Kepka Deanna, Bodson Julia, Lai Djin, Sanchez-Birkhead Ana, Villalta Jeannette, Mukundente Valentine, Tavake-Pasi Fahina, Davis France A, Lee Doriena, Napia Edwin, Mooney Ryan, Coulter Heather, Stark Louisa A
Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah.
College of Nursing, University of Utah, Salt Lake City, Utah.
Health Equity. 2018 Sep 1;2(1):223-232. doi: 10.1089/heq.2018.0028. eCollection 2018.
This study assesses the sociodemographic facilitators and barriers to human papillomavirus (HPV) vaccination for diverse teens in a region with low HPV vaccination rates. In this community-based participatory research study, we surveyed adult family members of teens aged 11-17 years from African American, African refugee, American Indian/Alaskan Native, Hispanic/Latino, and Native Hawaiian/Pacific Islander community groups in Salt Lake City, Utah. Bivariate analyses assessed associations between sociodemographic characteristics and, respectively, HPV vaccine receipt and intentions for vaccination. Barriers to vaccination were also investigated. Only 20% of participants had vaccinated at least one of their children with at least one dose of the HPV vaccine. HPV vaccination was significantly related to caregiver age (=0.035), race/ethnicity (=0.001), educational attainment (=0.006), annual household income (=0.0454), years in the United States (=0.023), and caregiver parent birthplace (=0.008). Among caregivers with unvaccinated children, intention to vaccinate was significantly related to race/ethnicity (=0.048 for daughters; =0.003 for sons), caregiver parent birthplace (=0.023 for sons), health insurance coverage (=0.028 for daughters; =0.047 for sons), and type of health insurance coverage (=0.008 for sons). The most frequently cited barriers to HPV vaccination were lack of knowledge about the HPV vaccine, costs, side effects, and child not being sexually active. Our results show substantially lower HPV vaccine coverage than both national and state rates, signaling the urgent need for multipronged HPV vaccination interventions within these communities; strategies are discussed.
本研究评估了在人乳头瘤病毒（HPV）疫苗接种率较低地区，不同青少年群体接种HPV疫苗的社会人口学促进因素和障碍。在这项基于社区的参与性研究中，我们对犹他州盐湖城非裔美国人、非洲难民、美洲印第安人/阿拉斯加原住民、西班牙裔/拉丁裔以及夏威夷原住民/太平洋岛民社区群体中11至17岁青少年的成年家庭成员进行了调查。双变量分析评估了社会人口学特征与HPV疫苗接种情况以及接种意愿之间的关联。同时还调查了疫苗接种的障碍。只有20%的参与者至少为其一个孩子接种了至少一剂HPV疫苗。HPV疫苗接种与照料者年龄（=0.035）、种族/族裔（=0.001）、教育程度（=0.006）、家庭年收入（=0.0454）、在美国居住年限（=0.023）以及照料者父母出生地（=0.008）显著相关。在孩子未接种疫苗的照料者中，接种意愿与种族/族裔（女儿为=0.048；儿子为=0.003）、照料者父母出生地（儿子为=0.023）、医疗保险覆盖情况（女儿为=0.028；儿子为=0.047）以及医疗保险覆盖类型（儿子为=0.008）显著相关。HPV疫苗接种最常被提及的障碍是对HPV疫苗缺乏了解、费用、副作用以及孩子没有性行为。我们的研究结果显示，HPV疫苗接种覆盖率远低于全国和该州的水平，这表明在这些社区迫切需要采取多方面的HPV疫苗接种干预措施；文中还讨论了相关策略。
