African American Attitudes Toward HPV Vaccination

描述(申请人提供)：密苏里州的非裔美国人宫颈癌死亡率高于普通人群；圣路易斯市和县的死亡率超过该州的非裔美国人死亡率。人乳头瘤病毒(HPV)是年轻人中最常见的性传播疾病之一，它与女性宫颈癌有关。在圣路易斯的非裔美国人中观察到较高的宫颈癌发病率和死亡率，这表明HPV筛查和疫苗接种对这个社区的重要性。虽然HPV由30多种可以通过性接触从一个人传播到另一个人的病毒组成，但HPV16病毒约占世界上所有宫颈癌的一半。在美国，非裔美国女性的患病率最高(19.1%)，而白人女性的患病率为12.5%。现在有一种被批准的预防性疫苗Gardasil可用。该疫苗推荐给11至12岁的女孩，但也可以接种给年仅9岁的女孩，也建议13至18岁的女孩追上或完成错过的疫苗。给年轻女孩接种疫苗很重要，因为在感染HPV之前接种疫苗最有效。调查显示，68%的非裔美国高中生性行为活跃，这可能导致HPV感染。圣路易斯市超过50%的非裔美国人，在青少年怀孕率和性传播疾病发生率方面存在显著差异。这些事实支持，如果要充分保护年轻的非裔美国女孩免受HPV的影响，就需要及早接种疫苗。从历史上看，在没有惩罚或强制接种疫苗要求的情况下，非裔美国人社区的免疫水平一直低于白人或其他少数群体；这一事实表明，需要确保非裔美国人社区的父母接受过良好的HPV和HPV疫苗接种教育，并且我们解决了接种疫苗的障碍。与我们的社区合作伙伴合作，该项目寻求评估HPV知识、对疫苗的认识、其益处以及接种疫苗的障碍。我们将对200名非裔美国家长进行横断面调查，并对随机选择的30名家长进行深入访谈，以解决三个具体目标。这项研究的具体目的是：1)确定非裔美国人父母关于HPV、HPV疫苗接种及其与癌症的关系的知识；2)确定9至17岁非裔美国女孩的父母对接种HPV疫苗的接受度和意向；3)描述影响非裔美国父母为9至17岁女孩接种HPV疫苗的意愿的个人特征、文化态度、社会和环境因素。这些数据将被用来开发和测试一种文化敏感的干预措施，旨在降低圣路易斯非裔美国人社区出现HPV疫苗接种差异的可能性。 西特曼癌症中心(SCC)消除癌症差异计划(PECaD)是一个以社区为重点的多学科计划，旨在消除癌症教育、预防和治疗方面普遍存在的差异。SCC高级领导层将这一计划作为首要任务，随后开发了大量的基础设施和科学组合，这一提议将进一步加强这些基础设施和科学组合。第一年的具体目标是：1)进一步发展SCC内的核心组织基础设施，通过建立一支对实施该计划至关重要的多学科专业人员队伍，支持以社区为基础的参与性活动，以减少癌症健康差距。2)加强现有关系，并与遭受癌症健康差距之苦的社区和其他组织建立新的伙伴关系，以减少这些社区成员之间的癌症健康差距。3)与其他NCI项目(即NCI中心以外的NCI中心/部门/办公室)建立或进一步发展至少四个合作伙伴关系，以减少癌症健康差异。4)增加有益干预措施的使用，以减少癌症健康差距。5)利用社区网络计划(CNP)的活动，维持并获得新的非CRCHD资金，用于旨在减少癌症健康差距的社区参与性活动。6)确定衡量本项目有效性的具体指标。(7)增加社区对初级和二级预防活动的参与。8)确定临床研究中比例收益的具体障碍。9)为调查人员、工作人员和受训人员计划有关克服差异和侧重差异的研究的培训计划活动。第二至第五年的目标将侧重于开发、监控和衡量这些活动的有效性，以及建立和利用资金以维持未来计划的增长。

DESCRIPTION (provided by applicant): African American cervical cancer mortality rates for Missouri are higher than those observed in the general population; and mortality rates in St. Louis City and county exceed the African American mortality rates for the state. Human Papillomavirus (HPV) is one of the most common sexually transmitted infections among young people and it is associated with cervical cancer in women. The higher cervical cancer incidence and mortality rates observed among African Americans in St. Louis suggests the importance of HPV screening and vaccination for this community. While HPV consists of over 30 types of viruses that can be passed from one person to another through sexual contact, the HPV 16 virus accounts for approximately half of all cervical cancers in the world. Its prevalence in the US is highest among African American women (19.1 percent) compared to 12.5 percent among white women. There is now an approved prophylactic vaccine, Gardasil, available. The vaccine is recommended for girls 11 to12 years of age, but can be given to girls as young as nine and is also recommended for girls 13-18 year to catch up on or complete missed shots. Giving the vaccine to young girls is important because the vaccine is most effective when given to people prior to HPV infection. Surveys show that 68% of African American high school students are sexually active, which can result in HPV infection. St. Louis city is over 50% African American, with notable disparities in the teen pregnancy and sexually transmitted disease rates. These facts support the need for early vaccination if young African American girls are to be adequately protected from the effect of HPV. Historically, where there are no penalties or mandated vaccination requirements, immunization levels are consistently lower in the African American community compared to those of Whites or other minorities; a fact that suggests the need to assure that parents in the African American community are well-educated on HPV, HPV vaccination, and that we address barriers to vaccination. Working with our community partners, this project seeks to assess HPV knowledge, awareness of the vaccine, its benefits, and barriers to vaccination. We will conduct a cross sectional survey of 200 African American parents, and complete in depth interviews with 30 randomly selected parents to address three specific aims. The specific aims of this research effort are to: 1) determine knowledge about HPV, HPV vaccination and its relationship to cancer among African American parents; 2) determine acceptability of and intent to vaccinate among parents of African American girls nine to 17; and 3) describe the individual characteristics, cultural attitudes, social and environmental factors that affect African American parents' intent to vaccinate girls, nine to 17, against HPV. These data will be used to develop and test a culturally sensitive intervention designed to reduce the likelihood that disparities in HPV vaccination will emerge in the St. Louis African American community. The Siteman Cancer Center (SCC) Program for the Elimination of Cancer Disparities (PECaD) is a multi- disciplinary community-focused program established to eliminate pervasive disparities of cancer education, prevention, and treatment. The SCC Senior Leadership made this program a top priority, and it subsequently developed a substantial infrastructure and scientific portfolio, which will be further strengthened by this proposal. Specific aims for the first year are: 1) To further develop the core organizational infrastructure within the SCC to support community-based participatory activities to reduce cancer health disparities by establishing a staff of multidisciplinary professionals critical to implementing the program. 2) To enhance existing relationships and build new partnerships with communities that suffer cancer health disparities and with other organizations with an interest in reducing cancer health disparities among members of these communities. 3) To form or further develop at least four collaborations with other NCI programs (i.e., NCI Centers/Divisions/offices other than the NCI Center to Reduce Cancer Health Disparities) for the purpose of reducing cancer health disparities. 4) To increase utilization of beneficial interventions to reduce cancer health disparities. 5) To leverage Community Networks Program (CNP) activities by maintaining and obtaining new non- CRCHD funding for community-based participatory activities directed at reducing cancer health disparities. 6) To identify specific metrics to measure effectiveness of this project. 7) To increase community participation in primary and secondary prevention activities. 8) To identify specific barriers to proportional accrual in clinical research studies. 9) To plan training program activities for investigators, staff, and trainees with regard to overcoming disparities and disparities-focused research. Aims in years 2-5 will focus on developing, monitoring, and measuring effectiveness of these activities, and on building and leveraging funding to sustain program growth in the future.