HPV Vaccination among Daughters of Latina Immigrants

拉丁美洲人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%，而白人的预计变化率为39%。2010年美国人口普查显示，阿拉巴马州的拉丁裔人口增长了145%，这是2000年至2010年间美国第二大增长率，仅次于南卡罗来纳州。

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.