how to remove psychological barriers?

how to remove psychological barriers?

2024-10-29 10:55:00

A widespread vaccination campaign against papillomaviruses (HPV) has been carried out at college since the start of the 2023 school year to improve vaccination coverage. Health psychology has tools to remove obstacles linked to both individual behavior and social pressure.

At the start of the 2024 school year, the widespread vaccination campaign against human papillomavirus infections (human papillomavirusHPV) was return to middle schools for 5th grade studentsgirls and boys, for the second time. As a reminder, it was in February 2023 that Emmanuel Macron, the President of the Republic, had announcement the implementation of this system.

A safe and effective vaccine against human papillomavirus infections

Until then, vaccination coverage was particularly low in France, when we compared the figures with those of other European countries, who were already organizing vaccination days in schools.

In France, since the first campaign in schools, vaccination coverage among 11-14 year olds jumped 17 points to 48% (55% for girls, 41% for boys).

It has been demonstrated for several years now that the vaccination was effective against HPV infections, genital warts (condyloma) and precancerous lesions of the cervix. Furthermore, if HPV can cause cervical cancer, several other types of cancer are linked to it, such as cancers of the vulva and vagina, anus or oropharynx.

The vaccine recommended by French health authorities is Gardasil 9 which protects against 9 strains of HP, 7 of which are at high risk of causing cancer. Philippe Lopez/AFP

The Gardasil vaccine has been marketed in France since 2006. Its latest version, Gardasil 9, protects against 9 strains of HPV, 7 of which have a high risk of causing cancer. which is recommended.). HPV vaccination is aimed at all boys and girls aged 11 to 14 years with a possible catch-up between 15 and 19 years old.

The causes of “vaccine hesitancy”

Despite this, the HPV vaccine (this is also the case for the hepatitis B vaccine) suffered a large defamation campaign in the 2000s. This led to a particularly strong distrust among the population which continues to this day. This phenomenon has generated strong “vaccine hesitancy”, which could be defined as “delaying or refusing a safe vaccination despite its availability”.

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This hesitation can be due to different types of factors. Studies carried out before the Covid-19 vaccine was made available showed the role of socio-economic and socio-demographic variables (age, gender, level of education, etc.) or even that of determinants linked to beliefs. Thus, the so-called 5 A model pour Access, Affordability, Awareness, Acceptance, Activation lists environmental factors as well as other determinants specific to vaccines or even inter/intra individual causes.

Please note that the Canadian Immunization Evidence Resource and Exchange Center (CANVax) translates the 5 A’s into French by “access, affordability [caractère abordable, NDLR]awareness (awareness), acceptance and activation”.

It is on these latter types of barriers to vaccination that it is most relevant and easy to act.

Changing behavior using health psychology

Behavior modification is a classic question of research in psychology, and it continues until today, particularly in the field of health psychology. Among the proposals resulting from research work in the social sciences, the theory of planned behavior is a very widespread theoretical and practical tool.

The guiding idea is as follows: the behavior of individuals can be adapted by acting on the intention regarding this behavior, itself determined by three factors.

The first is attitude regarding behavior,

to know if it makes me feel positive or negative affects.

The second is the subjective norm,

the social pressure that will be exerted on me according to what I believe others expect of me.

The third is perceived behavioral control, (i.e. the idea ofself-efficacy),

in other words what I imagine I am capable of doing to achieve the targeted behavior.

It is therefore possible to play on these determinants of the intention to tend towards a behavior. Thus, individuals may be led to think about the benefits that behavior could bring them, both in terms of physical health and psychological well-being.

It is also possible to refer to close groups or authority figures such as the doctor or gynecologist, in order to get individuals to conform to the standards from which they would not want to deviate.

To positively develop self-efficacy, one path is that of planning towards behavior: anticipating the stages as well as the levers and barriers towards the action taken (vaccination) can limit abandonment and discouragement at the first obstacles. .

Specificities specific to HPV as sexually transmitted infections

These lessons and avenues for intervention should be compared with the few specificities linked to HPV. Thus, if, as mentioned previously, the vaccine still arouses a certain distrust, the fact that it is a sexually transmitted infection (STI) can make attempts at action difficult, or even sometimes simply raising the subject. .

It is therefore necessary to properly train health professionals as well as external actors who intervene in educational establishments and in particular colleges, in order to guarantee dissemination of the most appropriate and up-to-date information possible.

Another characteristic specific to HPV infections is that they are, for many still currently, circumscribed, associated and perceived as problems which concern (exclusively) women. Although indeed, the latter are the most impacted by HPV, it remains true that men also suffer from it, and are factors in the transmission of HPV.

There is therefore a need to break away from these old patterns. This has started to be the case since the recommendation issued by the High Authority of Health at the end of 2019 to also vaccinate boys then at the end of 2020 to also reimburse the vaccine in boys.

Vaccinating in college: the solution to cost, medical deserts, etc.

It should also be remembered that these behavioral changes must be accompanied by a public health policy aimed at facilitating decision-making and action towards vaccination. Indeed, if individuals wish to be vaccinated but cannot access the vaccine for material reasons (cost of vaccination, medical deserts or logistical difficulties in accessing care or a Free Information, Screening and Diagnostic Center ( CeGIDD), etc.), the decision to enter into the behavior risks remaining a dead letter.

The vaccination route proposed within colleges so looks goodeven if access to information regarding HPV, including for national education professionals and parentsis also crucial for optimal vaccination coverage.

It is at the cost of these efforts, by making human, logistical and financial resources available to support an ambitious health policy, that we can hope to eradicate HPV, like researchers considered it possible for Australia within twenty years.

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W.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-faq”>implementation of vaccination programs that target both boys and girls, emphasizing that HPV can affect ⁢anyone, regardless of gender.

By addressing the myths and misconceptions surrounding HPV, health campaigns can create a more inclusive dialogue. ⁢It’s⁣ crucial to educate ⁣both parents and children about the broader implications‌ of HPV, including its role ‌in various cancers affecting both genders, such as oropharyngeal cancer in men.

Effective communication ‍strategies are necessary to eliminate the stigma often associated with sexually ⁤transmitted⁢ infections. Leveraging social media platforms, community outreach, and educational⁣ programs in schools can help normalize discussions​ about sexual health, ultimately ⁣facilitating a more informed and⁢ willing approach towards HPV vaccination.

Moreover, collaboration with healthcare professionals is vital. When⁣ doctors actively discuss the⁢ HPV vaccine as part of routine health check-ups, ‌parents‌ are more likely to consider vaccination seriously. Personalized‍ conversations that address specific concerns can foster trust in the vaccine and reduce hesitancy.

overcoming vaccine hesitancy⁣ regarding the HPV vaccine requires multifaceted strategies that bridge the gaps in understanding and awareness. By focusing on accurate education, inclusivity, and support from health professionals, communities can enhance vaccination rates and contribute to the long-term goal of reducing HPV-associated cancers.

It’s imperative ⁢for public health campaigns to continue to adapt their approaches based ⁤on current ‍research and societal attitudes towards vaccinations to ensure they meet the needs of all individuals, irrespective of gender, and ultimately protect public health.

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