Examining the Integrative Effects of Adolescent, Parent, Provider, and Practice Level Factors on Adolescents' HPV Vaccine Uptake across Six Asian American Subgroups

检查青少年、家长、提供者和实践水平因素对六个亚裔美国人亚群体青少年 HPV 疫苗接种的综合影响

• 批准号: 10551328
• 负责人: Lin Zhu
• 金额: $ 8.32万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10551328
• 关键词: 12 year old; 17 year old; 9 year old; Address; Adolescent; Advisory Committees; Affect; Age; Anogenital venereal warts; Asian; Asian Americans; Asian Indian; Awareness; Centers for Disease Control and Prevention (U.S.); Cervix Uteri; Cessation of life; Characteristics; Child; Chinese; Clinic; Clinical; Clinical Research; Complex; Data; Development; Disease; Disparity; Disparity population; Eligibility Determination; Empirical Research; Equation; Ethnic Origin; Family Practice; Female Adolescents; Filipino; Goals; Health; Hospitals; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papillomavirus 16; Human papillomavirus 18; Immunization; Individual; Japanese; Knowledge; Koreans; Link; Literature; Logistic Regressions; Malignant Neoplasms; Mediating; Mediator; Modeling; National Cancer Institute; Oropharyngeal; Parents; Pediatrics; Persons; President' s Cancer Panel; Process; Provider; Public Health; Recommendation; Reporting; Research; Role; Safety; Sampling; Sampling Studies; Services; Sexually Transmitted Diseases; Subgroup; Surveys; Teenagers; Translating; Vaccinated; Vaccination; Vaccines; Vietnamese; aged; boys; clinical practice; data to knowledge; disparity reduction; epidemiologic data; evidence base; girls; high risk; high risk population; human old age (65+); improved; medical specialties; penis; practice factors; prevent; racial population; social; social culture; social determinants; vaccination outcome; vaccine acceptance

PROJECT SUMMARY Human papillomavirus (HPV) is the most common form of sexually transmitted infection in the US, with approximately 79 million US individuals infected with HPV. The Advisory Committee on Immunization Practices (ACIP) recommends vaccine initiation between 11–12 years old, and it can be initiated as young as 9 years old. However, less than half of 13- to 17-year-old girls and less than one-third boys were fully vaccinated against HPV, much lower than the80% goal of Healthy People 2030. Significant barriers to HPV vaccination have been identified in 1) missed clinical opportunities due to provider and practice-related barriers, 2) low parental awareness, and 3) limited access to HPV vaccination services due to sociocultural and financial barriers. Asian Americans are disproportionally affected by HPV and HPV related conditions. Despite public health efforts, HPV vaccination rates were suboptimal in Asian American adolescents. Regional data showed low awareness of HPV vaccine and low vaccination rates in Chinese, Filipino, Japanese, Asian Indian, Korean, and Vietnamese subgroups. However, literature of the multilevel social determinants of HPV vaccine in Asian Americans is limited. Identifying high-risk groups and the multilevel mechanisms of HPV vaccine uptake are crucial in reducing disparities and increasing HPV vaccination rates in Asian American adolescents. This study will be the first study to use a nationally representative sample to examine the integrative effects of adolescent, parent, provider, and practice level factors in six Asian American subgroups. The proposed study will leverage the existing data from the 2010–2019 National Immunization Survey-Teen (NIS- Teen), the gold standard of US vaccination data. The study sample will include 6,019 boys and girls aged 13– 17 of Chinese (1,613), Filipino (1,383), Japanese (834), Indian (800), Korean (786), and Vietnamese (603) ethnicity. The specific aims are, Aim 1: to examine the integrative effects of adolescent, parent, provider, and practice level factors in their association with adolescent's HPV vaccine initiation and completion among six Asian American subgroups. Aim 2: to investigate the parent-reported reasons for delay or refusal of HPV vaccine for adolescents across six Asian American subgroups. Each specific aim addresses a unique research question that links practice/provider characteristics with adolescents/parent level factors, and together provide a comprehensive understanding of the social mechanisms of HPV vaccine uptake in Asian adolescents. Findings of this proposed study will provide subgroup-specific epidemiological data, guide the improvement of clinical practices, and inform the development of evidence-based strategies to reduce missed opportunities and improve adolescent vaccination in Asian American adolescents.

项目总结 人类乳头瘤病毒(HPV)是美国最常见的性传播感染形式， 大约7900万美国人感染了HPV。免疫接种做法咨询委员会 (ACIP)建议在11-12岁之间开始接种疫苗，并且可以在9岁时开始接种。 然而，只有不到一半的13到17岁的女孩和不到三分之一的男孩完全接种了疫苗。 HPV，远低于2030年健康人80%的目标。接种HPV疫苗的重大障碍是 1)由于提供者和实践相关的障碍而错过临床机会，2)父母人数较少 3)由于社会文化和经济障碍，获得HPV疫苗接种服务的机会有限。 亚裔美国人不成比例地受到HPV和HPV相关疾病的影响。尽管公众 在卫生努力下，亚裔美国青少年的HPV疫苗接种率并不理想。地区数据显示 中国、菲律宾、日本、亚裔印度人、韩国人、 和越南亚群。然而，关于亚洲人乳头瘤病毒疫苗的多层次社会决定因素的文献 美国人是有限的。识别高危人群和HPV疫苗接种的多水平机制是 这对缩小亚裔美国青少年中的差距和提高HPV疫苗接种率至关重要。 这项研究将是第一次使用具有全国代表性的样本来检验 青少年、父母、提供者和实践水平因素在六个亚裔美国人亚群中的影响。这个 拟议的研究将利用2010-2019年全国免疫调查-青少年(NIS- 青少年)，美国疫苗接种数据的黄金标准。研究样本将包括6,019名13岁的男孩和女孩- 中国人(1613人)、菲律宾人(1383人)、日语(834人)、印度人(800人)、韩国人(786人)和越南人(603人)中有17人 种族问题。具体目标是， 目的1：检验青少年、父母、提供者和实践水平因素在 6名亚裔美国人中青少年HPV疫苗启动和完成的关系 子组。 目的2：调查父母报告的青少年延迟或拒绝接种HPV疫苗的原因 在六个亚裔美国人亚群中。 每个具体目标都针对一个独特的研究问题，该问题将实践/提供者的特征与 青少年/家长层面的因素，并共同提供对社会 亚洲青少年感染HPV疫苗的机制。 发现 的 这 拟议数 学习 将要 提供 针对亚组的流行病学数据，指导临床实践的改进，并向 制定循证战略以减少错失的机会和改善青少年疫苗接种 在亚裔美国青少年中。