Wide Open Spaces

Supporting HPV Vaccination with Rural Communities  (March 2023)

This month’s Wide Open Spaces offers a recap of the March 3 seminar focused on HPV vaccination with rural communities. This virtual seminar focused on actions to improve HPV cancer prevention – and specifically HPV vaccination – within rural communities in the U.S. The seminar featured two presentations on efforts to improve HPV vaccination with rural communities, a Q&A session between a physician and HPV cancer survivor, and a moderated discussion.

Deanna Kepka, PhD, College of Nursing, Huntsman Cancer Institute, University of Utah, moderated the session. Benjamin Teeter, PhD, College of Pharmacy, University of Arkansas for Medical Sciences, presented Improving HPV Vaccination Using Implementation Strategies in Rural Community Pharmacies, which focused on implementation of pharmacy-based services in rural community pharmacies. Arkansas has the highest rate of HPV-associated cancers in the U.S. Teeter’s project worked to determine barriers and facilitators to pharmacy participation in the Vaccines for Children (VFC) program and help pharmacies enroll in VFC.

Teeter and his team had many conversations with parents who said their children had received the flu vaccine every year at the pharmacy, so they had no problem with their children getting the HPV vaccine there. They just want communication between the primary care doctor and pharmacists.

Rural communities are tight-knit, and it is important that health care providers and leaders earn the trust of these residents. During another presentation, Using Best Practices to Promote HPV Vaccination among Adolescents in Primary Care Setting, Daisy Y. Morales-Campos, PhD, Latino Research Institute, University of Texas at Austin, emphasized the importance of having community members involved in HPV cancer prevention. In five primary rural and Hispanic counties, Morales-Campos and her team worked in seven clinics to improve HPV vaccination through a cervical cancer prevention program delivered by promotoras, or community health workers.

Community outreach and clinic collaboration is essential to getting messaging out to the public. Including the voices of HPV cancer survivors is even more crucial to get the message across to parents. Anne Zajic, HPV cancer survivor, interviewed L. Joy Baker, MD, FACOG, PMH-C, C-EFM, MT(ASCP), who works in a clinic that provides care to about 100,000 women across six rural counties in Georgia. Zajic also had a chance to give her perspective as a cervical cancer survivor from Kansas, which is a majority rural state.

“What we found in Southern rural black women is they were able to access the screening but less likely to follow up on an abnormal pap test. Many women talked about the distance they had to travel in order to seek treatment… Not only does your region or location play a role, but there are still some lingering effects of systemic racism that are causing us to miss opportunities to care for these folks and prevent cervical cancer,” Baker said.

Similarly, Zajic noted that “misinformation and lack of education regarding HPV is keeping our numbers low for HPV vaccination.”

Overall, it will take the voices of health care providers, parents and survivors to improve HPV cancer prevention with rural communities. It is essential, now more than ever, to address the challenges and barriers that these residents face to provide them with the tools and resources to access quality care to prevent HPV cancers.

We invite guest contributors to share information on how they are working to improve HPV vaccination in rural areas. If you are interested in contributing or learning more about our efforts to improve HPV vaccination with rural communities, please email us at PreventHPV@stjude.org.