Addressing HPV vaccination disparities through tailored messaging for hesitant families

通过为犹豫不决的家庭量身定制信息来解决 HPV 疫苗接种差异

• 批准号: 10675432
• 负责人: Racquel Elizabeth Kohler
• 金额: $ 21.99万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-02 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675432
• 关键词: Address; Adolescent; Affect; Attitude; Awareness; Behavioral; Behavioral Research; Behavioral Sciences; Belief; Black Populations; Black race; Cancer Prevention Intervention; Catchment Area; Clinic; Communication; Communities; Complement; Complex; Data; Development Plans; Disparity; Dose; Education; Eligibility Determination; Enrollment; Environment; Equity; Ethnic Population; Family; Focus Groups; Funding; Funding Opportunities; Goals; Health Services Research; High Prevalence; Hispanic Populations; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papilloma Virus-Related Malignant Neoplasm; Human Papillomavirus; Individual; Intervention; Intervention Trial; Interview; Knowledge; Link; Literature; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Maps; Medical; Methods; Motivation; New Jersey; Parents; Patients; Process; Provider; Randomized; Randomized, Controlled Trials; Recommendation; Research; Research Infrastructure; Research Personnel; Resources; Risk; Self Efficacy; Shapes; Source; Southern Africa; Surveys; System; Testing; Text Messaging; Training; Transition Career Development Award (K22); Trust; United States; Vaccinated; Vaccination; Vaccines; Woman; Work; aged; arm; behavior change; black women; cancer health disparity; cancer type; career; career development; community engaged research; design; effective intervention; experience; follow-up; health equity; high risk; implementation barriers; implementation intervention; improved; informant; insight; intervention mapping; multi-site trial; perceived discrimination; pilot test; post intervention; prevent; programs; prototype; racial discrimination; racial disparity; racial population; randomized trial; recruit; safety net; screening; skills; social; sociocultural determinant; systematic review; tailored messaging; tailored text messaging; text messaging intervention; timeline; underserved community; vaccine acceptance; vaccine hesitancy; vaccine safety

PROJECT SUMMARY Human papillomavirus (HPV) causes over 34,800 cancers in the United States each year that disproportionately affect Black women. The HPV vaccine is highly effective, but less than half of adolescents aged 13-15 years have received recommended doses, with Blacks having the greatest disparity in completion. HPV vaccine hesitancy is associated with under-vaccination and refusal. An estimated 23% of parents with adolescents are hesitant about the HPV vaccine, but parents’ concerns vary due to a myriad of individual, interpersonal, and sociocultural factors. Effective strategies to overcome parents’ concerns are needed, especially among Black families, who have higher prevalence of general vaccine hesitancy and medical mistrust due to racial inequities. The purpose of this NCI Transition Career Development Award (K22) is to support me through specific training and research experiences as I become an independent investigator specializing in multilevel cancer prevention interventions to reduce cervical cancer disparities. Building on my strong health services research and behavioral science background in HPV screening, I will develop expertise in HPV vaccination communication, community- engaged intervention planning, and intervention trials. The objectives of this rigorous mixed methods proposal are to: (1) use a stakeholder-engaged approach to develop and refine an interactive, tailored text messaging intervention to address Black parents’ HPV vaccine hesitancy determinants and vaccination barriers; and (2) conduct a two-arm pilot RCT to determine feasibility, acceptability, appropriateness, and preliminary efficacy of the tailored messages compared to untailored messages. Following a provider’s initial recommendation, the intervention will allow parents of young adolescents to process HPV vaccination information on their preferred timeline, answer lingering questions and concerns, provide links to additional information from trusted sources, and support connections to local resources to help overcome barriers. By accomplishing these aims, I will address current gaps in strategies to increase vaccine confidence and motivation among high-risk Black families. Rutgers Cancer Institute with its well-funded behavioral research program, robust research infrastructure, and deep community connections is an exceptional environment to conduct high-impact, community-engaged cancer disparities research. As a logical next step in my career development, this K22 will give me the skills required to design, implement, and evaluate multilevel interventions to achieve HPV health equity. Findings and preliminary efficacy estimates will inform an R01 application of a multi-site trial to test a multiple component intervention addressing the complex, context-specific determinants of HPV vaccine hesitancy to motivate vaccination and change behaviors. Ultimately, this K22 proposal will facilitate my long-term goal to build an independent research program investigating community-driven solutions to reduce HPV disparities and advance the elimination of cervical cancer.

项目摘要 人类乳头瘤病毒（HPV）每年在美国引起34,800多种癌症 影响黑人妇女。 HPV疫苗非常有效，但不到一半的13-15岁的青少年 已经收到了建议的剂量，黑人在完成方面的差距最大。 HPV疫苗 犹豫与疫苗接触不足和拒绝有关。估计有23％的青少年父母是 对HPV疫苗的犹豫不决，但由于无数个人，人际关系和 社会文化因素。需要有效克服父母关注的策略，尤其是在黑人中 由于种族不平等而导致的一般疫苗犹豫和医疗不信任的家庭，他们的患病率更高。 NCI过渡职业发展奖（K22）的目的是通过特定的培训来支持我 当我成为专门研究多级癌症预防的独立研究者时，研究经验 减少宫颈癌分布的干预措施。建立在我强大的健康服务研究和行为的基础上 HPV筛查的科学背景，我将在HPV疫苗接种通讯中发展专业知识，社区 - 参与干预计划和干预试验。这种严格的混合方法提案的目标 是：（1）使用利益相关者参与的方法来开发和完善互动的，量身定制的文本消息传递 干预以解决黑人父母的HPV疫苗犹豫不决的决定剂和疫苗屏障； （2） 进行两臂飞行员RCT，以确定可行性，可接受性，适当性和初步效率 与静止消息相比，量身定制的消息。根据提供商的初步建议， 干预将允许年轻青少年的父母处理其首选的HPV疫苗接种信息 时间表，回答问题和疑虑，提供了可信赖来源的其他信息的链接， 并支持与当地资源的联系，以帮助克服障碍。通过完成这些目标，我将 解决了当前的策略差距，以增加高风险黑人家庭的疫苗信心和动力。 罗格斯癌症研究所的行为研究计划，强大的研究基础设施和 深层社区联系是进行高影响，社区参与癌症的特殊环境 差异研究。作为我职业发展的逻辑下一步，这个K22将为我提供所需的技能 设计，实施和评估多层干预措施以实现HPV健康公平。发现和初步 效率估算将为R01应用多站点试验的应用，以测试多个组件干预 解决HPV疫苗犹豫不决的动机疫苗和 改变行为。最终，这项K22提案将促进我建立独立研究的长期目标 计划调查社区驱动的解决方案，以减少HPV差异并提高消除 宫颈癌。