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

项目摘要/摘要 有记录表明，越南裔美国人的宫颈癌发病率很高，而人类 乳头瘤病毒疫苗(HPVV)接种。不幸的是，有限的研究对亚裔美国人进行了分类 来检验这种差异的机械解释。此外，之前没有检查过任何工作 影响越南裔美国人感染HPVV的多水平决定因素。这项研究将利用 卫生服务研究框架(P3模型)和解释性序贯混合方法设计 研究越南裔美国父母感染HPVV的多水平决定因素。具体目标 是：(1)定量检查影响越南语的实践、提供者和患者层面的因素- 美国父母对其青少年感染HPVV的情况；以及(2)定性地检查原因和如何影响因素 在目标1中确定的塑造越南裔美国父母的HPVV决策和评估实践-， 促进青少年感染HPVV的提供者、患者和患者层面的战略。这项提议将推进NCI的 通过探索HPVV高危人群的结构、社会和文化障碍来实现癌症健康公平的使命 通过支持发展一名才华横溢、有能力的初级调查员夏燕女士，并支持少数群体 (Milkie)Vu，他致力于推动这一使命的研究事业。Vu女士的三年培训计划包括： (1)加强卫生服务研究理论专业知识，重点研究卫生系统因素 影响亚洲移民的癌症预防实践和HPVV的使用；(2)增加Her 了解干预开发和翻译研究；以及(3)完善与以下相关的技能 研究设计、统计方法和混合方法研究。这笔奖学金将促进她的进步 她的职业目标是成为一名独立调查员，推动癌症健康知识的发展 移民和种族/少数民族之间的差异，将这一知识应用于制定干预措施 解决这种差异，并确保知识转化，为政策和实践提供信息。埃默里大学 对于拟议的研究和培训来说，是一个很好的环境。建议的导师团队，伯格博士 (主赞助商)、Bednarczyk(共同赞助商)、Escoery(联合赞助商)和Haardörfer(协作者)将提供贷款 他们的集体专业知识指导吴女士在癌症预防和控制、健康沟通、HPVV、 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还将利用现有的基础设施和资源 在Emory‘s Winship癌症研究所(NCI指定的综合性癌症中心)内；在Emory’s Global 卫生研究所及其联系的难民和移民健康与健康联盟； 博士项目，系，公共卫生学院，大学。候选人，导师团队， 和环境非常适合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.