HPV Vaccination among Daughters of Latina Immigrants

拉丁裔是美国最大的少数民族人口，预计到2050年，10至14岁的拉丁裔女孩的变化率为144%，而白人的变化率为39%。2010年美国人口普查显示，亚拉巴马的拉丁裔人口增长了145%，这是2000年至2010年美国第二大增长率，仅次于南卡罗来纳州。 拉丁裔妇女的宫颈癌发病率和死亡率高于白色妇女。除非在这一人群中有显着的HPV疫苗摄取，否则评估异常巴氏涂片和/或治疗浸润性宫颈癌的经济负担可能会在美国几十年来首次增加。我们提出了一项为期5年的分组随机对照试验（RCT），以测试基于理论的文化相关干预措施对促进9至12岁拉丁移民女儿接种HPV疫苗的有效性，具体目标有四个：（1）进行形成性评价，以发展基于理论的，文化相关的干预措施，以促进9至12岁的拉丁裔移民的女儿接受HPV疫苗;（2）根据目标1的结果和以前的试点数据制定拟议的干预措施;（3）在320名女儿在9岁至12岁之间的拉丁移民母亲中实施干预措施;（4）通过一组随机对照试验评估这种干预措施的有效性。对照组将接受健康饮食和体育活动的教育。主要结果将是在9至12岁的拉丁移民的女儿中接受第一剂以及完成所有三剂HPV疫苗。次要结局将包括：在9至12岁女儿的拉丁裔移民母亲中，对HPV/宫颈癌和HPV疫苗的态度和信念发生了变化。这项拟议的研究解决了一个重要的科学知识差距，因为对拉丁裔移民的女儿的HPV疫苗接种知之甚少，这是HPV感染和宫颈癌的高危人群。如果被证明是成功的，这种干预措施可以传播到美国各地的拉丁裔移民的女儿，有可能产生重大的公共卫生影响。

Latinos are largest minority population in the U.S with a projected change of 144% of Latino girls between the ages of 10 and 14 in 2050 as compared to 39% projected change among whites. The 2010 U.S. Census indicated that the Latino population in Alabama grew 145%, which represents the second largest percentage growth between 2000 and 2010 in the U.S. after South Carolina. Cervical cancer incidence and mortality is higher among Latinas than among white women. Unless there is significant HPV vaccine uptake in this population the economic burden of evaluating abnormal Pap smears and/or treating invasive cervical cancer is likely to increase in the U.S. for the first time in decades. We propose a 5-year group randomized controlled trial (RCT) to test the efficacy of a theory-based culturally relevant intervention to promote HPV vaccine uptake among daughters of Latina immigrants between the ages of 9 and 12 with four specific aims: (1) To conduct a formative evaluation in order to develop theory-based, culturally relevant intervention to promote HPV vaccine uptake among daughters of Latina immigrants between the ages of 9 and 12; (2) To develop the proposed intervention based on the results of Aim 1 and previous pilot data; (3) To implement the intervention among 320 Latina immigrant mothers of daughters between 9 and 12; and (4) To evaluate the efficacy of such intervention through a group RCT. The comparison group will receive education on healthy eating and physical activity. The primary outcomes will be receipt of first dose as well as completion of all three doses of the HPV vaccine among daughters of Latina immigrants between the ages of 9 and 12. Secondary outcomes will include: changes in attitudes, and beliefs regarding HPV/cervical cancer and HPV vaccine among Latina immigrant mothers of daughters between the ages of 9 and 12. The proposed study addresses an important scientific knowledge gap since little is known about HPV vaccine uptake among daughters of Latina immigrants, a high risk group for HPV infection and cervical cancer. If proven successful, this intervention could be disseminated to daughters of Latina immigrants across the U.S. with the potential of having a major public health impact.