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.

项目摘要 人乳头瘤病毒（HPV）是美国最常见的性传播病毒（美国）。 HPV感染是 与子宫颈，外阴，阴道，阴茎，肛门和口咽的癌症有关，因此代表了重要的公共卫生 忧虑。 HPV疫苗是打击HPV感染及其癌症的最有效和成本效益的机制 相关后果。尽管如此，美国符合年龄的青少年的HPV疫苗接种率在美国仍然是最佳的 科学证据强调了社会文化和情境因素对父母的可接受性和 HPV疫苗接种的摄取。社会文化价值观，家庭期望，健康素养，信念，吸引力和知识 影响父母的行为和决定，寻求医疗保健和利用以及健康成果。黑人妇女是 受HPV相关的发病率和死亡率的影响不成比例，第二高宫颈癌事件 率是仅次于非西班牙裔白人的第二高，癌症死亡率最高。但是，缺乏数据 对于非洲少数族裔亚组，例如美国佛得角（CV） 非洲和葡萄牙的根。美国是佛得角国家以外最大的简历人口的所在地， 估计居住在美国CVS主要居住的265,000名CV移民及其后代居住在马萨诸塞州（〜90％） 和罗德岛。了解特定种族的HPV和HPV疫苗接种知识，参与者和行为（KAB） 少数和移民子组（例如简历）将使满足特定的亚组需求并改善 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。虽然最近的研究 在少数民族中，包括 非洲裔美国人和黑人，没有数据表明，居住在美国的简历青少年也是如此 因此，关于HPV知识，吸引力和居住在美国的简历父母的行为的数据仍然很少 拟议的研究将重点介绍佛得角，这是一个目前在癌症健康差异方面不足的人口组 研究，并寻求：1）探索有关HPV和HPV疫苗接种的KAB（意图，犹豫，障碍，启动， 简历母亲和父亲的完成）（第1阶段：焦点小组）； 2）探索简历父母的HPV KAB，健康 沟通，社会文化因素，让儿子和女儿接受HPV疫苗接种的意图，HPV 疫苗犹豫，HPV疫苗的障碍以及父母报告的HPV疫苗或拒绝接种疫苗（相位 2：调查管理）。拟议的社区参与研究具有创新性，因为它将：1）CVS， 当前在HPV研究中所占的人数不足，2）包括父亲 在HPV研究中代表不足的人，以及3）与天主教和新教教会建立合作伙伴关系 协助解决HPV疫苗神话并将准确的HPV疫苗信息传播到的重要目标 简历社区。此外，它将为未来的语言和文化量身定制的未来设计提供可靠的基础 此外 在未来的HPV和癌症预防干预措施中吸引乏味的少数民族CV父母的研究能力。