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

项目摘要/摘要 低收入家庭的儿童和青少年是人乳头瘤病毒(HPV)的重要聚集地。 接种疫苗，因为来自低社会经济地位的人患HPV相关癌症的风险是 明显更高(宫颈癌高达20%，口咽癌高达20%，外阴癌高达17%，肛门癌高达50%)。这个 HPV疫苗可保护多达六种癌症(宫颈癌、阴道癌、外阴癌、口咽癌、肛门癌和阴道癌)和 如果在17岁之前使用，可以将这些癌症的发病率降低近90%。然而， 在许多州，疫苗接种率并不理想。德克萨斯州(HPV感染负担第三高的州 在接种HPV疫苗方面表现不佳。来自低收入家庭的孩子构成 得克萨斯州符合HPV疫苗接种资格的人口的一半。2018年，只有30%的低收入男女 家庭已经接种了推荐剂量的HPV疫苗。缺乏有效和强大的区域级别(ZIP 代码级别)对低收入儿童和青少年疫苗接种率的估计是实现 为德克萨斯州的疫苗接种工作制定战略。解决这些数据缺陷对于动员是必要的 资源和振兴人乳头状瘤病毒疫苗在得克萨斯州的推广。提出这项K01研究的申请人(Dr。 Kalyani Sonawane)是一名训练有素的药剂师和卫生服务研究员，她很适合为 HPV相关癌症预防方面的差异。卡利亚尼将接受差距研究方面的培训，高级 指导下的数据分析和可视化、地理空间技术以及道德和传播 全国公认的专家杜祥林博士(癌症健康服务研究和索赔数据分析)， 安娜·R·朱利亚诺(HPV疫苗和HPV相关癌症预防)，Maria E.Fernandez博士 (实施和传播减少癌症差异的科学研究)，Ashish A.Deshmukh博士 (人口健康，重点是HPV和相关癌症)和李若莎博士(生物统计学 卫生保健数据研究的方法)。这项提案将利用尖端方法为 通过利用医疗数据分析来量化地区级别(5位邮政编码级别)HPV疫苗接种率 医疗保健索赔480多万低收入儿童和青少年的信息(目标1)。老练 将利用地理空间模型来识别在HPV疫苗接种方面表现不佳的地理区域 (目标2)。随后，将创建一个新的基于网络的门户网站，用于HPV疫苗接种数据的可视化和 向医疗保健提供者传播基于证据的HPV疫苗接种资源(目标3)。这个K01奖将 为Sonawane博士提供结构化和量身定制的指导计划和资源，以合成初步的 这些数据将对她成为一名独立资助的癌症健康差异研究人员至关重要 研究。拟议的工作和随后的研究将为与HPV相关的推广工作注入活力 对易患癌症的人进行预防。

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.