title: Fatalistic beliefs and completion of the HPV vaccination series among a sample of young Appalachian Kentucky women.
abstract: OBJECTIVE
  Uptake and completion of the 3-dose human papillomavirus (HPV) vaccine is important for the primary prevention of cervical cancer. However, HPV vaccination rates among adolescent females and young women remain low in certain geographic areas of the United States, including Appalachia. Although greater fatalistic beliefs have been previously associated with lower rates of preventive cancer behaviors among adults, little research exists on the impact of fatalism on HPV vaccination behaviors, especially among younger individuals. Therefore, the purpose of this study was to examine the association between fatalistic beliefs and completion of the full HPV vaccine series among young women, ages 18-26, in Appalachian Kentucky.
  
  
  RESULTS
  Data from this study were from a baseline survey completed by 344 women randomized into a communication intervention trial focused on increasing adherence to the 3-dose HPV vaccine series. Principal components analysis was used to construct 2 fatalism-related subscales from 8 survey questions.
  
  
  RESULTS
  In a controlled analysis, 1 subscale--"lack of control over cancer"--was significantly associated with not completing the full HPV vaccine series. In a rural area that experiences higher rates of cervical cancer, poverty, limited access to health care, and negative cancer-related attitudes and experiences, fatalism may be common, even among young people.
  
  
  CONCLUSIONS
  Future educational and interventional research addressing fatalistic beliefs in a culturally sensitive manner may be warranted to improve HPV vaccination behaviors and impact cancer disparities among Appalachian women.
authors: College of Public Health, University of Kentucky, Lexington, Kentucky.
authors: Robin C
authors: RC
authors: Vanderpool
authors: Emily Van Meter
authors: EV
authors: Dressler
authors: Lindsay R
authors: LR
authors: Stradtman
authors: Richard A
authors: RA
authors: Crosby
mesh_terms: D000293:Adolescent; D000328:Adult; D001061:Appalachian Region; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007115:Immunization Schedule; D007629:Kentucky; D008487:Medical History Taking; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000523:psychology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D012424:Rural Population; D012959:Socioeconomic Factors; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000523:psychology; D016387:Women's Health; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Appalachia; HPV vaccination; health disparities; health promotion; utilization of health services
references: Cancer Epidemiol Biomarkers Prev. 2011 Oct;20(10):2132-40
references: 21953115
references: Ann Behav Med. 2011 Aug;42(1):79-90
references: 21472484
references: J Rural Health. 2005 Spring;21(2):149-57
references: 15859052
references: J Cancer Educ. 2013 Jun;28(2):254-61
references: 23355279
references: Sex Health. 2007 Mar;4(1):71-3
references: 17382042
references: Prev Med. 2007 Aug-Sep;45(2-3):107-14
references: 17628649
references: J Rural Health. 2011 Winter;27(4):380-4
references: 21967381
references: J Health Care Poor Underserved. 2008 Nov;19(4):1321-35
references: 19029755
references: J Rural Health. 2004 Fall;20(4):368-73
references: 15551854
references: Cancer Epidemiol Biomarkers Prev. 2011 Oct;20(10):2127-31
references: 21876191
references: Nurs Clin North Am. 2011 Jun;46(2):181-92, vi
references: 21501729
references: Health Educ Monogr. 1978 Spring;6(2):160-70
references: 689890
references: MMWR Morb Mortal Wkly Rep. 2002 Jun 21;51(24):527-9
references: 12088143
references: CA Cancer J Clin. 1989 Sep-Oct;39(5):266-88
references: 2513099
references: Oncol Nurs Forum. 2007 Nov;34(6):1133-9
references: 18024340
references: Ethn Health. 2009 Dec;14(6):607-24
references: 19953392
references: Cancer Nurs. 2003 Dec;26(6):454-65; quiz 466-7
references: 15022977
references: J Prim Prev. 2013 Apr;34(1-2):71-80
references: 23325057
references: Cancer Epidemiol Biomarkers Prev. 2007 May;16(5):998-1003
references: 17507628
references: J Relig Health. 1995 Jun;34(2):119-26
references: 24264364
references: Prev Chronic Dis. 2006 Oct;3(4):A125
references: 16978500
references: Psychol Health. 2009 Jun;24(5):597-613
references: 20205014
references: PLoS One. 2013;8(8):e74276
references: 24023700
references: Qual Health Res. 2012 Apr;22(4):476-87
references: 22068039
references: Hum Vaccin Immunother. 2013 Jan;9(1):90-6
references: 23143774
references: MMWR Morb Mortal Wkly Rep. 2014 Feb 7;63(5):95-102
references: 24500288
references: MMWR Morb Mortal Wkly Rep. 2010 May 28;59(20):626-9
references: 20508593
references: J Health Commun. 2010;15 Suppl 3:78-91
references: 21154085
references: Med Anthropol Q. 2011 Jun;25(2):164-82
references: 21834356
references: J Cancer Educ. 2013 Sep;28(3):521-6
references: 23813489
references: J Women Aging. 2001;13(1):57-72
references: 11217186
references: Fam Community Health. 2011 Apr-Jun;34(2):126-33
references: 21378509
references: Cancer Epidemiol Biomarkers Prev. 2008 Aug;17(8):1872-9
references: 18708374
references: MMWR Recomm Rep. 2014 Aug 29;63(RR-05):1-30
references: 25167164
references: J Commun. 2013 Feb;63(1):95-115
references: 26560123
references: Public Health Nurs. 2013 Jul;30(4):351-60
references: 23808860
references: Vaccine. 2009 Jun 19;27(30):3945-52
references: 19389447
references: Cancer. 2008 Jan 1;112(1):181-92
references: 18000806
references: Cancer Epidemiol Biomarkers Prev. 2012 Dec;21(12):2220-30
references: 23136141
references: Prev Chronic Dis. 2013;10:E17
references: 23391293
references: J Health Commun. 2014;19(1):100-14
references: 24093156