As Marla Wander tells it, she was stuck in a routine. She wanted to expand her expertise, while teaching basic and childhood psychology courses at Camden County College. She consulted a colleague, who told her about the new Ph.D. in childhood studies program at Rutgers–Camden. With her interest piqued, Wander accepted the challenge as a member of the program’s first cohort in 2007. She never looked back.
Wander credits the childhood studies program for fostering a collaborative, intellectually stimulating atmosphere amongst the faculty and students. She notes that often there is a stereotype that graduate school is competitive, but such was not the case at Rutgers–Camden. “You are very accessible to one another,” she says, adding that the members of her class came from a wide range of disciplines, including literature, media, counseling, education, and law. “Hearing their perspectives really opened my eyes to looking at the world in a different way,” she says. “It was invigorating.”
As Wander explored a focus for her research, she contemplated her fascination with how adolescents participate in their own decision-making. She recalls curiously observing her students at Camden County College, as well as her own children growing up. Much like countless parents and educators before her, Wander pondered the age-old question, “Why are they doing what they are doing?” “They are active participants in their life; their decisions aren’t just random,” says Wander.
Wander thus concentrated her research on a topic that would provide “a window” into adolescents’ active participation in their lives, while providing a health benefit to her work. Her resulting dissertation, “Adolescents Involved in Decision Making: Clinic Conversations about Human Papillomavirus and Vaccination,” examines the participation of healthy adolescents, in conjunction with their parents and physician, in the decision to take an optional vaccine preventing HPV infections that cause adult cancers.
Wander explains that there are more than 100 different strains of HPV. The vaccines are specifically targeted to prevent two strains that cause 70 percent of all cervical cancer in adult women, and two strains that cause 90 percent of the genital warts in humans. Genital warts can appear at the time of infection or later in life. There is no cure for any HPV-related diseases, yet these vaccines will prevent their acquisition.
Through the course of her research, Wander surveyed more than 400 male and female adolescents, and their parents, in what she terms “an academically affiliated adolescent medical practice,” when the children visited for healthy checkups. She routinely introduced herself to adolescents and parents in the waiting room, and explained that she and the pediatrician were conducting research to determine the general knowledge of HPV. In some instances, she would speak with them in the exam room after the doctor had completed the exam, or would speak with parents while their children were seeing the doctor.
Participants were given a three-page questionnaire to complete. In addition to basic demographical information, the survey asked a series of questions regarding HPV and sexually transmitted infections. The questions included: Is HPV a sexually transmitted infection? Is HPV curable? Is HPV related to HIV? Will condoms prevent someone from getting the disease? Wander notes that these questions could easily be answered after a conversation with their physician or from reading a few HPV articles.
Wander discovered that adolescents typically just listened and weren’t very vocal in discussing the vaccine or the virus when their parents were in the room. If they were vocal, they were only focused on not wanting to get a shot, she says. Furthermore, she found that adolescents only asked questions about the virus when their parents weren’t present. “They want to participate, the way that they want to participate,” says Wander. “They want to keep their responses safe.”
Meanwhile, Wander found that parents were having conversations about the infection with family and friends, but not with their children. In addition, parents often feared that their child was too young for the vaccine. Wander maintains that this parental concern was “code” for parents insisting that their children were not engaging in sexual behavior that could expose them to HPV. “They thought that the vaccinations could be postponed until their son or daughter went off to college, where they could be exposed to sexual activities,” says Wander.
She adds that her research also revealed several common misconceptions about the virus. For instance, she notes, parents were fearful of the dangers of the vaccine itself, and not of the life-threatening risks associated with the infection. “This is a barrier to all types of vaccines,” Wander says, adding, “You can’t get infected from the vaccine, but if you get it before you are infected by HPV, then it will protect against 70 percent of cervical cancers, plus a multitude of other cancers appearing in both males and females in adulthood.”
Reflecting on her project, Wander says that her experience as a childhood studies scholar taught her that she is inextricably engaged in her research. “I realize that my presence influenced what adolescents, parents and physicians say and do,” says Wander. “The presence of an observer or a researcher changes the setting, reconfigures the episode and participants’ interactions.
She adds that being aware of her interactive role in her research was a departure from believing that she functioned as a passive observer in her previous research experience. Wander said that she was used to functioning like a “fly on the wall” in a series of experiments involving rats, while earning a bachelor’s degree in psychology from Arcadia College in 1974, and those involving children, while earning her master’s degree in experimental psychology from Villanova University in 1982, and her master’s degree in educational psychology from the University of Delaware in 1986. “I was used to quantifying all of the variables associated with a situation,” she recalls, adding, “Now, as a childhood studies scholar, I have a more dialectical way of looking at the world.”
Wander would now like to utilize her research in an effort to increase the vaccination rate amongst adolescents. She says that, while her study focuses on adolescents during healthy visits, there is an underserved adolescent population that doesn’t receive healthcare. She would also like to disseminate information in order to help prepare adolescents to become active agents in their own healthcare decisions.
Incidentally, for Wander, Rutgers pride runs through the family. Her daughter, Rachelle, graduated with a bachelor’s degree in art history from Rutgers–New Brunswick, in 2006; and daughter, Daryl, graduated from Rutgers–New Brunswick in 2008, and Rutgers School of Law–Camden in 2011. Her daughter, Lauren, graduated from Union College in New York in 2003 and Boston University with a master’s degree in Spanish education in 2005.
Media Contact: Tom McLaughlin
856-225-6545
E-mail: thomas.mclaughlin@camden.rutgers.edu