Addressing HPV vaccination disparities through tailored messaging for hesitant families

项目摘要 人乳头瘤病毒（HPV）每年在美国导致超过34，800例癌症， 影响黑人女性。HPV疫苗非常有效，但13-15岁的青少年不到一半 接受了推荐剂量，黑人在完成方面的差距最大。HPV疫苗 犹豫与疫苗接种不足和拒绝有关。据估计，23%的青少年父母 对HPV疫苗犹豫不决，但父母的担忧因无数的个人，人际关系和 社会文化因素。需要采取有效的策略来克服父母的担忧，特别是在黑人中。 家庭，由于种族不平等，一般疫苗犹豫和医疗不信任的患病率更高。 这个NCI过渡职业发展奖（K22）的目的是通过特定的培训来支持我 和研究经验，因为我成为一个独立的研究人员专门从事多层次的癌症预防 采取干预措施，减少宫颈癌的差距。基于我强大的健康服务研究和行为 在HPV筛查的科学背景，我将发展HPV疫苗接种沟通，社区的专业知识， 参与干预计划和干预试验。这个严格的混合方法提案的目标 是：（1）使用一种由用户参与的方法来开发和完善一种交互式的、量身定制的文本消息传递 干预以解决黑人父母的HPV疫苗犹豫决定因素和疫苗接种障碍;以及（2） 进行一项两组试验性随机对照试验，以确定以下方法的可行性、可接受性、适当性和初步疗效： 定制的消息与未定制的消息相比。根据提供商的初步建议， 干预将允许年轻青少年的父母在他们喜欢的时间处理HPV疫苗接种信息。 时间轴，回答挥之不去的问题和担忧，提供链接到来自可信来源的其他信息， 并支持与当地资源的联系，以帮助克服障碍。通过实现这些目标，我将 解决目前在战略上的差距，以提高高风险黑人家庭对疫苗的信心和积极性。 罗格斯癌症研究所拥有资金充足的行为研究计划，强大的研究基础设施， 深厚的社区联系是开展高影响力，社区参与癌症的特殊环境 差距研究。作为我职业发展的合乎逻辑的下一步，这个K22将为我提供所需的技能， 设计，实施和评估多层次干预措施，以实现HPV健康公平。调查结果和初步报告 疗效估计将告知R 01申请多中心试验，以测试多组分干预 解决HPV疫苗犹豫的复杂，特定背景的决定因素，以激励接种疫苗， 改变行为最终，这个K22提案将有助于我建立一个独立研究的长期目标。 该计划调查社区驱动的解决方案，以减少HPV差异并促进消除 宫颈癌

PROJECT SUMMARY Human papillomavirus (HPV) causes over 34,800 cancers in the United States each year that disproportionately affect Black women. The HPV vaccine is highly effective, but less than half of adolescents aged 13-15 years have received recommended doses, with Blacks having the greatest disparity in completion. HPV vaccine hesitancy is associated with under-vaccination and refusal. An estimated 23% of parents with adolescents are hesitant about the HPV vaccine, but parents’ concerns vary due to a myriad of individual, interpersonal, and sociocultural factors. Effective strategies to overcome parents’ concerns are needed, especially among Black families, who have higher prevalence of general vaccine hesitancy and medical mistrust due to racial inequities. The purpose of this NCI Transition Career Development Award (K22) is to support me through specific training and research experiences as I become an independent investigator specializing in multilevel cancer prevention interventions to reduce cervical cancer disparities. Building on my strong health services research and behavioral science background in HPV screening, I will develop expertise in HPV vaccination communication, community- engaged intervention planning, and intervention trials. The objectives of this rigorous mixed methods proposal are to: (1) use a stakeholder-engaged approach to develop and refine an interactive, tailored text messaging intervention to address Black parents’ HPV vaccine hesitancy determinants and vaccination barriers; and (2) conduct a two-arm pilot RCT to determine feasibility, acceptability, appropriateness, and preliminary efficacy of the tailored messages compared to untailored messages. Following a provider’s initial recommendation, the intervention will allow parents of young adolescents to process HPV vaccination information on their preferred timeline, answer lingering questions and concerns, provide links to additional information from trusted sources, and support connections to local resources to help overcome barriers. By accomplishing these aims, I will address current gaps in strategies to increase vaccine confidence and motivation among high-risk Black families. Rutgers Cancer Institute with its well-funded behavioral research program, robust research infrastructure, and deep community connections is an exceptional environment to conduct high-impact, community-engaged cancer disparities research. As a logical next step in my career development, this K22 will give me the skills required to design, implement, and evaluate multilevel interventions to achieve HPV health equity. Findings and preliminary efficacy estimates will inform an R01 application of a multi-site trial to test a multiple component intervention addressing the complex, context-specific determinants of HPV vaccine hesitancy to motivate vaccination and change behaviors. Ultimately, this K22 proposal will facilitate my long-term goal to build an independent research program investigating community-driven solutions to reduce HPV disparities and advance the elimination of cervical cancer.