Harnessing Big Data to Identify Geographic Clusters of Low-income children with Poor HPV Vaccination Rates

项目总结/文摘

PROJECT SUMMARY/ABSTRACT Children and adolescents from low-income households are an important focus for human papillomavirus (HPV) vaccination because the risk of HPV-associated cancers for individuals from low socioeconomic status is markedly higher (up to 20% for cervical, 20% for oropharyngeal, 17% for vulvar, and 50% for anal cancer). The HPV vaccine protects up to six cancers (cervical, vaginal, vulvar, oropharyngeal, anal, and penile cancers) and can reduce the incidence of these cancers by nearly 90% if administered before 17 years of age. However, vaccination rates are suboptimal in many states. Texas (the state with 3rd highest burden of HPV-associated cancer in the nation) has underperformed on HPV vaccination. Children from low-income families constitute half of Texas’ HPV vaccine-eligible population. In 2018, only 30% of the boys and girls from low-income families had received the recommended doses of the HPV vaccine. The lack of valid and robust area-level (ZIP code level) estimates of vaccination rates for low-income children and adolescents is a major barrier to strategizing vaccination efforts in Texas. Addressing these data deficiencies is necessary for mobilizing resources and invigorating HPV vaccination outreach in Texas. The applicant proposing this K01 research (Dr. Kalyani Sonawane) is a trained pharmacist and health services researcher who is well-positioned to address disparities in HPV-associated cancer prevention. Kalyani will receive training in disparities research, advanced data analytics and visualization, geospatial techniques, and ethics and dissemination under the mentorship of nationally recognized experts Dr. Xianglin Du (cancer health services research and claims data analysis), Dr. Anna R. Giuliano (HPV vaccine and HPV-associated cancer prevention), Dr. Maria E. Fernandez (implementation and dissemination science research to reduce cancer disparities), Dr. Ashish A. Deshmukh (population health with a focus on HPV and associated cancers), and Dr. Ruosha Li (biostatistical methodologies for health care data research). This proposal will utilize cutting-edge methods devised for healthcare data analytics to quantify area-level (5-digit ZIP code level) HPV vaccination rates by harnessing healthcare claims information of over 4.8 million low-income children and adolescents (Aim 1). Sophisticated geospatial models will be utilized to identify geographic areas that are underperforming on HPV vaccination (Aim 2). Subsequently, a novel web-based portal will be created for HPV vaccination data visualization and disseminating evidence-based HPV vaccination resources to healthcare providers (Aim 3). This K01 award will provide Dr. Sonawane a structured and tailored mentoring program and resources for synthesizing preliminary data that will be critical for her to become an independently funded investigator in cancer health disparities research. The proposed work and subsequent research will invigorate outreach efforts for HPV-associated cancer prevention in vulnerable individuals.