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PurposeThis study aimed to determine individual- and partner-level factors associated with human papillomavirus (HPV) infection in vaccinated and unvaccinated men.MethodsA total of 747 men, aged 13-26 years, completed a survey of sexual behaviors and were tested for genital and perianal/anal HPV (36 types). Sexual network variables included recent and lifetime concurrency (being in more than one sexual relationship at the same time) and recent sex partner discordance (by race, ethnicity, age, and number of sexual partners). We determined individual-level and sexual network variables associated with ≥1 HPV type and HPV16/18, stratified by vaccination status, using separate multivariable logistic regression models.ResultsParticipants' mean age was 21.2 years; 64% were positive for ≥1 HPV type and 21% for HPV16/18. Factors associated with ≥1 HPV type in unvaccinated men included recruitment site and lifetime concurrency. Factors associated with ≥1 HPV type among vaccinated men included recruitment site, Chlamydia history, main male partner, number of lifetime female partners, and no condom use with female partner. Factors associated with HPV16/18 in unvaccinated men included race and partner concurrency. Factors associated with HPV16/18 in vaccinated men included ethnicity, main male partner, and recent concurrency.ConclusionsSexual network variables associated with HPV infection were different based on vaccination status and HPV type, suggesting risk factors for HPV infection may change as the proportion of vaccinated men increases. In addition, participant report of concurrency and not knowing whether one had practiced concurrency were consistent risk factors; clinicians should consider including concurrency in the sexual history to determine the risk of HPV.

In the USA, persons of Hispanic ethnicity experience higher rates of adolescent pregnancy and STIs than non-Hispanic white youth and there exists a lack of research concerning the sexuality education preferences of Hispanic adolescents. This study describes sexual health education preferences by Hispanic ethnicity among a high-risk sample of young people aged 14-20 years in Texas. Data were collected from participants in a teenage pregnancy prevention programme. Questions included preferred topics, provider of information and learning modality. Just over half of the participants was Hispanic (60%), nearly all participants were sexually experienced (96%) and more than half had been pregnant or caused a pregnancy (66%). Hispanic participants were significantly less likely to want to learn about sexual health from parents compared to non-Hispanic participants. Hispanic participants were also significantly less likely to prefer to learn about puberty and adolescent development, or to select role-playing as a preferred learning modality. Findings from the study provide evidence about the kind of sexual health topics US Hispanic adolescents are interested in as well as from who they prefer to receive sexuality education. Understanding these educational preferences can be useful to inform future policy and programming.

Background: School nurses and personnel play a vital role in promoting the human papillomavirus (HPV) vaccine. The purpose of this study was to identify factors associated with school nurses' and personnel's professional practice to provide parents with HPV vaccine information and to encourage parents to vaccinate their child against HPV. Methods: School nurses and personnel from Ohio and Missouri completed a survey to assess their professional practice in providing HPV vaccine information and encouraging parents to vaccinate their child against HPV. Independent variables included demographics, HPV knowledge/attitudes, perceptions of their as an opinion leader for the HPV vaccine, self-efficacy to provide vaccine education, and perception of school district support. Results: Providing parents with HPV vaccine information was predicted by age, role within the school, grade-serving, knowledge, perceptions, self-efficacy, and district support; accounting for 38% of the variance (p < 0.000, R[superscript 2] = 0.38). Encouraging parents to vaccinate their child against HPV was predicted by perception, self-efficacy, and grade-serving; accounting for 39% of the variance (p < 0.000, R[superscript 2] = 0.39). Conclusions: To enhance school nurses' and personnel's professional practice, interventions should focus on nurses' and personnel's perception of their role as opinion leaders and self-efficacy to provide HPV education and vaccine recommendation.

Virtual reality (VR) may be a viable method to observe and describe signals of implicit bias. Using the context of the human papillomavirus vaccine counseling, we sought to describe physicians' communication practices exploring differences when counseling parents with different skin colors. Physicians (N = 90) at an academic primary care center were recruited for a VR study in which they counseled dark or light-skinned parent avatars who expressed hesitation about human papillomavirus vaccination for their adolescent child. Investigators coded previously recorded simulations. Associations between communication and parent skin color were examined using t-tests and Chi-square tests. Both direct (e.g., addressing the concern immediately) and circuitous (e.g., providing alternative information) communication patterns were observed. Physicians used passive voice less commonly when counseling dark-skinned versus light-skinned avatars (p <.05). VR demonstrated feasibility in capturing clinicians' communication behaviors including measuring eight distinct indicators of implicit bias. [ABSTRACT FROM AUTHOR]

Purpose: Identify variables, including moderating variables, associated with adolescents, young adults, and parents' intention to receive a COVID-19 vaccine in January 2021. Design: Cross-sectional survey. Setting: United States Midwestern academic medical center. Sample: Adolescents (n = 242); young adults (n = 333); parents (n = 563). Measures: Associations between predictors—participant characteristics, general vaccine hesitancy, COVID-19 and vaccine knowledge, perceptions, and normative beliefs—and intention to receive a COVID-19 vaccine (outcome) were assessed. To determine variables impacting the strength of the relationship between predictors and outcome, moderators included 2020/2021 influenza vaccine receipt, having experienced discrimination, and primary sources of information for COVID-19. Analysis: Multivariable logistic regression examined associations, including moderating effects, for adolescents, young adults, parents, and parents for child. Results: With 20,231 email addresses receiving the survey, 1138 participants were included in the analysis. Intention to receive a COVID-19 vaccine was reported by 60.7% adolescents (n = 147), 65.2% young adults (n = 217), and 38.5% parents (n = 217) and 38.2% parents (n = 215) intended to vaccinate their child. Intention was associated with lower general vaccine hesitancy for adolescents (AOR = 1.50), young adults (AOR = 1.39), parents (AOR = 1.18), and parents' intention for their child (AOR = 1.17). Parents citing reputable medical experts as primary source of COVID-19 information positively moderated vaccine perceptions and intention for self (AOR = 8.25) and child (AOR = 6.37). Conclusion: Clinician training to address vaccine hesitancy may be effective at promoting positive COVID-19 vaccine perceptions. [ABSTRACT FROM AUTHOR]

At-risk adolescents may experience Social Determinants of Health (SDoH) that lead to higher rates of risky sexual behavior, including increased risk of pregnancy and sexually transmitted infections. These SDoH may include components such as unstable family structures, incomplete education, and poverty. Targeting at-risk youth for sexuality education is one way to work toward decreasing sexual health disparities. However, preferences for sexuality education approaches may differ among at-risk youth by additional factors including sex and sexual orientation. The purpose of this study was to describe sexuality education preferences among at-risk youth and how sexuality education preferences differ based on sex and sexual orientation in an at-risk sample of high school-aged youth in Texas. Results indicate sexuality education preferences differ based on sex and sexual orientation when examined by sexual health topics and methods of delivery. Implications of this study indicate including at-risk youth in sexual health programs may be a way to target those at-risk of adverse SDoH, but these groups also have specific preferences for sexuality education.

We performed a secondary analysis of Adolescent Health Risk Behavior Survey data (N=937), examining associations between lifetime alcohol and marijuana use with intrapersonal (i.e., risk perceptions) and interpersonal (e.g., peer approval and behavior) factors. Multinomial and binary logistic regression analyses contend students reporting lifetime alcohol use--compared to students who had never used alcohol or marijuana--perceived lower alcohol risk (p < 0.001), higher friend drinking approval (p < 0.001), and greater friend drinking (p = 0.003). Using both alcohol and marijuana in one's life was associated with being in public schools (p = 0.010), higher grade levels (p = 0.001), lower perceived alcohol (p = 0.011) and marijuana use risk (p = 0.003), higher friend approval of alcohol (p < 0.001) and marijuana use (p < 0.001), and believed more friends used alcohol (p < 0.001). Compared to lifetime alcohol only, perceived friend academic performance decreased the risk of lifetime alcohol and marijuana use (p = 0.043). Findings are beneficial to school nurses with students experiencing effects associated with substance use.

The purpose of this study was to describe college-aged females' human papillomavirus (HPV) knowledge and beliefs, perceptions and perceived benefits of the HPV vaccine, and identify characteristics associated with vaccination status and support for HPV vaccine mandates. Data were collected from 1,105 females by an Internet-delivered questionnaire during February to March 2011. This descriptive study utilizes ?[superscript 2] tests and t-tests to compare participant responses. HPV-related knowledge scores were 8.08 out of 11 points. Those who initiated HPV vaccination were significantly younger, single, engaged in sex, were sexually active, and had a Pap test. Participants who had more friends receiving the vaccine were significantly more likely to support mandates for 9-11 and 12-17 years and were more likely to complete the HPV vaccination cycle. Findings suggest the importance of educational programs adopted and delivered by school nurses, which aim to improve student knowledge and reduce misconceptions related to the HPV vaccine and vaccination mandates.

Background: We examine personal characteristics, alcohol consumption, normative beliefs, household factors, and extracurricular engagement associated with intentions to have intercourse before marriage among abstinent students. Methods: Data were analyzed from 245 freshmen enrolled in a school-based abstinence-only-until-marriage program. Two binary logistic regression analyses identified factors associated with intentions to engage in intercourse before marriage and within the next year. Results: Approximately 21% and 14% of participants reported intentions to have intercourse. Respondents participated in 2.2 (standard deviation [SD] = 1.2) extracurricular activities. Freshmen who were male, perceived their friends to approve of premarital sex, and consumed alcohol were more likely to report intentions to have intercourse. For every additional extracurricular activity in which freshmen participated, they were less likely to report intentions to have intercourse within the next year (odds ratio [OR] = 0.56). Conclusions: Factors such as extracurricular activities provide youth with opportunities to build supportive relationships, connect with peers and role models, and positively engage in schools and communities. Extracurricular activities typically already exist, have funding, and are generally well-supported. School-based strategies can increase teenagers' autonomy by providing a variety of activities to participate in and reduce unsupervised time. This, in turn, has the potential to decrease sexual risk taking behaviors.

Because U.S. human papillomavirus (HPV) vaccination rates remain low, we evaluated school nurses' knowledge, attitudes, perceptions of their role as opinion leaders, self-efficacy, intention, and professional practice regarding the HPV vaccine and determined if these variables influenced their professional practice concerning the HPV vaccine. We utilized a cross-sectional design by recruiting Ohio Association of School Nurses (OASN) members. Participants (n = 145) completed a paper survey during the OASN annual conference. Structural equation modeling was used to examine the proposed model. Our model yielded a well-fitting solution, ?[superscript 2] = 1.118 (degrees of freedom = 2, p = 0.57). Knowledge had positive effects on intention and self-efficacy. Attitude had a positive effect on perception of role as opinion leaders. Intention to provide HPV vaccine education had a positive effect on professional practice. To develop school nurses' practice, interventions should center on increasing knowledge, attitudes, and intention toward providing HPV vaccine education.

Background: Because human papillomavirus (HPV) vaccine rates remain low, we evaluated US school nurses' knowledge, attitudes, perceptions of their role as opinion leaders, and professional practice regarding HPV vaccine, and assessed whether knowledge, attitudes, and perceptions of being an opinion leader influenced their professional practice regarding the HPV vaccine. Methods: We used a cross-sectional design by recruiting members from the National Association of School Nurses. All participants (N?=?505) were e-mailed a survey designed for this study. Structural equation modeling (SEM) tested direct and indirect effects. Results: Overall, school nurses had knowledge about HPV and the vaccine, and positive attitudes toward the vaccine. They had less-than-enthusiastic perceptions of their role as opinion leaders regarding the vaccine and implemented few activities related to providing vaccine information. The model revealed a good fit (?[superscript 2]?=?20.238 [df?=?8, p?

The study purpose is to examine the impact of early substance use on lifetime and past year contraction of sexually transmitted diseases (STDs), including chlamydia, gonorrhea, herpes, and syphilis. A secondary analysis of the 2012 National Survey on Drug Use and Health (N = 52,529) was conducted to determine if lifetime or past year STD contraction differed based on demographic differences. Lifetime and past year contraction based on first use of substance before age 21 differed based on sex, race/ethnicity, age, alcohol, marijuana, crack, and sedatives. Recommendations for future studies are included.

The purpose of this paper is to examine the differences between statistical and practical significance, including strengths and criticisms of both methods, as well as provide information surrounding the application of various effect sizes and confidence intervals within health education research. Provided are recommendations, explanations and examples of reporting effect size and confidence intervals. Understanding and integrating practical significance measures provides health education scholars and practitioners with the tools to address issues related to statistical and practical significance. (Contains 2 tables.)

While most adolescents experience mild-COVID-19 infection, those with underlying medical conditions have an increased risk of severe health outcomes. Furthermore, compared with other pediatric populations, adolescents have experienced higher rates of COVID-19–associated hospitalization. COVID-19 vaccine decision-making in adolescents during COVID-19 surges is not well understood. Our objective was to explore factors influencing parental and adolescents’ COVID-19 vaccine decision-making during the Omicron winter 2021/2022 surge. Participants were recruited from an academic pediatric primary care clinic. Eligible adolescents (aged 12–17 years) who received their first dose of the COVID-19 vaccine between December 2021 and February 2022 were recruited to participate in a semistructured interview with their parent. Perspectives were illuminated through thematic analysis of the data that included coding and pattern identification. Ten parent–adolescent dyads’ interview data were analyzed and classified into three principal themes influencing vaccine acceptance during the Omicron surge: perceived risk of COVID-19 infection, family member influence, and clear, two-way communication with a clinician. Despite widespread COVID-19 vaccine availability for adolescents, vaccination rates remain suboptimal even during times of increased disease prevalence. Using health promotion practices to emphasize perceived risk of infection while navigating family dynamics through two-way communication during COVID-19 surges may support vaccine uptake. [ABSTRACT FROM AUTHOR]

Missed clinical opportunities and the lack of strong and consistent vaccine recommendations are key reasons for low HPV vaccination rates. The purpose of this study was to conduct a pilot evaluation of a web-based training's impact on knowledge, attitudes, and self-efficacy related to providing evidence-based HPV vaccine recommendations. Participants completed three online interactive learning modules and the HPV Vaccine: Same Way, Same Day™ smartphone application (app). Participants completed a pre-training survey, immediate post-training survey, and two-month post-survey. Participants demonstrated a statistically significant increase in knowledge scores from T1 to T2 and T1 to T3. Mean attitudes for recommending HPV vaccination for female patients increased from T1 to T2 and T1 to T3. Mean attitudes for recommending HPV vaccination for male patients increased from T1 to T2 and T1 to T3. Mean self-efficacy scores increased from T1 to T2 and T1 to T3. The HPV Vaccine: Same Way, Same Day™ app is a promising strategy for improving HPV vaccine recommendations among physicians. Future research should explore long-term effects and enroll attending and community physicians to examine its efficacy in other physician populations. [ABSTRACT FROM AUTHOR]