MisinformationReconceptualizenormativenatural processes by A
“ ”MisinformationReconceptualizenormativenatural processes by Address systemic racism in health care that leads to
countering the false duality of natural and mistrust, including the perception of the HPV
“ ”technologicalrelatedtovaccination,screeningandvaccinationasnew and untested.
Social Norms Incorporate sex-positive messages and address Raise the voices of marginalized women and share
concerns regarding sexual behavior and promiscuity. their stories to address discrimination.
Extricate the HPV 2-Guanidinoethylmercaptosuccinic Acid from gender.
Biomedical Address the ways medicalization disempowers Support negotiation of cervical cancer screening by
Paradigm women, including the frequency of abnormal Pap tests discussing the potential harms of overscreening.
and how women's experiences of follow-up care may Provide comprehensive information about risk to
be distressing and humiliating, leading some help women make the best choice for themselves.participantstostopseekinghealthcare.
ways. Some participants distanced themselves from the burden of HPV and cervical cancer and one participant described it as a “boogeyman.” Since a boogeyman is traditionally invoked to frighten children to be-have in a proscribed manner, this term oﬀers important insight into understandings of medical recommendations regarding HPV vaccina-tion and cervical cancer screening. This finding elaborates the role of medicalization and reproductive justice (Ross, 2016; Solinger, 2016; Stephens et al., 2012) in addressing misinformation and mistrust re-lated to women's reproductive health. Specifically, women deserve comprehensive, accurate information about their personal risk (e.g., absolute risk) that is easier to understand than population estimates of risk (e.g., relative risk). A reproductive justice approach to commu-nicating about risk should contextualize how inequities across many areas of daily life compound cervical cancer risk. Table 2outlines practical implications of a reproductive justice approach to increase women's agency in the development of successful cervical cancer pre-vention interventions.
Although the U.S. Food and Drug Administration (FDA) approved the first HPV vaccine over a decade ago, campaign planners must ad-dress systemic racism in health care that leads to mistrust, including the perception of the HPV vaccination as “new” and untested. This finding builds on recent research that vaccine refusal reflects concerns about science and technology as antithetical to natural health (Reich, 2016). The implications of this finding suggest that eﬀective public health interventions will reconceptualize normative “natural” processes by countering the false duality of natural and technological related to vaccination, screening and treatment. This finding urges campaign planners to move beyond increasing awareness, which studies show is not suﬃcient to increase vaccine uptake (Galbraith et al., 2016). The activist role of patient advocacy groups is another strategy in raising awareness of the benefits of the HPV vaccine separate from vaccine manufacturer's commercial advertising (Gottlieb, 2013). Health com-munication and social marketing campaigns that rely on the target audience's input throughout development and design, as well as stra-tegies congruent with the audience's values and needs oﬀer an eﬀective approach to address risks and benefits to increase vaccine uptake (Cates and Coyne-Beasley, 2015; Dempsey and Zimet, 2015). Implementing innovative and accessible approaches to education (e.g., telehealth, social media) and health communication campaigns that include a focus on health literacy and patient advocacy may help to counter systemic racism, classism, ableism, ageism, and xenophobia.