Information Proves to be Key Weapon

in War on Cancer

Sherrie Wallington, PhD, is adopting a different approach in the fight against cancer—by taking on misinformation.

Anton Wellstein, MD, PhD

 

Wallington, assistant professor of oncology and program director of the Health Disparities Initiative at Georgetown Lombardi Comprehensive Cancer Center, is working to bring down the disproportionately high rate of cervical cancer among black and Hispanic women in the District of Columbia through a targeted education campaign. The focus of her efforts is a 2007 D.C. law that appears to require that young girls be vaccinated against human papillomavirus (HPV)—an infection responsible for about 70 percent of cervical cancers—in order to be allowed in school.

The D.C. law was prompted by a U.S. Centers for Disease Control and Prevention (CDC) recommendation that all 11- and 12-year-old girls get the three-shot vaccine to protect against HPV. In October 2011, the CDC also recommended that boys be vaccinated. The D.C. council passed legislation in 2007 requiring that girls entering the sixth grade must get the vaccine or opt out — that is, sign a waiver declining vaccine.


Major Gaps in Understanding

Yet Wallington said that—all these years later—major gaps in understanding about the law persist.

“Many parents believed that they were not getting enough information from the schools or the city to make an informed decision about the HPV vaccine,” she says.

Moreover, several parents, particularly those in the minority and underserved communities, felt they were forced into making a decision for fear that their daughters would not be allowed in school otherwise. These parents did not understand that they could opt-out or, if they did understand, did not know how to do so.

“The lack of knowledge about HPV and the vaccine is an issue that affects parents across racial, ethnic and socioeconomic lines, but is especially problematic in minority and underserved groups — the very populations found to be most at risk for cervical cancer,” Wallington says.


Empowering Parents Through Education

Wallington is addressing these issues through targeted health communication strategies. While completing her postdoctoral fellowship at the Harvard School of Public Health and the Dana Farber Cancer Institute in 2009, she was recruited by Lucile Adams-Campbell, Ph.D., associate director of minority health and health disparities research at Georgetown, to help develop cancer prevention tactics that emphasize the role of health communications in reducing cancer health disparities in D.C.

“To make informed health decisions, individuals need accurate, complete and easy-to-understand health information. Once people have access to accurate information they can understand, they feel empowered and are able to make informed decisions,” Wallington says.

Wallington has conducted her research in three of D.C.’s most medically underserved neighborhoods — Wards 6, 7 and 8, where Georgetown Lombardi’s Office of Minority Health and Health Disparities has established a community partnership to address such topics as physical activity, nutrition, environmental health, breast cancer, HPV and cervical cancer.

Much effort is focused on developing culturally-sensitive cancer education materials and interventions—meaning they are targeted to address informational needs that specific minority and underserved groups might have.

Since her arrival at Georgetown, Wallington has had four HPV studies funded by federal and advocacy organizations. Grants include a National Institutes of Health (NIH) / National Cancer Institute (NCI) Career Award, Junior Investigator Award from the Robert Wood Johnson Foundation, American Cancer Society Young Investigator Award, and the D.C. Cancer Consortium Community Award.

Wallington’s recent award from the NIH/NCI funds a five-year study designed to increase knowledge awareness about HPV and the HPV vaccine among black mothers, assess the factors associated with mothers’ acceptability or non-acceptability of the HPV vaccine for their daughters, and foster improved informed decision-making.


Testing Intervention with Randomization

The only way to effectively accomplish these proposed goals, she believes, is to conduct a randomized controlled trial, considered to be the “gold standard” for intervention studies. The study will target black mothers who have daughters between the ages of 9 and 17 not vaccinated against HPV. The mothers will be randomized into either an education intervention or a control group (usual information). The education intervention group consists of four face-to-face HPV educational sessions supplemented with culturally tailored HPV materials adapted from two CDC-tested HPV educational tools. The control group will receive the standard educational material (i.e. flyers, brochures) now available from the CDC.

In addition, the grants funded by American Cancer Society and the D.C. Cancer Consortium allow her to study the impact of cell phone text messages as an appropriate form of communication that would increase their understanding—and acceptance—of the HPV vaccine.

Wallington believes that her current research with adolescent girls also helps to pave the way for future HPV research pertaining to adolescent males. “In all my work with parents and adolescent girls, they say, ‘What about the boys?’” Wallington says.

By Renee Twombly and Lauren Wolkoff
(Published February 29, 2012)