Toward Racial Equity and Justice in Human Papillomavirus (HPV) Vaccination: An Exploratory Study with Cape Verdean Parents

人乳头瘤病毒（HPV）疫苗接种中的种族公平和正义：佛得角家长的探索性研究

• 批准号: 10574086
• 负责人: ANA CRISTINA TERRA DE SOUZA LINDSAY
• 金额: $ 22.88万
• 依托单位: UNIVERSITY OF MASSACHUSETTS BOSTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10574086
• 关键词: 18 year old; Acculturation; Address; Adolescent; Affect; African; African American population; African ancestry; Age; Attitude; Awareness; Belief; Black Populations; Cancer Prevention Intervention; Cape Verde; Child Rearing; Church; Communities; Country; Data; Daughter; Educational Intervention; Eligibility Determination; Ethnic Origin; Family; Fathers; Focus Groups; Funding Mechanisms; Future; Gender; Genotype; Goals; Health; Health Disparities Research; Health Knowledge Attitudes Practice; Health Status; Healthcare; Home; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papilloma Virus-Related Malignant Neoplasm; Human Papillomavirus; Human papilloma virus infection; Immigrant; Incidence; Individual; Intention; Investments; Justice; Knowledge; Legal Guardians; Length; Linguistics; Link; Literature; Logistic Regressions; Malignant Neoplasms; Malignant Vaginal Neoplasm; Malignant neoplasm of anus; Malignant neoplasm of cervix uteri; Malignant neoplasm of penis; Malignant neoplasm of vulva; Massachusetts; Minority; Minority Groups; Morbidity - disease rate; Mothers; Not Hispanic or Latino; Outcome; Parents; Phase; Population; Population Group; Portuguese; Prevalence; Protestant; Public Health; Race; Racial Equity; Reporting; Research; Residencies; Rhode Island; Science; Solid; Son; Subgroup; Surveys; Testing; United States; Vaccines; black women; cancer health disparity; cancer risk; carcinogenicity; care seeking; community engaged research; contextual factors; cost effective; design; ethnic minority; ethnic minority population; expectation; health communication; health literacy; improved; innovation; malignant oropharynx neoplasm; member; mortality; parental influence; premalignant; prevent; preventive intervention; psychosocial; racial health disparity; sexually transmitted virus; social culture; sociocultural determinant; uptake; vaccine hesitancy; vaccine refusal

PROJECT SUMMARY Human papillomavirus (HPV) is the most common sexually transmitted virus in the United States (U.S.). HPV infection is linked to cancers of the cervix, vulva, vagina, penis, anus, and oropharynx, thus representing a significant public health concern. The HPV vaccine is the most efficient and cost-effective mechanism for combating HPV infection and its cancer- related consequences. Nonetheless, HPV vaccination rates for age-eligible adolescents remain suboptimal in the U.S. Scientific evidence underscores the critical influence of sociocultural and contextual factors on parents’ acceptability and uptake of the HPV vaccination. Sociocultural values, family expectations, health literacy, beliefs, attitudes, and knowledge influence parents’ behaviors and decisions, healthcare-seeking and utilization, and health outcomes. Black women are disproportionally affected by HPV-associated morbidity and mortality, with the second-highest cervical cancer incidence rate, the second highest after non-Hispanic Whites and the highest cancer mortality rate. However, there is a lack of data for African ethnic minority subgroups such as Cape Verdeans (CV) in the U.S, an ethnic minority group of mixed West African and Portuguese roots. The U.S. is home to the largest CV population outside the country of Cape Verde, with an estimated 265,000 CV immigrants and their descendants living in the U.S. CVs primarily reside (~90%) in Massachusetts and Rhode Island. Understanding HPV and HPV vaccination knowledge, attitudes, and behaviors (KAB) of specific ethnic minoritized and immigrant subgroups, such as CV, will make it possible to meet particular subgroup needs and improve knowledge and practices, thereby improving health status and outcomes by decreasing cancer risk. Though recent research has shown an increase in HPV uptake, but not necessarily HPV vaccine completion, among minority populations including African Americans and Blacks, no data exist to show that this is the case for CV adolescents living in the U.S. Also, there remains a paucity of data regarding HPV knowledge, attitudes, and behaviors of CV parents living in the U.S. Therefore, the proposed study will focus on Cape Verdeans, a population group currently underrepresented in cancer health disparity research, and seeks to: 1) explore the KAB regarding HPV and HPV vaccination (intention, hesitancy, barriers, initiation, and completion) among CV mothers and fathers (Phase 1: Focus Groups); and 2) explore CV parents’ HPV KAB, health communication, sociocultural factors, their intention to have their sons and daughters undergo HPV vaccination, HPV vaccine hesitancy, barriers to HPV vaccination, and parent-reported receipt of HPV vaccine or refusal of the vaccine (Phase 2: Survey Administration). The proposed community-engaged research is innovative in that it will: 1) engage CVs, an understudied ethnic minority and immigrant subpopulation currently underrepresented in HPV research, 2) include fathers who are under-represented in HPV research, and 3) establish a partnership with Catholic and Protestant churches to further assist with the important goal of addressing HPV vaccine myths and disseminating accurate HPV vaccine information to CV communities. Moreover, it will provide a solid basis for the design of future linguistically and culturally tailored education interventions to promote the HPV vaccine among CVs in the U.S. Moreover, this research will build further research capacity to engage underserved, minority CV parents in future HPV and cancer prevention interventions.

项目概要 人乳头瘤病毒 (HPV) 是美国最常见的性传播病毒。 与子宫颈癌、外阴癌、阴道癌、阴茎癌、肛门癌和口咽癌有关，因此代表着重要的公共卫生问题 HPV 疫苗是对抗 HPV 感染及其癌症的最有效且最具成本效益的机制。 然而，美国适龄青少年的 HPV 疫苗接种率仍然不理想。 科学证据强调社会文化和背景因素对父母的接受度和接受度的关键影响 HPV 疫苗接种的社会文化价值观、家庭期望、健康素养、信仰、态度和知识。 影响父母的行为和决定、医疗保健的寻求和利用以及黑人女性的健康结果。 受 HPV 相关发病率和死亡率影响不成比例，宫颈癌发病率位居第二 率，仅次于非西班牙裔白人，位居第二，癌症死亡率最高。但是，缺乏数据。 对于非洲少数民族亚群体，例如美国的佛得角人 (CV)，这是一个混血的西方少数民族群体 美国是佛得角以外拥有最多 CV 人口的国家，拥有非洲和葡萄牙血统。 估计有 265,000 名居住在美国的 CV 移民及其后代主要居住在马萨诸塞州 (约 90%) 了解特定种族的 HPV 和 HPV 疫苗接种知识、态度和行为 (KAB)。 少数族裔和移民亚群体，例如 CV，将能够满足特定亚群体的需求并改善 通过最近的研究，知识和实践，从而通过降低癌症风险来改善健康状况和结果。 少数群体（包括 非裔美国人和黑人，没有数据表明居住在美国的 CV 青少年的情况如此。此外， 关于居住在美国的 CV 父母的 HPV 知识、态度和行为的数据仍然很少。因此， 拟议的研究将重点关注佛得角人，该群体目前在癌症健康差异方面代表性不足 研究，并力求：1) 探索有关 HPV 和 HPV 疫苗接种的 KAB（意图、犹豫、障碍、启动、 和完成）在 CV 母亲和父亲中（第一阶段：焦点小组）；以及 2）探索 CV 父母的 HPV KAB、健康状况 沟通、社会文化因素、让子女接受 HPV 疫苗接种的意愿、HPV 疫苗犹豫、HPV 疫苗接种障碍以及家长报告的接受 HPV 疫苗或拒绝疫苗（阶段 2：调查管理）。拟议的社区参与研究具有创新性，因为它将：1）吸引简历， 目前在 HPV 研究中代表性不足的少数族裔和移民亚人群，2) 包括父亲 HPV 研究中代表性不足的人群，以及 3) 与天主教和新教教会建立合作伙伴关系，以进一步推动 协助实现解决 HPV 疫苗神话并向人们传播准确的 HPV 疫苗信息的重要目标 此外，它将为未来的语言和文化定制设计提供坚实的基础。 教育干预措施，以在美国CV中推广HPV疫苗。此外，这项研究将进一步建立 研究能力，让服务不足的少数族裔父母参与未来的 HPV 和癌症预防干预措施。