The Human Papillomavirus (HPV) is a precursor of cervical cancer and genital warts. HPV strains, 16 and 18, are recognized as precursors of 70% of cervical cancers. HPV strains, 6 and 11, are associated with 90% of genital warts. In 2006, the U.S. Food and Drug Administration (FDA) licensed a vaccine to protect against these four HPV types. Recent estimates indicate that only 18% of teenage girls have received the three-dose series in the U.S. Cervical cancer affects ethnic minorities disproportionately. Cervical cancer incidence is two to fourfold in Latina women when compared to non-Latina white women. Research also suggests that the prevalence of HPV is greater in ethnic minority women. Our inquiry will be guided by a combination of the Information-Motivation-Behavioral Skills (IMB) model of preventive behavior (Fisher &Fisher, 1992;Fisher, Fisher, &Shuper, 2009) and cultural factors. Our proposed investigation will consist of three studies conducted in sequence: two qualitative and one quantitative. Qualitative study 1 will consist of semi-structured interview conducted separately with 30 mothers and 30 non-vaccinated daughters. The purpose of qualitative study 1 will be to identify: a) format and communication source to provide information, in a future intervention, to mothers and daughters about HPV and the vaccine while considering health literacy and numeracy, b) deterrents and motivators of vaccination acceptance while considering cultural factors, and c) the skills and resources that mothers and daughters perceive they need to be self-efficacious in communicating effectively with one another regarding sexuality and the adoption of sexuality-related health preventive measures such as vaccination. The objective of qualitative study 2 will be to corroborate and expand our findings from qualitative study 1. Qualitative study 2 will consist of semi-structured interviews conducted separately with 30 mothers and 30 vaccinated daughters. The purpose of qualitative study 2 will be to elucidate: a) knowledge about HPV etiology and vaccination, b) how the decision to vaccinate was made, and c) mother and daughter level of comfort in discussing sexuality- related preventive behaviors. Lastly, the purpose of the quantitative study will be to establish that the domains pertaining to the decision to vaccinate- information, motivation, behavioral skills-predict vaccination decisions in a sample of 150 Latina mothers (50% who have vaccinated their daughters). The findings from the proposed study will be used to pursue an R01 to develop and pilot test a future intervention to promote adoption of the HPV vaccine in the Latino community. The accomplishment of our aims will inform the development of an intervention based on well-defined underlying decision-making mechanisms critical to the adoption of a disease preventive behavior that has the potential to considerably reduce ethnic health disparities in cancer. In addition, information gathered in our studies can be translated to promote uptake of the HPV vaccine by health care practitioners impacting directly the field of nursing science.
The findings from this research will be used to inform the development of an intervention to promote vaccination in the Latino community. In addition, the findings will inform health care practitioners of the information that can be provided to Latinas, n the patient-provider encounter, to motivate vaccination.