Individual, Interpersonal, and Community Factors Associated with HPV Vaccine Hesitancy among Mexican American Young Adult Women

项目总结/摘要 拉丁裔妇女，特别是墨西哥裔美国人，宫颈癌的发病率最高， 与其他种族和民族的关系。宫颈癌可以通过接种HPV疫苗来预防，但 这一比例仍然不理想，特别是在年轻的拉丁裔成年妇女中。此外，外国出生的拉丁裔 妇女的宫颈筛查和HPV疫苗接种率较低，而且往往事先得不到预防性护理。 来到美国人群研究发现HPV疫苗存在显著差异 在拉丁裔外国出生和美国之间完成-出生的年轻人（18-26岁），与外国出生的妇女 不太可能接种疫苗（7.2% vs 18.5%）。需要探索HPV疫苗犹豫的研究来告知 可扩展的干预措施，以防止感染和改善健康结果，不成比例地负担拉丁美洲 墨西哥裔美国女性。文献还没有确定关键的多层次机制， 墨西哥裔美国妇女在理解其疫苗犹豫方面的差异。HPV研究 外国出生和美国之间的疫苗接种差异-天生的女人很少。这种混合方法的目标是 一项研究确定了导致年轻墨西哥裔美国人对HPV疫苗犹豫不决的关键因素 妇女，将告知有效的公共卫生疫苗干预措施，为拉丁亚群在未来的K- 奖以前的定性研究揭示了HPV疫苗决策的重要差异 与其他种族和族裔群体相比，拉丁裔年轻人的比例更高。这项研究将以过去的工作为基础， 调查对HPV疫苗的犹豫以及个人、人际和社区的影响 疫苗犹豫因素。该研究将探讨两个目标：（1）研究HPV信息 拉丁人在个人、人际和社区层面上接受和传递信息， 拉丁裔妇女归因于他们收到的信息;（2）确定如何母女沟通 在重要的个人、人际和社区背景下， 水平因素。这一建议的独特优势包括它对理解多层次影响的关注 解释高危墨西哥裔美国妇女对HPV疫苗的犹豫。此外，一个独特的重点是 研究美国与美国之间的差异，和在国外出生的墨西哥裔美国女性最后，申请人将 受益于强大的导师团队和健康导师专业的研究环境 沟通，健康差距，拉丁美洲健康，和多层次建模。该研究具有创新性， 它提出的计划，以了解如何影响HPV的信息可能有助于疫苗接种差距 美国-出生和外国出生的拉丁美洲人在文献中确定。这项研究的结果将告知HPV 为墨西哥裔美国妇女量身定制的疫苗干预措施，以及基于社区的诊所干预措施如何 通过增加HPV疫苗接种来有效地实施，以减少HPV相关的癌症 人口

PROJECT SUMMARY/ABSTRACT Latina women, particularly Mexican Americans, have the highest incidence rates of cervical cancer compared to other racial and ethnic groups. Cervical cancer is preventable through HPV vaccination, but vaccination rates remain suboptimal, particularly among young adult Latina women. Additionally, foreign-born Latina women have lower cervical screening and HPV vaccination rates and often no access to preventive care prior to coming to the United States. Population studies have found significant differences in HPV vaccine completion among Latina foreign-born and U.S.-born young adults (18–26 years old), with foreign-born women less likely to vaccinate (7.2% vs 18.5%). Studies exploring HPV vaccine hesitancy are needed to inform scalable interventions to prevent infection and improve health outcomes that disproportionately burden Latina Mexican American women. The literature has not identified key multilevel mechanisms contributing to differences among Mexican American women in understanding their vaccine hesitancy. Studies on HPV vaccination differences among foreign-born and U.S.-born women are scarce. The goal of this mixed-methods study is to identify key factors contributing to HPV vaccine hesitancy among young adult Mexican American women that will inform effective public health vaccine interventions tailored for Latina subgroups in a future K- award. Previous qualitative studies have uncovered important differences in HPV vaccine decision-making among Latina young adults compared to other racial and ethnic groups. This study will build on past work by investigating hesitancy toward the HPV vaccine and the influence of individual, interpersonal, and community factors on vaccine hesitancy. The proposed study will explore two aims: (1) investigate what HPV messages Latinas receive and relay to others at the individual, interpersonal, and community levels and what meaning Latina women ascribe to the messages they receive; and (2) identify how mother-daughter communication is associated with HPV vaccine hesitancy in the context of important individual-, interpersonal-, and community- level factors. The unique strengths of this proposal include its focus on understanding multilevel influences explaining HPV vaccine hesitancy among at-risk Mexican American women. Additionally, a unique focus is studying differences between U.S.- and foreign-born Mexican American women. Finally, the applicant will benefit from a strong team of mentors and research environment with mentor specialties in health communication, health disparities, Latino health, and multilevel modeling. The proposed study is innovative in its proposed plan to understand how the effect of HPV messages may contribute to the vaccination gap between U.S.-born and foreign-born Latinas identified in the literature. Results of this study will inform HPV vaccine interventions tailored for Mexican American women and how community-based clinic interventions can be effectively implemented to reduce HPV-associated cancer by increasing HPV vaccination for this population.