Increasing HPV and Cervical Cancer Education Among Native American Communities and Healthcare Providers

Sep 23, 2026

Human papillomavirus (HPV) is the most common sexually transmitted infection, and in Native American communities HPV-associated cancers contribute to health disparities, including elevated cervical cancer burden and higher rates of oral cancer in men. A one-hour culturally tailored pilot intervention in Northern Arizona delivered in-person and online presentations, supported by pre- and post-electronic surveys. Among 67 participants, knowledge and attitudes about HPV and vaccination improved; most recognized catching up on vaccines, and vignette responses reflected positive beliefs about importance and safety. The results indicate culturally tailored education can strengthen knowledge and attitudes to help reduce cancer-related disparities, while remaining gaps in awareness and vaccine uptake require further action.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Introduction

Cervical Cancer in US and Native American Communities

HPV Vaccination and Prevalence in Native American Communities

Factors Contributing to HPV Infections and Cervical Cancer in Native Americans

Increasing HPV and Cervical Cancer Education Among Native American Communities and Healthcare Providers T. R. Joe1,3 · K. M. Natonie2,3 · K. R. Charley3 · N. R. Lee3 Accepted: 24 March 2025 / Published online: 10 April 2025 © The Author(s) 2025 Abstract Human papillomavirus (HPV) is the most common sexually transmitted infection. Among Native Americans, HPV-associated cancers can lead health disparities in cervical cancer and increased rates of oral cancer in men. We designed a pilot study using a culturally tailored educational intervention aimed to improve knowledge and attitudes toward HPV and the vaccine among community members and healthcare providers in Northern Arizona. The one-hour intervention included in-person and online presentations, along with pre-and post-electronic surveys that assessed changes in knowledge and attitudes regarding HPV. The surveys featured demographic questions, true/false knowledge questions, and vignettes. Of the 67 participants in the intervention, the majority were females aged 18 to 55 years. About 32% identified as Native American, 47% as nonHispanic White, and 8% as Hispanic. Students comprised the majority (46%) of participants, while healthcare providers, educators, staff, and social workers accounted for 25%. Attitudes towards HPV and the vaccine indicated that 93% of participants recognized the importance of catching up on vaccinations, though only 64% supported vaccination following a positive Pap test. Vignettes showed generally positive attitudes towards vaccination, with strong agreement on its importance and safety. Knowledge about HPV, the vaccine, and its association with cancer improved following the intervention. The pilot study demonstrates that culturally tailored educational interventions can effectively enhance knowledge and attitudes toward HPV and its vaccine, potentially reducing cancer-related disparities in Native American communities. Ongoing efforts are necessary to address remaining gaps in awareness and vaccine uptake. Keywords Vignette · Intervention · Knowledge and attitudes · Vaccine Introduction Cervical Cancer in US and Native American Communities Cervical cancer is one of the most common cancers affecting women, with an estimated 13,800 cases reported in 2020 [1] . American Indian/Alaska Native (herein referred to as Native American) women are disproportionately impacted by cervical cancer, exhibiting higher prevalence and mortality rates compared to non-Hispanic White women, with a prevalence rate * N. R. Lee [Naomi.Lee@nau.edu](Naomi.Lee@nau.edu) 1 Interdisciplinary Health Program and Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA 2 Department of Family & Community Medicine, University of Arizona, Tucson, AZ, USA 3 Department of Chemistry and Biochemistry, Northern Arizona University, Flagstaff, AZ, USA 2.11 times higher and a mortality rate 1.55 times higher [2–5] . Cervical cancer can be attributed to persistent human papillomavirus (HPV) infections. Disparities in cervical cancer rates among Native American (NA) communities can be attributed to several factors, including a lack of screening, unequal access to healthcare, lower rates of HPV vaccination, a higher prevalence ofoncogenic, or high-risk, HPV genotypes, and limited awareness and knowledge about HPV and its vaccine [6] . HPV Vaccination and Prevalence in Native American Communities Currently, Gardasil 9® is the only recommended HPV vaccine for both males and females in the U.S. The vaccine is recommended for individuals aged 11 to 16 years, but it can be administered as early as age 9, following a two-dose regimen. Adults aged 27 to 45 may also choose to receive the vaccine after consulting with their physician [7] . Since the introduction of the HPV vaccine, the prevalence of HPV types covered by the vaccine has declined among women in the USA. However, there is currently no approved test for detecting HPV in males. Additionally

FAQs

What outcomes were measured and what changed after the intervention?

Participants’ knowledge and attitudes toward HPV and the vaccine were assessed using demographic items, true/false knowledge questions, and vignette responses; results showed improved knowledge and generally positive attitudes, including beliefs about vaccination importance and safety.

Sep 23, 2026

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