The purpose of this study was to investigate if there were any differences in in the Knowledge, attitude and intention to obtain HPV vaccination among the male and female undergraduates of a selected Community College in St. Lucia.
Methods:
A descriptive, quantitative and cross-sectional study. Previous research conducted of HPV has indicated many misconceptions and misperceptions of HPV and HPV vaccinations. Education and knowledge on HPV plays a significant role in the intention of receiving HPV vaccinations (Lambert, 2014). It is important to recognize benefits and barriers to obtaining HPV vaccinations to increase vaccination rates.
In the review of literature findings, problems pertaining to minimal knowledge level and awareness of HPV vaccine and cultural hurdles of HPV vaccination were discussed. The studies incorporated in this review showed a general lack of knowledge about HPV and HPV vaccine among males and females in some Caribbean countries as well as international countries such as China (Ribeiro et al., 2015; Lambert, 2014; Perrotte et al., 2011; Villa, 2012). On the other hand, knowledge deficit about HPV is not the only issue for males and female in the Caribbean but also the high cost attributed to the HPV vaccine (Stocker et al., 2013). Additional studies in Western countries, comparatively well-developed society, also showed similar deficiency in knowledge of HPV. As the deficiency of knowledge could be one of the obstacles for acceptance of HPV vaccine, the findings from current research suggest that there is an instantaneous and dire need for public education on HPV and its vaccines. Notwithstanding the low level of knowledge and awareness about HPV and HPV vaccines, studies conveyed relatively high intentions and optimistic attitudes toward HPV vaccination among males as well as females (Kim, 2015; Stocker et al., 2010, and Yanikkerem & Koker, 2013).
In general the various studies revealed some concerns about HPV vaccine efficacy, vaccine safety and side effects, overall cost of vaccine and the availability of insurance coverage for same (Fesenfeld, Hutubessy & Jit, 2014; Jit et al., 2014; and Laprise et al., 2014).
The present study was the first of its kind to be conducted in St. Lucia and an attempt was made to study the Knowledge, attitude and intention to obtain HPV vaccination among male and female undergraduate students at the selected Community College in St. Lucia.
The participants (n=100) were selected using stratified random sampling. Samples were drawn from five Departments viz Department of Arts, Science and General Studies; Department of Health Sciences; Department of Agriculture; Department of Teacher Education; and Department of Technical, management Studies.The objectives of the study were; to determine the knowledge, attitude and intention to obtain HPV vaccination among subjects and to examine the association of knowledge, attitude and intention to obtain HPV vaccination with selected social, demographic variables among subjects. Criteria for selection of the sample included respondents who were: Male or female between the ages of 18 to 26, willing to participate voluntarily. And full time students studying in the five main departments at the selected Community College. Exclusion criteria was respondents who were part time, on-line students and who did not give consent for the study. The Health Belief Model (HBM) was utilized as a framework for this study.
Ethical approval was obtained from the UWI Campus Ethics Committee as well as the college Ethics Board to conduct the study. Subjects of this research study had the right to consent freely in the absence of coercion. They were offered the right to refuse to participate, or to withdraw at any time with no explanation, and without consequences or coercion of any kind.
Self-administered questionnaire were distributed to 100 undergraduate, full-time students at the selected college, in St. Lucia to assess socio-demographic characteristics, knowledge, and statements on vaccinations. Self-administered questionnaire included demographic profile and knowledge of HPV and HPV (10 items) vaccination (24 Items) Responses to items were rated using a 3-point Likert scale ranging from 3 (yes) to 1 (don’t know) point and an Opinionnaire on attitude and intention to obtain of the HPV vaccination (15 items). Responses to items were rated using a 5-point Likert scale ranging from 4 (strongly agree) to 0 (strongly disagree). Scoring and Interpretation of reliability & validity of the tool was established through test retest method. Data were analyzed using SPSS. Multivariable statistical methods were applied to identify independent predictors for HPV-vaccine uptake among participants.
Limitations of the study is that it focused on the geographical region of St. Lucia which may not necessarily be applicable to other Caribbean territories.
Results:
The analysis of the data was based on the research question; What is the Knowledge, attitude and intention to obtain HPV vaccination among the male and female undergraduates at the selected Community College in St. Lucia? Are there differences in knowledge, attitude and intention to obtain HPV vaccine that may impact one’s likelihood of seeking medical aid? How informed are the subjects on HPV vaccination and it effectiveness in preventing cancer (cervical, oral) at the Sir Arthur Lewis Community College in St. Lucia?
The analysis of results showed majority, 56% of respondents were of African race and 93% do not have migration background. Nearly 75% respondents had past sexual intercourse. Most of the respondents 69% were not aware of HPV vaccination, 92% of them were not vaccinated against HPV, 51% of them felt the need for vaccination while 49% not. Majority of the respondents, 92% did not have history of abnormal pap smear or HPV infection, while 54% had not heard of the virus. However 46% confined that they had heard of the virus. Nearly 51% of the respondents had heard about the HPV vaccine while, 49% did not do not.
What was interesting though was almost 50% of the respondents felt a need for vaccination and heard of the virus and HPV vaccine. High T-values were found significant in the means of knowledge of HPV (1.35+0.57), HPV (1.08+0.75), HPV Causes (0.98+0.84), HPV and gender (1.04+0.53), HPV is preventable (0.84+0.54) and HPV infection is serious (0.68+0.54). All 6 variables showed P-values much less than the significance level (p<0.05).
Factor Analysis of knowledge, attitude and intention to obtain HPV vaccination with selected social, demographic variables among subjects was measured against 26 variables. HPV vaccine cause short term problems like fever or discomfort had fairly high correlation with Factor 1 (4.368), HPV vaccine is being pushed to make money for drug companies had fairly high correlation with Factor 2 (3.332), if a teenage girl gets the HPV vaccine, more likely to have sex had fairly high correlation with Factor 3 (2.204), HPV vaccine is unsafe had fairly high correlation with Factor 4 (1.935), the risk that HPV can cause diseases like cancer is too little had fairly high correlation with Factor 5 (1.693), not enough information about the HPV vaccine to decide whether to take it or not had fairly high correlation with Factor 6 (1.372), HPV vaccine is effective in preventing genital warts had fairly high correlation with Factor 7 (1.159), belief that the vaccine has too many side-effects had fairly high correlation with Factor 8 (1.101), and in general against vaccination had fairly high correlation with Factor 9 (1.006).
However the factor analysis of intension to obtain HPV did not show any significance.
Component matrix was done for all the 9 factors. Factor 6 and 9 did not explain any variance when compared with other factors. In the second component matrix, except factor 9 all factors showed correlation. In the third component matrix, except factor 7 and 8, all factors showed correlation.
A scree plot displays the eigenvalues associated with a component or factor in descending order versus the number of the component or factor. A factor analysis was conducted on 26 different characteristics of HPV. This scree plot shows that 9 of those factors explain most of the variability because the line starts to straighten after factor 9. The slope is changing after 2 variables which means that most of the variance is explained by initial two factors. The remaining factors explain a very small proportion of the variability and are likely unimportant.
Conclusion:
In conclusion despite risk acknowledgment the researcher had identified, the results revealed significant lack of public health promotion. Although HPV is very much prevalent in St. Lucia and it’s the causative factor for cancer in both men and women, not enough is being done to create awareness about HPV. Secondly, the vaccine is unavailable in St. Lucia. Thirdly, the high cost of the vaccine ($500 US) and HPV test ($275 EC) have proven to be a deterrent to obtain the aforementioned. HPV vaccine uptake was low among the participants; only 7 out of the 100 participants had been vaccinated and had received it in the United States. Although low vaccine uptake 53% agreed that there was a dire need for vaccination.