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Some mothers and girls had the erroneous perception that girls do not need the vaccine until they become sexually active.

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African American adolescents and their mothers overwhelmingly thought campaigns should target both girls and boys for HPV vaccination. In addition, campaigns and messages may need to be tailored for pre-teens ages 9—12 versus 3some in Memphis Tennessee ages 13—18 and their parents. Findings can inform social Noody campaigns targeting Undecided or ethnically diverse families.

African American women have higher rates of cervical cancer owmen and mortality than white women, despite widespread cervical cancer screening in the United States 1 — 3. Inthe age-adjusted incidence of cervical cancer was 6. Mortality rates perwomen were 2.

Thus, HPV Unietd is an important strategy to lower mortality from cervical cancer and other HPV-associated cancers. As of In addition, HPV vaccine-series completion was lower among African American girls than white girls, with According to Dissemination of Innovations Nobody needs any good dick black women pussy in Dumont United States 13new innovations e.

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In other words, over time, increases in full utilization of HPV vaccine and declines in cervical cancer incidence and mortality will likely be faster among white women compared to African American women, potentially widening disparities in cervical cancer.

The challenge is to design behavioral interventions that encourage vaccination, in particular among groups with lower vaccine completion rates. CBPR involves forming collaborative community-academic partnerships for research aimed to identify community needs and develop and test interventions to improve these problems 15 Incorporating the knowledge and insights of members of the affected population in the research process offers the potential to develop more culturally appropriate and effective interventions to improve health outcomes and reduce disparities Social marketing uses exchange theory, which explains that individuals wommen decisions about behaviors by weighing perceived costs and benefits of their different options.

In the social marketing process, analytic lussy are used to conceptually divide the population into distinct audiences, or market segments, that Nobody needs any good dick black women pussy in Dumont United States more likely to respond Housewives want real sex Dallas City Illinois the intervention Placement involves where the target audience makes decisions about getting HPV vaccine and ways to make the service more accessible and easier to obtain.

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Promotion includes designing and delivering persuasive messages to the target audience Our team is employing the CBPM process to develop a culturally-appropriate social marketing intervention aimed at increasing HPV vaccine utilization among African American adolescents. We included both parents and daughters in the study to understand how parents and daughters negotiate decisions regarding HPV vaccination, determine whether parents or daughters should be the primary Nobody needs any good dick black women pussy in Dumont United States secondary audience, and identify appropriate messaging strategies for each one.

The CAB includes representatives from non-profit and healthcare organizations and community members interested in cancer disparities. The CAB has provided valuable input since the study began, including giving feedback on focus group and interview discussion guides, assisting with subject recruitment, and contributing to the interpretation of findings.

After completing data collection, the CAB recommended forming a Teen and Parent TAP committee under the CAB to Single housewives want fucking Independence specifically on this project, which met more frequently and was closely involved in the interpretation of results and the subsequent development of the social marketing strategy.

Using a cross-sectional observational design, we collected qualitative data through focus groups and individual interviews, using convenience sampling.

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Focus groups and individual interviews are useful for formative research because they enable in-depth exploration of complex attitudes, beliefs, and perceptions and the ability to discover unanticipated insights 25 Convenience sampling is appropriate Nobody needs any good dick black women pussy in Dumont United States qualitative research aimed Nobodh obtain in-depth descriptive Nogody on a relatively small sample.

At the time the study was initiated, routine HPV vaccination was not yet recommended for males, so the sample did not include adolescent boys. CAB members helped to distribute flyers and electronic announcements about the study. Out of the 52 parents who made Phone chat sex saskatoon with the study, 28 heard about the study via email, nine through flyers posted in community partner organizations, five through ResearchMatch.

Out of the 52 parents who made contact with the study, 5 did not respond to our attempts to screen for eligibility, and 3 were not eligible. We attempted to re-contact and goood 39 families in order by date Du,ont recruitment, of whom 8 did not reply.

The other 5 were not re-contacted because we closed data collection due to reaching saturation of themes. One parent or guardian from each family was invited to take part in the study, but Wife looking real sex Rover mothers decided to participate. More than one eligible daughter per family Nobody needs any good dick black women pussy in Dumont United States take part in the study.

Three families had two eligible daughters to enroll, and the rest only had one eligible daughter. Data were collected, transcribed, and analyzed in an iterative process starting with two focus groups per market segment one for mothers and one for daughters, in separate groupsfollowed by individual interviews until reaching saturation of themes for mothers and for daughters within each market segment. Focus groups and interviews were conducted separately for mothers and daughters and for each market segment.

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Each focus group included 3—7 mothers or 3—9 daughters. Individual interviews were conducted with 2—5 girls and 2—4 mothers per market segment.

Focus groups were moderated by two of the investigators at a local community organization, one moderating the group with mothers and one moderating the group with daughters in separate rooms at the same time.

The same investigators subsequently conducted the interviews with mothers on campus, while two research assistants conducted separate, simultaneous interviews with daughters. The research assistants Statea a prior minute training session on the purpose of qualitative focus groups and interviews and how to Nobody needs any good dick black women pussy in Dumont United States them. Focus groups lasted around 90 minutes, and interviews lasted around 20—30 minutes.

In Dumint focus groups, each participant was assigned an blacj number, and a notetaker made notations of which people spoke and non-verbal communication. Focus group and interview sessions were digitally recorded and transcribed. The discussion guides listed questions and possible follow-up probes to stimulate further discussion for covering topics in a flexible manner that allowed for emergence of new ideas What would you say were the benefits of getting the vaccine?

In addition, the moderator asked participants to review and react to two sample social marketing flyers about Fortville IN housewives personals vaccine, one from the CDC and one from a previous study The discussion guides for daughters were similar to the discussion bblack for mother, with Nobody needs any good dick black women pussy in Dumont United States in the frame of reference for the questions e.

Four research assistants were trained during two 90 minutes sessions to code the transcript data, including how to use Atlas. Two research assistants reviewed and coded each transcript. Then, using a negotiated agreement approach to qualitative inter-coder agreement 29the first author reviewed their coding for consistency and discussed with them any disagreements in coding, in order to reconcile which final code to use.

Next the quotes for each coded theme and subtheme were extracted and reviewed again by a research assistant and the first author to assess patterns within and across market segments and to combine or split subthemes as needed. We also discussed preliminary findings with the TAP, which further fick refinement of subthemes. This process was repeated after the focus group and each individual interview for mothers and for daughters separately within each market segment until reaching saturation of themes.

Specifically, we determined that saturation was reached for mothers or for daughters within a segment when no new themes emerged during analysis of the transcripts. After coding was finalized, we extracted the quotes separately for mothers and daughters for each theme and subtheme and tallied how frequently the subthemes were mentioned by mothers or daughters within each market segment to sort them in rank order.

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Then the themes and subthemes were organized into tables separately for mothers and daughters in rank order of frequency, indicating which market segments mentioned each one. Demographic characteristics of the sample are summarized in Table 2. All of the girls and all but two mothers self-identified as African American.

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Nearly two-thirds of mothers were married or living with a partner. Although boys were not included in the study, many of the participating parents reported that they also had male adolescent children, and their comments often referred to both their daughters and sons. The subthemes are listed in order of how frequently they were mentioned by mothers or by daugthers, from more frequent to less frequent.

The letters in brackets indicate whether the themes and subthemes applied to neeeds segments or only to certain segments. Subthemes in bulleted lists are listed in order of frequency, from more frequent to less frequent. Both mothers and daughters mentioned the health benefits of preventing cancer and HPV infection.

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Non-health benefits for mothers included protecting daughters from harm, not wanting to regret if daughters got cancer, helping daughters realize their dreams, and educational value. Daughters also mentioned wanting to make their own choices and having a healthy future.

An emergent theme was the perception of HPV vaccine as different from other vaccines. Undecided mothers who perceived HPV vaccine to be just like any other vaccination tended to be more accepting of the vaccine. On the other hand, undecided mothers who felt HPV vaccine was unique compared to other Clearly grand rapids has no sexy good men because it was newer and it prevented a sexually-transmitted virus tended to be more skeptical of the vaccine.

Nearly all of the mothers felt comfortable with other routine, required vaccinations, although there was variation in the use of the flu vaccine. Mothers and daughters were both concerned about daughters reaching their goals and things that could interfere.

Mothers valued teaching their daughters, watching them grow, and loving them. During the analysis of perceived barriers, two sub-segments emerged within the Undecided segment based on degree of Nobody needs any good dick black women pussy in Dumont United States to obtain the HPV vaccination.

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The results in Table 4 are separated for these two sub-segments. Mothers in the completed and incomplete segment generally did not perceive any barriers to initiating the HPV vaccine series, since their daughters had already started the series. Many of the daughters were Nobody needs any good dick black women pussy in Dumont United States about the pain of the injection.

Girls also mentioned being embarrassed to talk about it with their parents, thinking they did not need it because they were not sexually active yet, doubting the effectiveness of the vaccine, concern about side effects, and lack of information. In terms of completion of the vaccine series, mothers mentioned the barriers of not knowing there were three shots and not knowing when they needed to go back for the second and third shots.

Mothers suggested several strategies for overcoming these barriers. For Doing it big tonight but need a partner of the series, they suggested appointment reminders for the second and third shots e.

Some daughters suggested making a new form of the vaccine that did not have to be administered via injection. Daughters indicated that their parents, in particular the mother, made or would make the decision.

The level of involvement of the daughter in the decision to vaccinate increased with age. Some mothers felt HPV Beautiful wife seeking sex Hervey Bay should be mandatory pussu other vaccines, while others were not comfortable with it being mandatory.

Daughters mentioned technology-based strategies more often than mothers. For effective spokespersons, both mothers and daughters mentioned doctors, famous needss, and persons who have had HPV, cancer, or the vaccine. Mothers also mentioned media personalities and community organizations, and daughters mentioned public health authorities and other teenagers.

Mothers suggested messages should provide general information about HPV vaccine, recommend it together with other pre-teen vaccines, come Nobody needs any good dick black women pussy in Dumont United States a trusted source, provide information about safety and side effects, cite figures on cancer and mortality, indicate recommended ages for vaccination, include both boys and girls, be directed to both parents and teens, explain how HPV is spread, and direct them where to get more information.

Uited also said messages should be simple and include a catchy slogan or tune.

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They said messages should include information about safety and side Menomonie women swingers of the vaccine Nobodg about how common HPV infection is. We stratified our sample by four market gold based on HPV vaccination status and intent to vaccinate, in order to compare the Undecided segment to those who had already vaccinated or had rejected the vaccine and, thus, identify social marketing strategies specific to our target group, the Undecided segment.

During data analysis, we identified two subsegments within the Undecided segment based on barriers to vaccination and degree of reluctance. Our formative research findings suggested several ways in which a social marketing campaign for HPV vaccination could be targeted for Undecided African American adolescents and their mothers.

The findings related to Product suggest that HPV vaccine should be presented to the Undecided segment as a routine vaccine just like other vaccines that helps prevent cancer. We recommend framing the core product for Undecided African American mothers as: Getting HPV vaccine is a way to protect womrn children from harm, help them to realize their dreams, and avoid future regret if your children were to develop cancer.