ENHANCING CERVICAL CANCER PREVENTION STRATEGIES AMONG HOPI WOMEN AND ADOLES...

加强霍皮族妇女和青少年的宫颈癌预防策略...

• 批准号: 8711321
• 负责人: Angela A Gonzales
• 金额: $ 15.59万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8711321
• 关键词: Adenocarcinoma In Situ; Adolescent; Age; Age-Years; American Indian and Alaska Native; American Indians; Arizona; Asian Americans; Attitude; Cancer Control; Cervical; Cervical Cancer Screening; Cervical Intraepithelial Neoplasia; Collection; Complement; Cytology; DNA; Daughter; Detection; Diagnosis; Educational Intervention; Educational Materials; Enrollment; Ethnic group; Event; Family; Female; Female Adolescents; Focus Groups; Genotype; Guidelines; HPV-High Risk; Health Status; High Prevalence; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Human papillomavirus 16; Human papillomavirus 18; Incidence; Individual; Infection; Knowledge; Learning; Lesion; Link; Longevity; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methods; Minority; Modeling; Mothers; Odds Ratio; Oncogenic; Pap smear; Population; Premalignant; Prevalence; Prevention; Prevention strategy; Provider; Public Health; Recommendation; Records; Reproducibility; Research; Research Design; Research Project Grants; Risk; Risk Factors; Sampling; Self-Administered; Surveys; Testing; Time; Tribes; Vaccination; Vaccines; Vagina; Variant; Virulent; Woman; aged; authority; cervical cancer prevention; experience; girls; health disparity; high risk; northern plains; novel; population health; prevent; programs; public health priorities; racial and ethnic; screening; social

Almost all cervical cancers are causally related to infections by human papillomavirus (HPV), with HPV types 16 and 18 responsible for ~70% of this malignancy. American Indian (Al) women have one of the highest incidences of cervical cancer among U.S. women, and this rate is increasing. Al women also have the poorest cervical cancer survival of any racial/ethnic group. Reasons for the high incidence, poor survival, and variation by tribe are unknown, but might be explained by lower rates of Papanicolaou (Pap) screening, a higher prevalence of oncogenic HPV infection,15 or a higher prevalence of particularly virulent HPV 16 or HPV 18 variant. We found that the prevalence of high-risk HPV types in Al women was over twice that in White women. After adjusting for age and abnormal Pap results, the odds ratio of high-risk HPV infection in Al versus White women was 2.9 and Al women were 4 times more likely to have an abnormal Pap test. In this Research Project, we propose to partner with the Hopi Tribe in Arizona to conduct 2 theoretically linked studies, designed to complement one another and cover the lifespan of HPV prevention and screening. The first study aims to increase HPV vaccination rates among girls aged 11-12 years by engaging motherdaughter dyads. The second study examines the presence of high-risk HPV types and variants, particularly HPV 16 and 18, in Hopi women. Our specific aims in Study 1 are to 1) Compare the number of Hopi girls ages 11-12 receiving HPV vaccination before and after a 2-year implementation of our mother-daughter educational intervention; and 2) Assess individual predictors of HPV vaccination. In Study 2 we aim to 2): compare the prevalence of high-risk HPV types in Hopi women adherent with cervical cancer screening guidelines to those who are non-adherent; and 4) Compare risk and protective factors for high-risk HPV infection among screening adherent and non-adherent Hopi women. We hypothesize that screening nonadherent women will have more high risk HPV types, more risk factors, and fewer protective factors than those who are adherent. This study fits into the multi-level health disparities model by examining how individual, family, and organizational variables influence cervical cancer prevention among Hopi women and young adolescents.

几乎所有宫颈癌都与人乳头瘤病毒 (HPV) 感染有因果关系，其中约 70% 的宫颈癌是由 HPV 16 和 18 型引起的。美洲印第安人 (Al) 女性是美国女性中宫颈癌发病率最高的群体之一，而且这一比例还在增加。在所有种族/族裔群体中，所有女性的宫颈癌生存率也是最差的。发病率高、生存率低以及部落差异的原因尚不清楚，但可能是由于巴氏 (Pap) 筛查率较低、致癌 HPV 感染患病率较高15 或特别致命的 HPV 16 或 HPV 18 变异体患病率较高所致。我们发现，白人女性中高危 HPV 类型的患病率是白人女性的两倍多。调整年龄和异常巴氏涂片结果后，阿尔及利亚女性与白人女性相比，高危 HPV 感染的优势比为 2.9，阿尔及利亚女性巴氏检查异常的可能性是白人女性的 4 倍。在 在这个研究项目中，我们建议与亚利桑那州的霍皮部落合作开展两项理论上相关的研究，旨在相互补充并涵盖 HPV 预防和筛查的整个生命周期。第一项研究旨在通过母女二人组的参与来提高 11-12 岁女孩的 HPV 疫苗接种率。第二项研究检查了霍皮族女性中是否存在高危 HPV 类型和变异，特别是 HPV 16 和 18。我们在研究 1 中的具体目标是 1) 比较在实施 2 年母女教育干预之前和之后接受 HPV 疫苗接种的 11-12 岁霍皮族女孩的数量； 2) 评估 HPV 疫苗接种的个体预测因子。在研究 2 中，我们的目标是 2)：比较遵守宫颈癌筛查指南和未遵守宫颈癌筛查指南的霍皮族女性中高危 HPV 类型的患病率； 4) 比较在筛查依从性和非依从性霍皮族女性中高危 HPV 感染的风险和保护因素。我们假设，与坚持筛查的女性相比，筛查不坚持的女性将有更多的高危 HPV 类型、更多的危险因素和更少的保护因素。这项研究通过研究个人、家庭和组织变量如何影响霍皮族妇女和青少年的宫颈癌预防，符合多层次健康差异模型。