Addressing HPV vaccination disparities through tailored messaging for hesitant families

项目总结 人乳头瘤病毒(HPV)每年在美国导致超过34,800例癌症，这与 影响黑人女性。HPV疫苗是非常有效的，但在13-15岁的青少年中只有不到一半 已经接受了推荐剂量，黑人在完成剂量方面差距最大。人乳头瘤病毒疫苗 犹豫不决与接种不足和拒绝接种有关。据估计，23%的有青少年的父母 对HPV疫苗犹豫不决，但父母的担忧因个人、人际和 社会文化因素。需要有效的策略来克服父母的担忧，特别是在黑人中 由于种族不平等，普遍存在疫苗迟疑和医疗不信任的家庭比例较高。 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，因为我成为一名独立的调查员，专门从事多层次的癌症预防 减少宫颈癌差异的干预措施。以我强大的健康服务研究和行为能力为基础 HPV筛查的科学背景，我将在HPV疫苗接种沟通、社区- 参与干预计划和干预试验。这一严格的混合方法提案的目标是 目的是：(1)使用利益相关者参与的方法来开发和改进交互式、量身定制的短信 干预措施，以解决黑人父母HPV疫苗接种迟疑的决定因素和接种障碍；以及(2) 进行双臂试点RCT，以确定以下项目的可行性、可接受性、适当性和初步效果 定制的消息与非定制的消息进行比较。根据提供商的初始建议， 干预措施将允许青少年的父母处理他们喜欢的HPV疫苗接种信息 时间表，回答挥之不去的问题和关切，提供指向来自可信来源的其他信息的链接， 并支持与当地资源的连接，以帮助克服障碍。通过实现这些目标，我将 解决目前在增加高危黑人家庭接种疫苗信心和积极性的战略方面的差距。 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，以及 深入的社区关系是进行高影响力、社区参与的癌症的特殊环境 差异研究。作为我职业发展的合乎逻辑的下一步，这门K22将给我所需的技能 设计、实施和评估多层次干预措施，以实现HPV健康公平。调查结果和初步结果 疗效评估将通知R01应用程序进行多点试验以测试多组分干预 解决HPV疫苗接种迟缓的复杂的、特定于背景的决定因素，以激励接种和 改变行为。最终，这项K22建议将有助于我建立独立研究的长期目标 调查社区驱动的解决方案的计划，以减少HPV差距并推动消除 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.