Increasing HPV Vaccine Uptake in a Low Income Ethnic Minority Population

提高低收入少数族裔人群对 HPV 疫苗的接种率

• 批准号: 8239244
• 负责人: Roshan Bastani
• 金额: $ 74.54万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-01 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8239244
• 关键词: Address; Affect; Age; Asians; Attitude; Belief; Centers for Disease Control and Prevention (U.S.); Clinic; Comprehensive Cancer Center; Control Groups; County; Daughter; Development; Disease; Dose; Education; English Language; Ensure; Goals; Health Services; Health Services Accessibility; Health education; Health system; Healthcare; Hotlines; Human Papilloma Virus Vaccine; Human Papillomavirus; Immigrant; Immunization; Incidence; Institutionalization; Intervention; Interview; Knowledge; Koreans; Latina; Los Angeles; Low income; Mails; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Mediator of activation protein; Minority; Morbidity - disease rate; Mothers; Pacific Island Americans; Pamphlets; Participant; Patient Self-Report; Pattern; Printing; Protocols documentation; Public Health; Public Health Schools; Randomized; Registries; Research Infrastructure; Sampling; Series; Services; Source; Subgroup; Target Populations; Telephone; Telephone Interviews; Time; United States; Vaccination; Vaccines; Woman; Women' s Health; arm; cervical cancer prevention; cost; demographics; ethnic minority population; follow-up; girls; group intervention; high risk; innovation; intervention effect; mortality; multi-component intervention; primary outcome; randomized trial; treatment as usual; uptake

DESCRIPTION (provided by applicant): Cervical cancer incidence in Los Angeles County is significantly higher than the national average, with highest rates among Latinas and Asian/Pacific Islanders. The discovery of HPV as the primary causal agent in cervical cancer and subsequent development of HPV vaccines have revolutionized the potential for cervical cancer prevention. However, vaccine utilization rates in the US remain unacceptably low among age-eligible girls, including among the highest risk groups. The UCLA School of Public Health & Jonsson Comprehensive Cancer Center have teamed with the Los Angeles County Department of Public Health, Office of Women's Health (OWH) to address the unequal burden of cervical cancer in Los Angeles. The primary goal of the study is to evaluate, in a randomized trial, a theoretically driven, culturally sensitive and individually tailored intervention to increase HPV vaccine receipt among underserved, high risk girls in Los Angeles. The intervention will be delivered via the existing OWH telephone education and service referral hotline in six languages (English, Spanish, Cantonese, Mandarin, Korean, Armenian). The multi-component intervention, directed at mothers of age-eligible girls (11-18 years), will consist of a brief telephone intervention that will deliver basic HPV vaccine information, individually tailored messages to address callers' barriers to HPV vaccination, and tailored referral to a clinic offering low cost/free vaccine. A tailored print intervention reinforcing the telephone messages will also be mailed to participants. The control group will receive usual care and a standard CDC fact sheet on the HPV vaccine. The primary outcome will be vaccine initiation among age-eligible girls (receipt of at least one vaccine dose) assessed at a 3 month telephone follow-up with mothers. A 9 month follow-up will assess vaccine completion rates (receipt of 3-dose series) and overall patterns of vaccine dose initiation and completion. The study also seeks to characterize HPV related knowledge, beliefs and barriers in the target population, and understand the mediators (e.g., knowledge, barriers reduction) through which the intervention may have achieved its desired effect. Differential effects of the intervention on subgroups of the sample (e.g., more acculturated) will also be assessed. The study is innovative in that we are partnering with the county health system which is the only realistic source of health care for our target population. The commitment of the county department of public health to increasing HPV vaccine uptake and the utilization of existing county infrastructure (the OWH hotline) for intervention delivery will ensure institutionalization of the intervention upon trial completion. PUBLIC HEALTH RELEVANCE: The HPV vaccine has the potential to greatly reduce the burden of cervical cancer, particularly among those at high risk for the disease. However, vaccine uptake in the United States remains low. The goal of this study is to increase rates of HPV vaccine receipt among low-income, ethnic minority, vaccine eligible girls, through an intervention targeting their mothers.

描述（由申请人提供）：洛杉矶县的宫颈癌发病率明显高于全国平均水平，其中拉丁裔和亚洲/太平洋岛民的发病率最高。 HPV 作为宫颈癌主要致病因子的发现以及随后 HPV 疫苗的开发彻底改变了宫颈癌预防的潜力。然而，美国适龄女孩（包括最高风险群体）的疫苗使用率仍然低得令人无法接受。加州大学洛杉矶分校公共卫生学院和 Jonsson 综合癌症中心与洛杉矶县公共卫生部、妇女健康办公室 (OWH) 合作，解决洛杉矶宫颈癌负担不平等的问题。该研究的主要目标是在一项随机试验中评估一种理论上驱动、文化敏感且个性化的干预措施，以提高洛杉矶服务不足的高风险女孩的 HPV 疫苗接种率。干预措施将通过现有的 OWH 电话教育和服务转介热线以六种语言（英语、西班牙语、粤语、普通话、韩语、亚美尼亚语）提供。这项多组成部分的干预措施针对符合年龄条件的女孩（11-18 岁）的母亲，其中包括简短的电话干预，提供基本的 HPV 疫苗信息、为解决呼叫者接种 HPV 疫苗障碍而量身定制的信息，以及量身定制的转介至提供低成本/免费疫苗的诊所。强化电话留言的定制印刷版干预措施也将邮寄给参与者。对照组将接受常规护理和有关 HPV 疫苗的标准 CDC 情况说明书。主要结果将是通过与母亲进行为期 3 个月的电话随访来评估符合年龄条件的女孩是否开始接种疫苗（至少接种一剂疫苗）。 9 个月的随访将评估疫苗完成率（接受 3 剂系列）以及疫苗剂量开始和完成的总体模式。该研究还旨在描述目标人群中与 HPV 相关的知识、信念和障碍，并了解干预措施可能达到其预期效果的中介因素（例如知识、减少障碍）。还将评估干预措施对样本亚组（例如，文化程度更高的亚组）的差异影响。这项研究的创新之处在于，我们正在与县卫生系统合作，这是我们目标人群唯一现实的医疗保健来源。县公共卫生部门承诺增加 HPV 疫苗的接种率，并利用现有的县基础设施（OWH 热线）进行干预措施，这将确保试验完成后干预措施的制度化。 公共卫生相关性：HPV 疫苗有可能大大减轻宫颈癌的负担，特别是对于宫颈癌高危人群。然而，美国的疫苗接种率仍然很低。这项研究的目标是通过针对母亲的干预措施，提高低收入、少数族裔、符合疫苗接种条件的女孩的 HPV 疫苗接种率。