At the request of the Paca Regional Health Agency (ARS) and with the support of Public Health France in the Paca and Corsica region, and the UMR1252 SESSTIM (Aix Marseille University, INSERM, IRD), the Corhesan and Sept associations have developed a health mediation project with vulnerable populations in Marseille (“13 en santé” project). The main objective of this project is to promote cancer screening (cervical, breast and colorectal) and update the vaccination schedule. It includes several areas of evaluation including a cross-sectional survey to estimate the level of vaccine hesitancy, the participation rate in cancer screenings, vaccination coverage for the DTP booster and against papillomavirus (HPV) and levels of knowledge, attitudes and barriers to cancer screening and vaccination. A survey to establish a baseline level was carried out in September 2022 by the Corhesan and Sept associations among people aged 18 to 74 living in vulnerable neighborhoods in the center and north of the city of Marseille. The sample size was estimated based on the screening rate of the eligible population for each program to aim for a total of 2,400 participants. Statistical associations between non-participation in screening and vaccination and sociodemographic factors were analyzed by univariate and multivariate and unadjusted logistic regression models. In total, investigators interviewed 2,647 people door-to-door using a standardized questionnaire. Regarding cancer screening, the participation rates for breast, cervical and colorectal cancer screening (respectively 51%, 68% and 31%) are lower than the participation rates in France. Knowing about the screening and having received the invitation letter for it strongly encourages participation. The absence of symptoms is the main barrier cited to participation in cancer screening (18% to 50% depending on the cancer). Concerning vaccination, there is low knowledge of HPV vaccination (43% of women and 17% of men aged 18-35). HPV vaccination coverage among women aged 18-35 is 24% and is strongly associated with knowledge of the vaccine. Vaccination coverage for the DTP booster in adulthood (51%) is comparable to national coverage. However, a third of the population is unaware of this vaccination. Overall, 72% of people surveyed said they were in favor of vaccination with moderate vaccine hesitancy (median=60, [EI 45-71]). However, 20% of the population in northern neighborhoods and 10% in central neighborhoods report high vaccine hesitancy. These results show the importance of improving the knowledge of vulnerable populations in the North and Center districts of Marseille on the methods of cancer screening and vaccination against HPV and the DTP booster in adulthood. This could help increase participation rates in cancer screening as well as vaccination coverage. It is also essential to raise awareness among the population of the benefit of being screened for cancer in the absence of symptoms and to reduce vaccine hesitancy among part of the population. Health mediation through going-to, doing-with and bringing-back can meet the needs for support and targeted information adapted to the different population profiles of these neighborhoods.
Auteur : Ramalli Lauriane, Chaud Pascal, Franke Florian, Kelly David
Year of publication: 2024
Pages : 41
Collection : Studies and surveys
Health
