{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:23:22Z","timestamp":1786116202917,"version":"build-2736575974"},"reference-count":45,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Environ. Res. Public Health","IJERPH"],"abstract":"<jats:p>American Indian and Alaska Native (AI\/AN) communities experience disproportionate rates of HPV-associated cancers, yet vaccination uptake remains low. This scoping review mapped research on HPV vaccination among AI\/AN college students aged 18\u201326, including vaccine uptake, knowledge, perceptions, and barriers. Using Joanna Briggs Institute scoping review methodology and the PRISMA-ScR checklist, MEDLINE (Ovid), CINAHL Ultimate, Embase (Ovid), ERIC (Ovid), Scopus, and Web of Science Core Collection were searched with no restrictions on publication year. Eligible studies included AI\/AN college students aged 18\u201326 and examined factors influencing HPV vaccine uptake; studies that did not disaggregate AI\/AN data were excluded. Of 911 abstracts identified, three publications met inclusion criteria; all included studies drew exclusively on American Indian samples and did not include Alaska Native participants. The findings reveal low HPV knowledge, limited perceived risk, gender differences in attitudes, and barriers including stigma, access challenges, and mistrust of healthcare systems. The near absence of contemporary research reflects ongoing data invisibility and structural factors affecting AI\/AN young adults. AI\/AN college students represent a critical yet overlooked population for catch-up HPV vaccination, requiring community-engaged strategies to advance cancer equity.<\/jats:p>","DOI":"10.3390\/ijerph23081027","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T08:08:02Z","timestamp":1786003682000},"page":"1027","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding HPV Vaccine Uptake Among American Indian and Alaska Native College Students: A Scoping Review"],"prefix":"10.3390","volume":"23","author":[{"given":"Vanessa","family":"Wright","sequence":"first","affiliation":[{"name":"Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Campus, Oklahoma City, OK 73117, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5635-4489","authenticated-orcid":false,"given":"Katy","family":"Fisher-Cunningham","sequence":"additional","affiliation":[{"name":"Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Campus, Oklahoma City, OK 73117, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8869-5390","authenticated-orcid":false,"given":"Brayton","family":"Amidon","sequence":"additional","affiliation":[{"name":"Texas A&M Health Science Center, Bryan, TX 77807, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shari","family":"Clifton","sequence":"additional","affiliation":[{"name":"Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Campus, Oklahoma City, OK 73117, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024, November 08). Human Papillomavirus and Cancer [Fact Sheet]. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/human-papilloma-virus-and-cancer."},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2024, November 10). About Human Papillomavirus (HPV), Available online: https:\/\/www.cdc.gov\/hpv\/about\/index.html."},{"key":"ref_3","unstructured":"National Cancer Institute (2025, July 01). HPV and Cancer, Available online: https:\/\/www.cancer.gov\/about-cancer\/causes-prevention\/risk\/infectious-agents\/hpv-and-cancer."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.15585\/mmwr.mm6937a2","article-title":"Cancers Associated with Human Papillomavirus in American Indian and Alaska Native Populations\u2014United States, 2013\u20132017","volume":"69","author":"Melkonian","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ygyno.2022.11.007","article-title":"Persistent disparities of cervical cancer among American Indians\/Alaska natives: Are we maximizing prevention tools?","volume":"168","author":"Bruegl","year":"2023","journal-title":"Gynecol. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.ygyno.2020.03.033","article-title":"Gynecologic cancer incidence and mortality among American Indian\/Alaska Native women in the Pacific Northwest, 1996\u20132016","volume":"157","author":"Bruegl","year":"2020","journal-title":"Gynecol. Oncol."},{"key":"ref_7","unstructured":"Centers for Disease Control and Prevention (2025, October 10). Vaccines for Children (VFC) Program: Program Eligibility, Available online: https:\/\/www.cdc.gov\/vaccines-for-children\/hcp\/program-eligibility\/index.html."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"698","DOI":"10.15585\/mmwr.mm6832a3","article-title":"Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices","volume":"68","author":"Meites","year":"2019","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kamolratanakul, S., and Pitisuttithum, P. (2021). Human Papillomavirus Vaccine Efficacy and Effectiveness against Cancer. Vaccines, 9.","DOI":"10.3390\/vaccines9121413"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Waheed, D.E., Schiller, J., Stanley, M., Franco, E.L., Poljak, M., Kjaer, S.K., Del Pino, M., van der Klis, F., Schim van der Loeff, M.F., and Baay, M. (2021). Human papillomavirus vaccination in adults: Impact, opportunities and challenges\u2014A meeting report. BMC Proc., 15.","DOI":"10.1186\/s12919-021-00217-4"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"708","DOI":"10.15585\/mmwr.mm7333a1","article-title":"National Vaccination Coverage Among Adolescents Aged 13\u201317 Years\u2014National Immunization Survey-Teen, United States, 2023","volume":"73","author":"Pingali","year":"2024","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_12","unstructured":"National Center for Health Statistics (2025, October 10). Increase the Proportion of Adolescents Who Get Recommended Doses of the Human Papillomavirus (HPV) Vaccine (IID-08) [Data Summary]. Healthy People 2030, Available online: https:\/\/health.gov\/healthypeople\/objectives-and-data\/browse-objectives\/vaccination\/increase-proportion-adolescents-who-get-recommended-doses-hpv-vaccine-iid-08."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss6611a1","article-title":"Surveillance of Vaccination Coverage among Adult Populations\u2014United States, 2015","volume":"66","author":"Williams","year":"2017","journal-title":"MMWR Surveill. Summ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1007\/s10900-018-0539-4","article-title":"HPV Misconceptions Among College Students: The Role of Health Literacy","volume":"43","author":"Albright","year":"2018","journal-title":"J. Community Health"},{"key":"ref_15","first-page":"1178633718825077","article-title":"Knowledge and Awareness of Human Papillomavirus Among College Students in South Carolina","volume":"12","author":"Kasymova","year":"2019","journal-title":"Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.ypmed.2016.11.019","article-title":"Factors associated with parents\u2019 attitudes to the HPV vaccination of their adolescent sons: A systematic review","volume":"95","author":"Radisic","year":"2017","journal-title":"Prev. Med."},{"key":"ref_17","first-page":"36","article-title":"A Systematic Review on Interventions Affecting Parents\u2019 Knowledge and Attitudes about HPV Vaccine","volume":"4","author":"Hamzehgardashi","year":"2022","journal-title":"Tabari Biomed. Stud. Res. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/s10865-023-00463-1","article-title":"Factors associated with HPV-associated sexual risk behaviors among sexually active college students","volume":"47","author":"Lee","year":"2024","journal-title":"J. Behav. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3564","DOI":"10.1016\/j.vaccine.2023.04.071","article-title":"Application of the theoretical domains framework to identify factors influencing catch-up HPV vaccinations among male college students in the United States: A review of evidence and recommendations","volume":"41","author":"Olusanya","year":"2023","journal-title":"Vaccine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.15585\/mmwr.mm6933a1","article-title":"National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13\u201317 Years\u2014United States, 2019","volume":"69","author":"Yankey","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_21","unstructured":"Kaiser Family Foundation (2026, May 01). The HPV Vaccine: Access and Use in the U.S. Available online: https:\/\/www.kff.org\/womens-health-policy\/the-hpv-vaccine-access-and-use-in-the-u-s\/."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3705","DOI":"10.3390\/curroncol28050316","article-title":"Designing Inclusive HPV Cancer Vaccines and Increasing Uptake among Native Americans-A Cultural Perspective Review","volume":"28","author":"Bordeaux","year":"2021","journal-title":"Curr. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"849","DOI":"10.2105\/AJPH.2023.307349","article-title":"Improving Indian Health Service Vaccination Campaigns Across the Full Spectrum of Age, Clinical, and Public Health Settings","volume":"113","author":"Baker","year":"2023","journal-title":"Am. J. Public Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/s10900-022-01079-3","article-title":"Barriers and Factors Associated with HPV Vaccination Among American Indians and Alaska Natives: A Systematic Review","volume":"47","author":"Gopalani","year":"2022","journal-title":"J. Community Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"71","DOI":"10.17953\/AICRJ.40.4.SAMUEL-NAKAMURA","article-title":"Modifiable and Non-Modifiable Factors Associated with HPV Vaccine Decision-Making among American Indian Women College Students","volume":"40","author":"Hodge","year":"2016","journal-title":"Am. Indian Cult. Res. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1000222","DOI":"10.4172\/2157-7560.1000222","article-title":"American Indian Male College Students Perception and Knowledge of Human Papillomavirus (HPV)","volume":"5","author":"Hodge","year":"2014","journal-title":"J. Vaccines Vaccin."},{"key":"ref_28","first-page":"415","article-title":"HPV vaccine readiness among American Indian college students","volume":"21","author":"Hodge","year":"2011","journal-title":"Ethn. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"96","DOI":"10.15585\/mmwr.mm7406a4","article-title":"Trends in Cervical Precancers Identified Through Population-Based Surveillance\u2014Human Papillomavirus Vaccine Impact Monitoring Project, Five Sites, United States, 2008\u20132022","volume":"74","author":"Gargano","year":"2025","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kutz, J.M., Rausche, P., Gheit, T., Puradiredja, D.I., and Fusco, D. (2023). Barriers and facilitators of HPV vaccination in sub-saharan Africa: A systematic review. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-15842-1"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kisa, S., and Kisa, A. (2024). Religious beliefs and practices toward HPV vaccine acceptance in Islamic countries: A scoping review. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0309597"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1080\/13557858.2018.1494821","article-title":"Cervical cancer, human papillomavirus (HPV), and HPV vaccination: Exploring gendered perspectives, knowledge, attitudes, and cultural taboos among Mexican American adults","volume":"26","author":"Snipes","year":"2021","journal-title":"Ethn. Health"},{"key":"ref_33","first-page":"73","article-title":"Improving HPV Vaccination Uptake Among Adolescents in Low Resource Settings: Sociocultural and Socioeconomic Barriers and Facilitators","volume":"15","author":"Xu","year":"2024","journal-title":"Adolesc. Health Med. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jped.2024.07.012","article-title":"Cultural barriers and facilitators of the parents for human papillomavirus (HPV) vaccination uptake by their daughters: A systematic review","volume":"101","author":"Salleh","year":"2025","journal-title":"J. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s13187-022-02172-w","article-title":"College Students\u2019 Awareness of the Link Between Human Papillomavirus (HPV) and HPV-Associated Cancers","volume":"38","author":"Franca","year":"2023","journal-title":"J. Cancer Educ."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Malik, S., Mock, K.O., Martillotti, R., Caravella, G., Zhou, X., Mbamelu, M., and Scarbrough, K.H. (2024). HPV Vaccines Among University Students: Understanding Barriers and Facilitators of Vaccine Uptake. Vaccines, 12.","DOI":"10.3390\/vaccines12121385"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"14","DOI":"10.32398\/cjhp.v12i3.1577","article-title":"Communication Pathways","volume":"12","author":"Hodge","year":"2014","journal-title":"Californian J. Health Promot."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Barnard, M., George, P., Perryman, M.L., and Wolff, L.A. (2017). Human papillomavirus (HPV) vaccine knowledge, attitudes, and uptake in college students: Implications from the Precaution Adoption Process Model. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0182266"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1080\/19325037.2022.2163005","article-title":"1-2-3! Catch-Up for HPV: A Theoretically Informed Pilot Intervention to Increase HPV Vaccine Uptake among Young Adults","volume":"54","author":"Harper","year":"2023","journal-title":"Am. J. Health Educ."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s11121-018-0952-z","article-title":"Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities","volume":"21","author":"Walters","year":"2020","journal-title":"Prev. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Louw, G.E., Hohlfeld, A.S., Kalan, R., and Engel, M.E. (2024). Mobile Phone Text Message Reminders to Improve Vaccination Uptake: A Systematic Review and Meta-Analysis. Vaccines, 12.","DOI":"10.3390\/vaccines12101151"},{"key":"ref_42","unstructured":"National Institutes of Health (2025, October 10). New Funding Opportunity Supports Research on Understudied, Underrepresented, and Underreported (U3) Populations of Women, Available online: https:\/\/orwh.od.nih.gov\/in-the-spotlight\/all-articles\/new-funding-opportunity-supports-research-on-understudied-underrepresented-and-underreported-u3."},{"key":"ref_43","first-page":"1","article-title":"Contextualizing Cbpr: Key Principles of Cbpr Meet the Indigenous Research Context","volume":"7","author":"Laveaux","year":"2009","journal-title":"Pimatisiwin"},{"key":"ref_44","unstructured":"World Health Organization (2024, November 08). WHO Updates Recommendations on HPV Vaccination Schedule. Available online: https:\/\/www.who.int\/news\/item\/20-12-2022-WHO-updates-recommendations-on-HPV-vaccination-schedule."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"101195","DOI":"10.1016\/j.pmedr.2020.101195","article-title":"The influence of affect on HPV vaccine decision making in an HPV vaccine naive college student population","volume":"20","author":"Przybyla","year":"2020","journal-title":"Prev. Med. Rep."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/8\/1027\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T08:12:12Z","timestamp":1786003932000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/8\/1027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":45,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["ijerph23081027"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23081027","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]}}}