Zimet studying barriers and facilitators to acceptance of cervical cancer vaccine
Gregory D. Zimet, PhD, member of the Cancer Control Program at Indiana University Cancer Center, is taking a key role in the investigation of issues that may be helpful in the development of human papillomavirus (HPV) vaccination policies and programs for the prevention of cervical cancer. Zimet, also a professor of pediatrics and clinical psychology in the Section of Adolescent Medicine at Indiana University School of Medicine, is researching how health care providers, parents and young people feel about the potential for vaccines, as well as what interventions may increase participation in vaccination programs.
Zimet’s specific interests are related to understanding potential predictors of acceptance or refusal of the vaccine by parents and adolescents and attitudes among primary care physicians about implementing HPV vaccination guidelines. His research has revealed that public and providers, in general, have a positive response to the vaccine. Health care providers are more willing to recommend with approval from their professional associations. Parents’ interest in the efficacy of vaccination and severity of disease it prevents outweighs their fear that the vaccination may increase risky adolescent sexual behavior. They also find provider recommendation for the vaccine important. Adolescents have a high level of interest, especially if their physicians’ recommendations and parents’ attitudes are in favor of the vaccine. They tend to have a positive perception of the vaccine if they have a positive perception of vaccinations in general, know what HPV is and what it can cause and if they understand the consequences of their own risky behaviors.
“The media has frequently portrayed the HPV vaccine as controversial. In fact, for most it is not at all controversial,” says Zimet. “Research that I and others have conducted indicates most parents want to protect their daughters by having them vaccinated.”
The cervical cancer vaccine, which has already been proven to be safe and effective, is positioned to prevent the common infectious disease whose most dangerous strains cause 70 percent of all cervical cancers. However, to ensure widespread access and effective use of the HPV vaccine, Zimet’s research underscores the importance of recommendations by professional organizations and providers as well as the education of parents and adolescents regarding HPV, cervical cancer and the vaccine. His efforts contributed to the release of a position statement from the Society of Adolescent Medicine (SAM) in October 2006 which fully endorses the recommendation from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention. ACIP recommends a three-dose HPV vaccine for all females 11 to 12 years of age and 13- to 26-year-olds not previously vaccinated, as well as coverage of vaccination costs by third-party payers and government programs for low-income persons.
In addition to his attitudinal research, Zimet is involved in the development of interventions that may increase participation in health screening programs, such as HIV testing, and prevention programs for the HPV and hepatitis B virus (HBV) vaccination. His intervention research, developed with colleagues, Anthony and Dena Cox of the Kelley School of Business, focuses on how health care providers may be able to influence patient utilization of health care using brief persuasive messages.
“One proven, brief and effective intervention that could be easily implemented in a clinical setting is to ask, ‘If the doctor recommends the HPV vaccine, will you accept the vaccine?’” says Zimet. “Asking intention of the patient to get the vaccine, before asking if he or she wants the vaccine, may have a positive influence on their behavior.”
Another aim of Zimet’s research is to identify barriers to participation in clinical trials, an area of concern given that only three percent of adults with cancer participate in the research necessary to develop life-saving treatments.
Zimet received his doctoral degree from Duke University in 1985 and did his Clinical Psychology Internship and post-doctoral training at Case Western Reserve University School of Medicine in Cleveland, OH.He has been at Indiana University since 1993 and has authored or co-authored over 20 research articles and review papers focusing on issues related to the acceptability of vaccines designed to prevent sexually transmitted infections such as HPV. In addition to Anthony and Dena Cox, Zimet collaborates on his research with faculty from the Departments of Medicine and Pediatrics and the School of Nursing.