HPV Literacy in Korean American Women: Does English Proficiency Matter?

Background: Studies show that Korean American (KA) women reported having low levels of literacy on Human Papillomavirus (HPV) and the HPV vaccine (Kim, Kim, Choi, Song, & Han, 2015; Lee & Lee, 2016), which is the most effective prevention strategy for cervical cancer. Although Korean American women have one of the highest cervical cancer incidence and mortality rates among all Asian American and non-Hispanic White women (McCracken et al., 2007), they are less likely to utilize the HPV vaccine to prevent cervical cancer. Thus, this study examines Korean American women’s HPV literacy and explores factors related to HPV literacy to identify targeted intervention strategies.

Methods: The study employed a convenience sample of 243 KA women aged 19 to 85 in the Metro-Atlanta Area recruited by a quota sampling strategy. Face-to-face structured interviews were conducted with the women aged over 60, and self-administered questionnaires were used with those under 60 years old. HPV literacy was measured by a 7-item questionnaire condensed from McPartland et al.’s 16-item scale regarding HPV disease and prevention (McPartland, Weaver, Lee, & Koutsky, 2005). Predisposing characteristics of age and marital status; enabling resources involving education, English proficiency, having health insurance, and having a primary physician; and need variables including family cancer history and health status were utilized according to Andersen’s Health Behavioral Model (Andersen, 1995). A frequency analysis was used to explore the participants’ HPV literacy levels, then a multiple linear regression analysis was conducted to examine factors associated with HPV literacy.

Results: Findings show that the HPV literacy of KA women was moderate, and the percentage of correct answers regarding HPV detection items were especially low. Age was the only predisposing factor that had a significantly negative association with HPV literacy, with older women displaying lower HPV literacy. Among the enabling factors, education level and English proficiency had a significantly positive correlation with HPV literacy. Health status of need factor was significantly positively associated with HPV literacy.

Implications: This study suggests that HPV literacy education, combined with HPV detection and vaccination guidelines, should primarily target KA women with limited health care accessibility to reduce the HPV-associated cancer health disparity. Future studies should expand the scope to examine KA women’s rates of HPV vaccination and the relationship between their HPV literacy and rates of HPV vaccination. Further research considering Korean cultural factors should be examined in order to develop more culturally attuned and targeted interventions to increase HPV literacy and HPV vaccination rates.