Background and Context: The Australian adolescent HPV vaccine program has disparate uptake rates seven years after its introduction, especially within its culturally and linguistically diverse (CALD) sub-populations. The ethnocentric implementation strategy exposed critical socio-cultural and system dynamics that reveal important lessons for diverse nations when introducing new vaccines related to cancer prevention.
Aim: To understand the risk factors for HPV-related cancers in vulnerable population groups when participation in prevention programs is low so that novel approaches can be developed as part of the cancer prevention strategy.
Strategy/Tactics:A qualitative cross-cultural study within a socio-ecological framework on Australian male and female CALD parental attitudes toward adolescent HPV vaccination. Focus groups were purposively selected according to cultural and linguistic characteristics: Arabic, Turkish, Sri-Lankan, and Horn of Africa immigrants (n=60) residing in Victoria where low adolescent HPV vaccine uptake rates and disparate cervical cancer screening among women had been identified. Recruitment was through local government immunisation services and cultural agencies. Participants were asked to review current HPV vaccine resources and recommend innovative and culturally acceptable alternatives.
Programme/Policy Process: A socio-ecological approach integrated with a Community Based Participatory Marketing model will optimise outcomes for CALD populations. Intracultural diversity is fundamental to the implementation of prevention strategies requiring cultural relativism, population engagement, and differentiated policy discourses.
Outcomes/What was learned: Naivety and language contributed to very low knowledge levels, and compromised their cognitive decision making, informed consent and self-efficacy.CALD populations remain at risk for developing HPV-related cancers if culturally tailored interventions are not developed. Socio-cultural-impact analysis of ethnocentric strategies is vital to increase prevention among CALD populations. Diverse cultural and linguistic norms and social class determinants of cancer and vaccine knowledge acquisition and decision-making in immigrant populations need to be sufficiently addressed. Building linguistic, knowledge and cultural capital will empower and engender action.