Cervical cancer is a major cause of morbidity and mortality. Virtually all cancers of the cervix are caused by HPV infection. Several HPV vaccines (that could prevent 70 percent of all cervical cancers) have been approved for American girls and young women. The majority of Cambodian Americans came to the US as immigrants and over one-half have limited English proficiency. Women of Southeast Asian descent have higher cervical cancer incidence rates than any other racial/ethnic group, and the incidence among Cambodians is twice the incidence among non-Hispanic whites (15.0 versus 7.7 per 100,000). The study goal is to conduct mixed-methods research that could be used to inform the development, implementation, and evaluation of culturally appropriate HPV vaccination interventions targeting Cambodian women with daughters in the 9-17 age group. Qualitative and quantitative methods should both be used to examine determinants of preventive health practices in Southeast Asian and other immigrant groups. Our primary objectives are: to provide qualitative data relevant to the promotion of HPV vaccine use in Cambodian communities;and quantitative data about the uptake of HPV vaccination among Cambodian adolescents, as well as correlates of HPV vaccine uptake. A recent review of HPV vaccine surveillance in the US found no publications addressing the reliability of self-reported HPV vaccine uptake. Our secondary objective is to assess the test-retest reliability of survey measures addressing HPV vaccine uptake in a Cambodian study group. Our community-based participatory research will build on a long-standing collaboration with the Cambodian community. An existing Cambodian Community Coalition will serve as the community advisory board for the project. Cambodian women who have a daughter in the 9-17 age group and live in the Seattle-Tacoma metropolitan area will be included in this study. Our research will use the theoretical perspective of the Health Behavior Framework. Qualitative and quantitative study phases will be conducted sequentially. We will complete 25 qualitative interviews with Cambodian mothers. Qualitative data findings will be used to guide the development of a quantitative survey instrument. A community-based telephone survey of 200 Cambodian mothers will be conducted, and a sub-sample of 50 survey participants will be asked to complete a retest survey.

Public Health Relevance

This project will provide valuable qualitative and quantitative information about HPV vaccination in the Cambodian community. Project findings could be used to guide the development, implementation, and evaluation of culturally appropriate HPV vaccination educational materials and intervention programs for Cambodian Americans.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Exploratory/Developmental Grants (R21)
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Health Disparities and Equity Promotion Study Section (HDEP)
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Kobrin, Sarah
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Fred Hutchinson Cancer Research Center
United States
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Burke, Nancy J; Do, Huyen H; Talbot, Jocelyn et al. (2015) Protecting our Khmer daughters: ghosts of the past, uncertain futures, and the human papillomavirus vaccine. Ethn Health 20:376-90
Taylor, Victoria M; Burke, Nancy J; Ko, Linda K et al. (2014) Understanding HPV vaccine uptake among Cambodian American girls. J Community Health 39:857-62