Policy- and Provider-Level Determinants of Human Papillomavirus Vaccination Disparities Among Young U.S. Women

美国年轻女性人乳头瘤病毒疫苗接种差异的政策和提供者层面的决定因素

• 批准号: 10481278
• 负责人: Madina Agénor
• 金额: $ 3.56万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-08 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10481278
• 关键词: Policy; Provider; Level; Determinants; Human

PROJECT SUMMARY Guided by Taplin et al.’s model of multilevel influences of the cancer care continuum, the proposed project investigates how state health policies and provider-level factors influence human papillomavirus (HPV) vaccination among sexual and racial/ethnic minority women. The project’s two specific aims are to: (1) examine the effect of state Medicaid expansions and HPV vaccine policies on HPV vaccination initiation among sexual and racial/ethnic minority U.S. women aged 15-25 years and (2) explore health care providers’ beliefs, attitudes, decision-making processes, and practices related to HPV vaccination among adolescent and young adult sexual and racial/ethnic minority women. I will address Aim 1 by using state-level data from the National Conference of State Legislatures and individual-level 2011-2015 National Survey of Family Growth data to conduct a difference-in-difference analysis that uses multivariable linear regression to assess the association between the implementation of state Medicaid expansions and HPV vaccine policies and the proportion of U.S. women aged 15-25 years who initiated HPV vaccination in relation to both sexual orientation identity and race/ethnicity (separately). I will address Aim 2 by conducting 30 in-depth interviews with health care providers selected using a purposive sampling approach and recruited from four Boston-area community health centers that provide care to underserved populations. I will analyze the provider interview transcripts using immersion/crystallization, the template organizing style of qualitative data analysis, discourse analysis, and within- and cross-case analysis. By engaging in mentored research with Dr. Deborah Bowen (Mentor) and collaborators, completing coursework, and participating in seminars, conferences, and regular mentoring meetings, I will develop expertise in three new areas critical to my development as an interdisciplinary, independent investigator who examines how factors at not only the patient but also the provider and policy levels influence cancer screening and prevention disparities: health services research, health policy, and advanced econometrics. Moreover, I will extend my grant writing and oral presentation skills by participating in grant writing courses and presenting at research meetings and seminars. The Harvard T.H. Chan School of Public Health offers junior scholars with the intellectual and practical resources they need to develop into successful independent investigators, including junior faculty seminars, grant writing, editing, and review services, and opportunities for intellectual exchange and collaboration with senior colleagues. A K01 award will provide me with the research experience, skills, and mentorship I need to build a cutting-edge independent research program that examines how factors at the patient, provider, and policy levels influence the utilization of cervical and other cancer prevention and screening services among underserved U.S. women and men.

项目摘要 在塔普林等人的指导下。的癌症护理连续体的多层次影响的模型，拟议的项目 调查国家卫生政策和提供者层面的因素如何影响人乳头瘤病毒（HPV） 在性别和种族/族裔少数妇女中接种疫苗。该项目的两个具体目标是：（1） 检查州医疗补助扩展和HPV疫苗政策对HPV疫苗接种启动的影响 在15-25岁的性和种族/少数民族美国妇女中，（2）探索医疗保健提供者的 在青少年中与HPV疫苗接种相关的信念、态度、决策过程和实践， 年轻的成年性和种族/少数民族妇女。我将通过使用来自 2011-2015年全国家庭成长调查全国州议会会议和个人层面 数据进行差异分析，使用多变量线性回归来评估 国家医疗补助扩张和HPV疫苗政策的实施与 15-25岁的美国女性开始接种HPV疫苗的比例与性取向有关 身份和种族/族裔（分别）。我将通过对30名健康问题专家进行深入访谈， 护理提供者使用目的抽样方法，并从波士顿地区的四个社区招募 为服务不足的人群提供医疗服务的医疗中心。我会分析供应商的访谈记录 运用沉浸/结晶、定性数据分析的模板组织方式、语篇分析、 以及案例内和案例间分析。通过与Deborah Bowen博士（导师）进行指导研究， 合作者、完成课程作业以及参加研讨会、会议和定期指导 会议上，我将在三个新的领域发展专业知识，这三个领域对我作为一个跨学科的发展至关重要， 独立调查员，不仅检查患者，还检查提供者和政策的因素 水平影响癌症筛查和预防差距：卫生服务研究，卫生政策， 高级计量经济学此外，我将通过参加以下活动来扩展我的赠款写作和口头陈述技能： 资助写作课程，并在研究会议和研讨会上发表演讲。哈佛大学禅宗 公共卫生为初级学者提供了他们发展成为 成功的独立调查员，包括初级教师研讨会，赠款写作，编辑和审查 服务，以及与高级同事进行知识交流和合作的机会。K 01奖项将 为我提供研究经验，技能，和指导，我需要建立一个尖端的独立 一项研究计划，研究患者、提供者和政策层面的因素如何影响 宫颈癌和其他癌症的预防和筛查服务，在服务不足的美国妇女和男子。

项目成果

School Restroom and Locker Room Restrictions and Sexual Assault Risk Among Transgender Youth.

• DOI: 10.1542/peds.2018-2902
• 发表时间: 2019-06
• 期刊: Pediatrics
• 影响因子: 8
• 作者: Murchison GR;Agénor M;Reisner SL;Watson RJ
• 通讯作者: Watson RJ

Contraceptive Care Disparities Among Sexual Orientation Identity and Racial/Ethnic Subgroups of U.S. Women: A National Probability Sample Study.

美国妇女性取向认同和种族/民族亚群之间的避孕护理差异：全国概率样本研究。

• DOI: 10.1089/jwh.2020.8992
• 发表时间: 2021
• 期刊: Journal of women's health (2002)
• 作者: Agénor,Madina;Pérez,AshleyE;Wilhoit,Amanda;Almeda,Florence;Charlton,BrittanyM;Evans,MeganL;Borrero,Sonya;Austin,SBryn
• 通讯作者: Austin,SBryn

Sexual Orientation Differences in Cervical Cancer Prevention among a Cohort of U.S. Women.

美国女性群体中宫颈癌预防的性取向差异。

• DOI: 10.1016/j.whi.2020.02.002
• 发表时间: 2020
• 期刊: Women's health issues : official publication of the Jacobs Institute of Women's Health
• 作者: Solazzo,AlexaL;Agénor,Madina;Austin,SBryn;Chavarro,JorgeE;Charlton,BrittanyM
• 通讯作者: Charlton,BrittanyM

Sexual orientation inequalities during provider-patient interactions in provider encouragement of sexual and reproductive health care.

提供者与患者互动期间的性取向不平等，以鼓励提供者提供性健康和生殖健康护理。

• DOI: 10.1016/j.ypmed.2019.105787
• 发表时间: 2019
• 期刊: Preventive medicine
• 影响因子: 5.1
• 作者: Solazzo,AlexaL;Tabaac,AriR;Agénor,Madina;Austin,SBryn;Charlton,BrittanyM
• 通讯作者: Charlton,BrittanyM

Use of media sources in seeking and receiving sexual health information during adolescence among adults of diverse sexual orientations in a US cohort.

美国队列中不同性取向的成年人在青春期期间使用媒体资源寻求和接收性健康信息。

• DOI: 10.1080/14681811.2021.1873122
• 发表时间: 2021
• 期刊: Sex education
• 作者: Tabaac AR;Benotsch EG;Agénor M;Austin SB;Charlton BM
• 通讯作者: Charlton BM