Budhwani H, De P
University of Alabama at Birmingham, Department of Health Care Organization and Policy, 310 Ryals Public Health Building, 1665 University Boulevard, Birmingham, AL 35294, USA.
City College and the Graduate Center, City University of New York, 160 Convent Avenue, New York, NY 10031, USA.
Public Health. 2017 Dec;153:111-117. doi: 10.1016/j.puhe.2017.07.036. Epub 2017 Oct 10.
Vaccine disparities research often focuses on differences between the five main racial and ethnic classifications, ignoring heterogeneity of subpopulations. Considering this knowledge gap, we examined human papillomavirus (HPV) vaccine initiation in Asian Indians and Asian subpopulations.
National Health Interview Survey data (2008-2013), collected by the National Center for Health Statistics, were analyzed.
Multiple logistic regression analysis was conducted on adults aged 18-26 years (n = 20,040).
Asian Indians had high income, education, and health insurance coverage, all positive predictors of preventative health engagement and vaccine uptake. However, we find that Asian Indians had comparatively lower rates of HPV vaccine initiation (odds ratio = 0.41; 95% confidence interval = 0.207-0.832), and foreign-born Asian Indians had the lowest rate HPV vaccination of all subpopulations (2.3%).
Findings substantiate the need for research on disaggregated data rather than evaluating vaccination behaviors solely across standard racial and ethnic categories. We identified two populations that were initiating HPV vaccine at abysmal levels: foreign-born persons and Asian Indians. Development of culturally appropriate messaging has the potential to improve these initiation rates and improve population health.
疫苗差异研究通常聚焦于五个主要种族和族裔分类之间的差异，而忽略了亚群体的异质性。考虑到这一知识空白，我们研究了亚洲印度人和亚洲亚群体中人乳头瘤病毒（HPV）疫苗的接种情况。
对美国国家卫生统计中心收集的2008 - 2013年全国健康访谈调查数据进行分析。
对18 - 26岁的成年人（n = 20,040）进行多因素逻辑回归分析。
亚洲印度人收入高、受教育程度高且医疗保险覆盖率高，这些都是预防性健康参与和疫苗接种的积极预测因素。然而，我们发现亚洲印度人的HPV疫苗接种率相对较低（优势比 = 0.41；95%置信区间 = 0.207 - 0.832），并且在所有亚群体中，出生在国外的亚洲印度人的HPV疫苗接种率最低（2.3%）。
研究结果证实了对分类数据进行研究的必要性，而不是仅根据标准种族和族裔类别来评估疫苗接种行为。我们确定了两个HPV疫苗接种率极低的群体：出生在国外的人和亚洲印度人。制定适合文化背景的宣传信息有可能提高这些接种率并改善人群健康状况。
