Bodson Julia, Ding Qian, Warner Echo L, Hawkins Amy J, Henry Kevin A, Kepka Deanna
Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, Utah, 84112, USA.
Matern Child Health J. 2017 Jul;21(7):1500-1511. doi: 10.1007/s10995-017-2274-3.
Objectives We investigated the similarities and differences in the factors related to human papillomavirus (HPV) vaccination of female adolescents in three sub-regions of the Intermountain West (IW). Methods We analyzed 2011-2012 National Immunization Survey-Teen data. Respondents (parents) who were living in the IW and who had daughters aged 13-17 years old with provider-verified immunization records were included in our analyses. East, Central, and West sub-regions were defined based on geographic contiguity and similarity in HPV vaccination rates and sociodemographic characteristics. Survey-weighted Chi square tests and multivariable Poisson regressions were performed. Results In all three sub-regions, older teen age and receipt of other recommended adolescent vaccinations were significantly associated with HPV vaccination. In the East sub-region, providers' facility type and source of vaccines were significantly related to HPV vaccination. In the Central sub-region, teens with married parents were significantly less likely to be vaccinated than were those with unmarried parents. In the West sub-region, non-Hispanic teens were significantly less likely to be vaccinated than were Hispanic teens. Conclusions for Practice In order to improve HPV vaccine coverage in the IW, region-wide efforts to target younger teens and to promote the HPV vaccine with other recommended adolescent vaccinations should be supplemented with sub-regional attention to the health care system (East sub-region), to married parents (Central sub-region), and to non-Hispanic teens (West sub-region).
目的 我们调查了美国西部山间地区（IW）三个子区域中与女性青少年人乳头瘤病毒（HPV）疫苗接种相关因素的异同。方法 我们分析了2011 - 2012年全国青少年免疫调查数据。分析纳入了居住在IW且女儿年龄在13 - 17岁且有经医疗机构核实的免疫记录的受访者（父母）。根据地理邻接性以及HPV疫苗接种率和社会人口学特征的相似性定义了东部、中部和西部子区域。进行了调查加权卡方检验和多变量泊松回归分析。结果 在所有三个子区域中，年龄较大的青少年以及接种其他推荐的青少年疫苗与HPV疫苗接种显著相关。在东部子区域，医疗机构类型和疫苗来源与HPV疫苗接种显著相关。在中部子区域，父母已婚的青少年接种疫苗的可能性明显低于父母未婚的青少年。在西部子区域，非西班牙裔青少年接种疫苗的可能性明显低于西班牙裔青少年。实践结论 为了提高IW地区的HPV疫苗接种率，在全地区针对较年轻青少年并将HPV疫苗与其他推荐的青少年疫苗一起推广的努力，应辅之以对子区域的关注，即关注医疗保健系统（东部子区域）、父母已婚的情况（中部子区域）以及非西班牙裔青少年（西部子区域）。
