Tailoring an Intervention with Parents in Rural Areas to Reduce HPV Transmission

描述（申请人提供）：为农村地区的父母量身定制干预措施，以减少HPV传播生活在农村地区的妇女死于与人乳头瘤病毒（HPV）感染有关的宫颈癌的比率高于城市妇女，但每年有37亿美元用于治疗HPV感染，生殖器疣，1 -4如果在第一次性接触之前接种HPV疫苗，即在六个月内连续注射三次，这些人力和财政成本可以显著降低。4 -6然而，为了保护儿童免受HPV感染，父母必须同意。6不幸的是，在农村地区，HPV疫苗接种率非常低，在一些县，HPV疫苗的接种率低于20%。4 2006年，HPV疫苗被批准用于9至26岁的女孩，2009年12月被批准用于9至26岁的男性，但目前还没有关于男性疫苗接种的统计数据。10全国宫颈癌和其他HPV相关癌症的发病率对于生活在农村地区的妇女来说不成比例地更高，因为农村地区的地理差异来自长途旅行9 -11影响生活在格鲁吉亚农村地区的家庭的健康差异是有据可查的，这为选择这一人群进行研究提供了令人信服的理由。11 -15过去的研究集中在父母和HPV疫苗接种上，但其中许多研究是在疫苗可用之前完成的，依赖于自我报告，16 -23这些研究提供了有价值的信息，但不能普遍适用于生活在农村地区的父母。此外，没有定性研究解决格鲁吉亚农村地区的低HP疫苗接种率。任何旨在减少HPV传播和HPV相关癌症（如宫颈癌）的干预措施都必须包括父母的意见，因为只有父母/护理人员（P/C）才能同意接种HPV疫苗。拟议的研究将使用匿名焦点小组方法提供叙述性数据，以更好地解释为什么父母选择为9至13岁的儿童接种疫苗，HPV疫苗。27 -29完成定量试验的结果构成了本拟议焦点小组研究中提出的问题的基础;这些问题将由主要研究者（PI）培训的焦点小组领导提出。我们希望使用这种定性方法收集更多深入的、文化丰富的信息，然后开发一种量身定制的干预措施，该干预措施将从焦点小组数据中产生，以提高HPV疫苗接种率，从而减少HPV传播。 公共卫生相关性： 每年有近40亿美元用于治疗HPV感染，包括生殖器疣、宫颈癌和其他HPV相关癌症。如果在第一次性接触之前接种HPV疫苗，这些人力和财政成本可以减少。然而，为了保护儿童免受HPV感染，父母必须同意。本研究将收集居住在格鲁吉亚农村的9至13岁儿童的父母的焦点组数据，以确定他们为孩子接种或不接种HPV疫苗的原因。

DESCRIPTION (provided by applicant): Tailoring an Intervention with Parents in Rural Areas to Reduce HPV Transmission Women who live in rural areas are dying at higher rates from cervical cancer related to Human Papillomavirus (HPV) Infection than their urban counterparts, and yet 3.7 billion healthcare dollars are spent each year for the treatment of HPV infection, genital warts, and cervical cancer.1-4 These human and fiscal costs could be markedly reduced if the HPV vaccine, a series of three shots over six months, is given prior to first sexual contact.4-6 However, for children to be protected against HPV infection, parents must give consent.6 Unfortunately in rural areas, rates of HPV vaccination are very low, less than 20% in some counties.4 The HPV vaccine was approved in 2006 for girls and in December 2009 for males ages 9 to 26 though there are no statistics available for male vaccination yet.7-10 National incidence rates of cervical cancer and other HPV related cancers are disproportionately higher for women living in the rural areas where geographic disparities emerge from large distances traveled to access healthcare resources.9-11 The health disparities affecting families living in rural areas of Georgia are well documented, providing a compelling reason to choose this population for study.11-15 Past research studies have focused on parents and HPV vaccination but many of these were completed prior to vaccine availability, relied on self-report, and focused predominantly on women living in urban areas seeking clinical services.16-23 These studies provided valuable information though they cannot be generalized to parents living in rural areas. In addition, there are no qualitative studies that address low HP vaccination rates in rural areas of Georgia. Any intervention developed to reduce HPV transmission and HPV-related cancers, such as cervical cancer, must include parental input as only the parent/caregiver (P/C) can provide consent for HPV vaccination.24-26 Since there is evidence that mistrust of healthcare interventions persists, particularly among African Americans, the proposed study will use an anonymous focus group approach to provide narrative data to explicate a better understanding of why parents choose to vaccinate their children ages 9 to 13 with the HPV vaccine.27-29 Results from a completed quantitative pilot form the basis of the questions to be asked in this proposed focus group study; these questions will be posed by focus group leaders who are trained by the Principal Investigator (PI). We expect to collect greater amounts of in-depth, culturally rich information using this qualitative method and then develop a tailored intervention that will emerge from the focus group data to increase HPV vaccine rates thereby reducing HPV transmission. PUBLIC HEALTH RELEVANCE: Project Narrative Almost 4 billion healthcare dollars are spent each year for the treatment of HPV infection including genital warts, cervical cancer and other HPV-related cancers. These human and fiscal costs can be reduced if the HPV vaccine is given prior to first sexual contact. However, for children to be protected against HPV infection, parents must give consent. This study will collect focus group data from parents with children ages 9 to 13 who reside in rural Georgia to identify the reasons why they do or do not vaccinate their children with the HPV Vaccine.