title: Knowledge, attitudes, and beliefs regarding HPV vaccination: ethnic and cultural differences between African-American and Haitian immigrant women.
abstract: BACKGROUND
  Black women have higher rates of cervical cancer and lower rates of HPV vaccination than White women in the United States, and Haitians may be an especially vulnerable subgroup of Black women. To reduce these disparities, understanding differences among subgroups of Black women is crucial.
  
  
  METHODS
  The objective of our study was to assess similarities and differences in the knowledge, attitudes, beliefs, and practices toward HPV vaccination and actual vaccination rates among African-American and Haitian immigrant women and their daughters. We used validated surveys of HPV knowledge, trust in physicians, acculturation, and constructs of the health belief model: Perceived susceptibility, severity, and barriers. We probed women's thought processes about vaccination using open-ended questions. We then reviewed medical records to determine vaccination rates.
  
  
  RESULTS
  Nineteen African Americans and 51 Haitians participated. Although 75% of Haitians and 63% of African Americans intended to vaccinate their daughters, only 47% of African-American and 31% of Haitian daughters were vaccinated. African Americans were more knowledgeable than Haitians and had more prior experience with HPV disease. Most African Americans felt that vaccination fell within the parental role, whereas many Haitians felt uncomfortable vaccinating against sexually transmitted infections because they felt children should not be having sex. Both ethnic groups wanted more information about HPV vaccines.
  
  
  CONCLUSIONS
  Cultural differences between African-American and Haitian immigrant mothers revealed distinct barriers for vaccine acceptance. Improving HPV vaccine rates in Black women may require culturally competent and sensitive approaches that address ethnic-specific barriers.
authors.affiliation: Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts, USA. napierre@bu.edu
authors.forename: Natalie Pierre
authors.initials: NP
authors.lastname: Joseph
authors.forename: Jack A
authors.initials: JA
authors.lastname: Clark
authors.forename: Howard
authors.initials: H
authors.lastname: Bauchner
authors.forename: Jared P
authors.initials: JP
authors.lastname: Walsh
authors.forename: Glory
authors.initials: G
authors.lastname: Mercilus
authors.forename: Jean
authors.initials: J
authors.lastname: Figaro
authors.forename: Caroline
authors.initials: C
authors.lastname: Bibbo
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: Perkins
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D002648:Child; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006205:Haiti / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000523:psychology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D010465:Perception; D036301:Qualitative Research; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines