberts SA, Stretch R, Baxter D, Chambers G,

Kitchener H, et al. Uptake of first two doses of human

papillomavirus vaccine by adolescent schoolgirls in Manchester:

Prospective cohort study. BMJ 2008;336:1056‑8.

Rothholz MC, editor Pharmacists: Access to immunization

services. Presentation to the 1st National Stakeholder Meeting:

review of priorities in the National Vaccine Plan; 2008.

Kessels SJ, Marshall HS, Watson M, Braunack‑Mayer AJ,

Reuzel R, Tooher RL. Factors associated with HPV vaccine uptake

in teenage girls: A systematic review. Vaccine 2012;30:3546‑56.

Mohammad Pour F, Mnsouri A, Hadjibabaie M. Utilization

evaluation of human papilloma virus vaccine (GARDASIL®) in

Iran; a cross‑sectional study. Iran J Pharm Res 2020;19:68‑76.

Shafaghi B, Jarollahi A, Yousefzadeh B, Ameri A, Moghadam S,

Mostafavi M. Human papilloma virus prevalence and types

among Iranian women attending regular gynecological visits.

Rep Radiother Oncol 2013;1:e2389.

Kwan TT, Chan KK, Yip AM, Tam K, Cheung AN, Lee P, et al.

Barriers and facilitators to human papillomavirus vaccination among

Chinese adolescent girls in Hong Kong: A qualitative–quantitative

study. Sex Transm Infect 2008;84:227‑32.

Haesebaert J, Lutringer‑Magnin D, Kalecinski J, Barone G,

Jacquard A‑C, Régnier V, et al. French women’s knowledge

of and attitudes towards cervical cancer prevention and the

acceptability of HPV vaccination among those with 14–18 year

old daughters: A quantitative‑qualitative study. BMC Public

Health 2012;12:1034.

Cruz MRID, Tsark JAU, Chen JJ, Albright CL, Braun KL.

Human papillomavirus (HPV) vaccination motivators, barriers,

and brochure preferences among parents in multicultural Hawai

‘i: A qualitative study. J Cancer Educ 2017;32:613‑21.

Yarmohammadi S, Taheri G, Mousavi SS, Sheikhehpour M,

Paykoub MH, Hashemian AH. The effect of education on

knowledge, attitude and practice of patients with vaginitis. Adv

Biol Res 2015;9:196‑200.

Batista Ferrer H, Trotter CL, Hickman M, Audrey S. Barriers

and facilitators to uptake of the school‑based HPV vaccination

programme in an ethnically diverse group of young women.

J Public Health 2016;38:569‑77.

Fontenot HB, Fantasia HC, Zimet GD. Increasing HPV

vaccination and eliminating barriers: Recommendations

from young men who have sex with men. J Adolesc Health

;60:S124‑5.

Tissot AM, Zimet GD, Rosenthal SL, Bernstein DI, Wetzel C,

Kahn JA. Effective strategies for HPV vaccine delivery: The

views of pediatricians. J Adolesc Health 2007;41:119‑25.

Patel DA, Zochowski M, Peterman S, Dempsey AF, Ernst S,

Dalton VK. Human papillomavirus vaccine intent and

uptake among female college students. J Am Coll Health

;60:151‑61.