Young women and an affirmative decision to get the HPV vaccine occurs less often among ethnic minorities, and Asian and Black women are at an increased risk of developing cervical cancer (Ferrer, Trotter, Hickman & Audrey, 2015). A socio-ecological model will identify barriers and facilitators to getting the vaccine, and this will aid in the development of actions to promote positive health outcomes among ethnic minorities. Five levels of influence will be considered: interpersonal factors, interpersonal processes and relations with primary social groups, institutional factors, community factors and public policy.
In a study by Ferrer et. al, interpersonal factors inhibiting minors from choosing the HPV vaccine include fear of needles and side effects. Interpersonal processes and relations with primary social groups involved parents above all others. Barriers in this influence included religious beliefs and indifference. Institutional barriers consisted of staff commitment issues, but community issues were more complex. They included cultures that promote monogamous relationships and the overall discouragement of sexual contact prior to marriage. Lastly, public policy concerns the ability of young women to get parental consent. It also considers what a woman decides to do without consent (Ferrer et. al, 2015).
This information is invaluable in addressing the health issue of cervical cancer among minorities. It can be applied to public health promotion practice in multiple ways. Education can reduce the wariness of parents and the fear behind the vaccination process. This also includes parent education, as they may not be aware of the risk of cervical cancer. Knowledge of risk and potential regret facilitated HPV vaccination. Staff must be committed to getting consent forms, but it was not known at the time of this study what factors limited vaccination without parental consent (Ferrer et. al, 2015). Lastly, community education may enhance vaccination among cultures that prohibit sexual conduct outside of marriage.
Socio-ecological models are tools to reveal the decision-making processes among selected populations due to social factors. These factors lead to inequities in healthcare delivery, and if these inequities are to be levelled, they must first be understood.
- Ferrer, H., Trotter, C., Hickman, M., & Audrey, S. (2015, June 7). Barriers and facilitators to uptake of the school-based HPV vaccination programme in an ethnically diverse group of young women. Journal of Public Health Advance Access (1-9).
doi: 10.1093/pubmed/fdv073
