Geographic access to care and HPV vaccine uptake among ethnic minority girls
少数民族女孩获得护理的地理机会和 HPV 疫苗的接种情况
基本信息
- 批准号:8069498
- 负责人:
- 金额:$ 3.66万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2011
- 资助国家:美国
- 起止时间:2011-09-01 至 2012-05-31
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
DESCRIPTION (provided by applicant): Cervical cancer disproportionately affects minority, immigrant, and low income women. Human Papillomavirus (HPV) vaccines have the potential to substantially prevent high-risk HPV infections and future cases of cervical cancer. However, recent studies show that HPV vaccine uptake in high risk groups remains low. Even with available programs that provide the vaccine for free to low income populations, multiple barriers, such as lack of geographic/spatial accessibility to safety-net immunization clinics, may prevent disadvantaged girls from obtaining the HPV vaccine. Current disparities in cervical cancer will likely persist as a result of HPV vaccine under-utilization among low income, ethnic minority populations. This cross-sectional study will examine geographic/spatial access to care and neighborhood factors, in addition to individual level factors, that influence HPV vaccine initiation (receiving e 1 dose of the HPV vaccine) among low-income, minority girls in Los Angeles County (LAC). The study will build on primary data collected from mothers of HPV vaccine age-eligible girls who primarily reside in disadvantaged areas of LAC and routinely access the county safety-net system. This individual-level data will be linked at the census tract level to neighborhood socio-demographic data from the U.S. Census Bureau and neighborhood cervical cancer risk data from the LAC Sexually Transmitted Diseases Program. Geographic information systems mapping techniques will be employed to create geographic/spatial access measures (shortest travel distance to clinic, coverage of e 1 clinic within a 3-mile radius of household) using residential addresses of vaccine age-eligible girls and locations of safety-net immunization clinics. The study will evaluate whether spatial access to immunization clinics is associated with HPV vaccine initiation, as well as whether the relationship between spatial access and vaccine initiation is modified by individual race/ethnicity, while controlling for other individual level risk factors. Hierarchical logistical regression modeling will also be used to assess the impact of neighborhood factors (socio-demographic characteristics and cervical cancer risk), in addition to spatial access and individual level risk factors, on HPV vaccine initiation. The study is unique in that it moves beyond individual level predictors to assess geographic and neighborhood factors that impact HPV vaccine initiation in an underserved, urban population. Study results will inform local county health officials about factors that contribute to low HPV vaccine utilization and provide information relevant to resource allocation decisions for cancer prevention and control programs in LAC. Results will also inform health policymakers and researchers on geographically based interventions that could improve HPV vaccine uptake.
PUBLIC HEALTH RELEVANCE: This study will examine the impact of geographic/spatial access to safety-net immunization clinics and other neighborhood socio-demographic and cervical cancer risk factors on HPV vaccine initiation among low- income, ethnic minority girls in Los Angeles County. Individual survey data, collected from mothers of HPV vaccine age-eligible girls, will be combined with data from the Los Angeles County Department of Public Health STD Program and the U.S. Census Bureau to conduct geographic information systems (GIS) mapping and multi-level analysis. Findings will provide an understanding of how spatial and neighborhood factors influence HPV vaccine uptake in a large urban setting and inform cervical cancer control programs and policies.
描述(由申请人提供):宫颈癌不成比例地影响少数民族,移民和低收入妇女。人乳头瘤病毒(HPV)疫苗有可能在很大程度上预防高危HPV感染和未来的宫颈癌病例。然而,最近的研究表明,高危人群的HPV疫苗接种率仍然很低。即使有向低收入人群免费提供疫苗的计划,多重障碍,如缺乏安全网免疫诊所的地理/空间可及性,可能会阻止弱势女孩获得HPV疫苗。由于HPV疫苗在低收入少数民族人群中的利用率不足,目前宫颈癌的差异可能会持续下去。这项横断面研究将探讨地理/空间获得护理和邻里因素,除了个人层面的因素,影响HPV疫苗启动(接受HPV疫苗的e 1剂量)之间的低收入,少数民族女孩在洛杉矶县(LAC)。该研究将建立在从HPV疫苗年龄合格女孩的母亲收集的主要数据的基础上,这些女孩主要居住在LAC的贫困地区,并定期访问县安全网系统。这些个人层面的数据将在人口普查区层面与来自美国人口普查局的社区社会人口数据和来自LAC性传播疾病计划的社区宫颈癌风险数据相关联。将利用地理信息系统制图技术,利用符合接种年龄的女孩的居住地址和安全网免疫接种诊所的位置,建立地理/空间访问措施(到诊所的最短旅行距离,e 1诊所覆盖家庭半径3英里内)。该研究将评估免疫诊所的空间访问是否与HPV疫苗启动相关,以及空间访问和疫苗启动之间的关系是否受个体种族/种族的影响,同时控制其他个体水平的风险因素。分层逻辑回归模型还将用于评估邻里因素(社会人口统计学特征和宫颈癌风险)以及空间访问和个体水平风险因素对HPV疫苗启动的影响。这项研究的独特之处在于,它超越了个体水平的预测因素,评估了影响服务不足的城市人群启动HPV疫苗的地理和邻里因素。研究结果将告知当地县卫生官员导致HPV疫苗利用率低的因素,并提供与LAC癌症预防和控制计划资源分配决策相关的信息。研究结果还将为卫生政策制定者和研究人员提供有关基于地理的干预措施的信息,这些干预措施可以提高HPV疫苗的接种率。
公共卫生关系:本研究将检查地理/空间进入安全网免疫诊所和其他社区社会人口统计学和宫颈癌风险因素对洛杉矶县低收入少数民族女孩开始接种HPV疫苗的影响。从符合HPV疫苗接种年龄的女孩的母亲那里收集的个人调查数据将与洛杉矶县公共卫生部性病项目和美国人口普查局的数据相结合,进行地理信息系统(GIS)制图和多层次分析。研究结果将提供空间和邻里因素如何影响HPV疫苗在大城市环境中的摄取的理解,并为宫颈癌控制计划和政策提供信息。
项目成果
期刊论文数量(0)
专著数量(0)
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Jennifer Tsui其他文献
Jennifer Tsui的其他文献
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{{ truncateString('Jennifer Tsui', 18)}}的其他基金
Advancing the implementation of evidence-based strategies for HPV vaccination in safety-net primary care settings
推动在安全网初级保健机构中实施基于证据的 HPV 疫苗接种策略
- 批准号:
10242629 - 财政年份:2020
- 资助金额:
$ 3.66万 - 项目类别:
Advancing the implementation of evidence-based strategies for HPV vaccination in safety-net primary care settings
推动在安全网初级保健机构中实施基于证据的 HPV 疫苗接种策略
- 批准号:
10612339 - 财政年份:2020
- 资助金额:
$ 3.66万 - 项目类别:
Advancing the implementation of evidence-based strategies for HPV vaccination in safety-net primary care settings
推动在安全网初级保健机构中实施基于证据的 HPV 疫苗接种策略
- 批准号:
10392509 - 财政年份:2020
- 资助金额:
$ 3.66万 - 项目类别:
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