Vietnamese-American parents' HPV vaccine uptake for their adolescent children: An examination of practice-, provider-, and patient-level influences

项目总结/摘要 据记录，越南裔美国人的宫颈癌发病率很高， 乳头瘤病毒疫苗（HPVV）摄取。不幸的是，有限的研究已经分解了亚裔美国人 人口来研究这种差异的机械解释。此外，以前没有研究过 影响越南裔美国人HPVV摄取的多层次决定因素。这项研究将利用一个 卫生服务研究框架（P3模型）和解释性序贯混合方法设计， 研究越南裔美国人父母中HPVV摄取的多层次决定因素。具体目标 是：（1）定量研究实践，供应商，和患者层面的因素影响越南- 美国父母对青少年HPVV的摄取情况;（2）定性地研究为什么和如何影响因素 目标1中确定的影响越南裔美国父母的HPVV决策和评估实践， 提供者和患者层面的策略，以促进青少年HPVV的吸收。该提案将推动NCI的 癌症健康公平的使命，通过探索HPVV的结构、社会和文化障碍， 通过支持发展一位有才华、泰然自若的初级调查员Ha Ngan女士， 武致力于推进这一使命的研究事业。吴女士的三年培训计划包括： (1)加强对卫生服务研究理论的研究，重点关注卫生系统因素 影响亚洲移民的癌症预防实践和HPVV利用;（2）增加她的 了解干预措施的发展和转化研究;（3）完善她的技能， 研究设计、统计方法和混合方法研究。这个奖学金将促进她的进步 她的职业目标是成为一名独立的研究人员， 移民和种族/族裔少数群体之间的差异，运用这些知识制定干预措施 解决这些差距，并确保知识转化为政策和实践的信息。埃默里大学 为拟议的研究和培训提供了良好的环境。建议的导师团队，贝格博士 （主要赞助商）、Bednarczyk（联合赞助商）、Escoffery（联合赞助商）和Haardörfer（合作者）将提供 他们的集体专业知识，指导吴女士在癌症预防和控制，健康传播，HPV， 传播和实施研究，混合方法研究，理论开发和测试，以及 研究翻译和传播。此外，Vu女士将利用现有的基础设施和资源， 埃默里大学温希普癌症研究所（NCI指定的综合癌症中心）内;埃默里大学全球 卫生研究所及其相关的难民和移民卫生和健康联盟;以及 博士课程，系，公共卫生学院，大学。候选人，导师团队， 和环境，以有效地实现拟议的研究和培训目标。

PROJECT SUMMARY/ABSTRACT Vietnamese-Americans have been documented to have high cervical cancer rates and low human papillomavirus vaccine (HPVV) uptake. Unfortunately, limited research has disaggregated the Asian-American population to examine mechanistic explanations for this disparity. Additionally, no prior work has examined multilevel determinants influencing HPVV uptake among Vietnamese-Americans. This study will leverage a health services research framework (P3 model) and an explanatory sequential mixed-method design to examine multilevel determinants of HPVV uptake among Vietnamese-American parents. The specific aims are to: (1) quantitatively examine practice-, provider-, and patient-level factors influencing Vietnamese- American parents’ HPVV uptake for their adolescents; and (2) qualitatively examine why and how factors identified in Aim 1 shape Vietnamese-American parents’ HPVV decision-making and assess practice-, provider-, and patient-level strategies to promote adolescent HPVV uptake. This proposal will advance NCI’s mission of cancer health equity by exploring structural, social, and cultural barriers to HPVV for a high-risk minority group and by supporting the development of a talented, well-poised junior investigator, Ms. Ha Ngan (Milkie) Vu, who is devoted to a research career furthering this mission. Ms. Vu’s 3-year training plan includes: (1) strengthening her expertise of health services research theories, focusing on health system factors impacting Asian immigrants’ cancer prevention practices and HPVV utilization; (2) increasing her understanding of intervention development and translational research; and (3) refining her skills set related to research design, statistical methods, and mixed-method research. This fellowship will facilitate her progress towards her career goal of becoming an independent investigator who advances knowledge of cancer health disparities among immigrants and racial/ethnic minorities, applies this knowledge to develop interventions addressing such disparities, and ensures knowledge translation to inform policy and practice. Emory University is an excellent environment for the proposed research and training. The proposed team of mentors, Drs. Berg (Primary Sponsor), Bednarczyk (Co-Sponsor), Escoffery (Co-Sponsor), and Haardörfer (Collaborator) will lend their collective expertise to mentor Ms. Vu in cancer prevention and control, health communication, HPVV, dissemination and implementation research, mixed-methods research, theory development and testing, and research translation and dissemination. Moreover, Ms. Vu will leverage infrastructure and resources available within Emory’s Winship Cancer Institute (NCI-designated comprehensive cancer center); within Emory’s Global Health Institute and its associated Refugee and Immigrant Health and Wellness Alliance; and within the Doctoral Program, Department, School of Public Health, and University. The candidate, the mentorship team, and the environment are uniquely suited to effectively achieve the proposed research and training aims.