Department of Pediatrics, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Department of Pediatrics, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI, 53226, USA.
J Community Health. 2019 Jun;44(3):544-551. doi: 10.1007/s10900-018-00610-9.
Increasing HPV vaccination rates may decrease the disproportionately high HPV-associated disease incidence and mortality in African Americans (AA) and lower socioeconomic individuals. Data from a community-based participatory research (CBPR) study addressing immunization disparities among 19-35 month old children was analyzed to identify ancillary benefits in HPV immunization rates for adolescent siblings. Sub-study analysis inclusion criteria: AA (N = 118), 13-17 years old, younger sibling enrolled in parent study, and enrolled ≥ 9 months. Parent/caregiver interventions included: a web-based immunization toolkit with information on age-appropriate vaccines; a multimedia community outreach campaign; and reminder mailings. HPV up-to-date (UTD) status was defined as Wisconsin Immunization Registry (WIR) documentation of at least three HPV vaccines. McNemar's test compared pre/post intervention HPV status. Two dependent proportions testing compared the proportion of adolescents that became UTD in the study cohort, City of Milwaukee, and State of Wisconsin. Parents/caregivers perceived that 92% of adolescents were HPV-UTD, while only 24% had a WIR-verified HPV-UTD status. Baseline UTD status of the younger siblings 19-35 month old 4:3:1:3:3:1:4 antigen series was 63%, which increased to 86% at study completion. Adolescent's HPV-UTD immunization status increased from 30 (25%) at enrollment to 54 (46%) at study completion [p = 0.004]. A statistically significant larger proportion of adolescents became HPV-UTD in the study cohort (20%) compared to the City of Milwaukee [14%, p = 0.042] and the State of Wisconsin [14%, p = 0.046]. A culturally-tailored CBPR approach targeting parents/caregivers of younger AA children can have significant ancillary benefit to increase HPV immunization rates in adolescent siblings.
提高 HPV 疫苗接种率可能会降低非裔美国人（AA）和社会经济地位较低人群中 HPV 相关疾病发病率和死亡率的不成比例现象。对一项基于社区的参与性研究（CBPR）进行了数据分析，该研究旨在解决 19-35 个月大的儿童中的免疫接种差距问题，以确定青少年兄弟姐妹 HPV 免疫接种率的辅助益处。子研究分析纳入标准：AA（N=118），13-17 岁，年龄较小的兄弟姐妹参加了父母研究，并且参加时间≥9 个月。父母/照顾者干预措施包括：一个包含适龄疫苗信息的基于网络的免疫工具包；多媒体社区外展活动；以及提醒邮件。HPV 最新状态（UTD）定义为威斯康星州免疫登记处（WIR）记录的至少三种 HPV 疫苗。McNemar 检验比较了干预前后 HPV 状态。两个独立比例检验比较了研究队列、密尔沃基市和威斯康星州青少年成为 UTD 的比例。父母/照顾者认为 92%的青少年 HPV 是 UTD 的，而只有 24%的人在 WIR 中核实了 HPV-UTD 状态。年龄较小的兄弟姐妹 19-35 个月 4:3:1:3:3:1:4 抗原系列的基线 UTD 状态为 63%，在研究完成时增加到 86%。青少年 HPV-UTD 免疫接种状况从入学时的 30（25%）增加到研究结束时的 54（46%）[p=0.004]。与密尔沃基市[14%，p=0.042]和威斯康星州[14%，p=0.046]相比，研究队列中青少年成为 HPV-UTD 的比例显著增加（20%）。针对年轻 AA 儿童的父母/照顾者的文化上量身定制的 CBPR 方法可以显著提高青少年兄弟姐妹的 HPV 免疫接种率。
