Vietnamese-Americans have been documented to have high cervical cancer rates and low human papillomavirus vaccine (HPVV) uptake. Unfortunately, limited research has disaggregated the Asian-American population to examine mechanistic explanations for this disparity. Additionally, no prior work has examined multilevel determinants influencing HPVV uptake among Vietnamese-Americans. This study will leverage a health services research framework (P3 model) and an explanatory sequential mixed-method design to examine multilevel determinants of HPVV uptake among Vietnamese-American parents.
The specific aims are to: (1) quantitatively examine practice-, provider-, and patient-level factors influencing Vietnamese- American parents? HPVV uptake for their adolescents; and (2) qualitatively examine why and how factors identified in Aim 1 shape Vietnamese-American parents? HPVV decision-making and assess practice-, provider-, and patient-level strategies to promote adolescent HPVV uptake. This proposal will advance NCI?s mission of cancer health equity by exploring structural, social, and cultural barriers to HPVV for a high-risk minority group and by supporting the development of a talented, well-poised junior investigator, Ms. Ha Ngan (Milkie) Vu, who is devoted to a research career furthering this mission. Ms. Vu?s 3-year training plan includes: (1) strengthening her expertise of health services research theories, focusing on health system factors impacting Asian immigrants? cancer prevention practices and HPVV utilization; (2) increasing her understanding of intervention development and translational research; and (3) refining her skills set related to research design, statistical methods, and mixed-method research. This fellowship will facilitate her progress towards her career goal of becoming an independent investigator who advances knowledge of cancer health disparities among immigrants and racial/ethnic minorities, applies this knowledge to develop interventions addressing such disparities, and ensures knowledge translation to inform policy and practice. Emory University is an excellent environment for the proposed research and training. The proposed team of mentors, Drs. Berg (Primary Sponsor), Bednarczyk (Co-Sponsor), Escoffery (Co-Sponsor), and Haardrfer (Collaborator) will lend their collective expertise to mentor Ms. Vu in cancer prevention and control, health communication, HPVV, dissemination and implementation research, mixed-methods research, theory development and testing, and research translation and dissemination. Moreover, Ms. Vu will leverage infrastructure and resources available within Emory?s Winship Cancer Institute (NCI-designated comprehensive cancer center); within Emory?s Global Health Institute and its associated Refugee and Immigrant Health and Wellness Alliance; and within the Doctoral Program, Department, School of Public Health, and University. The candidate, the mentorship team, and the environment are uniquely suited to effectively achieve the proposed research and training aims.
Human papillomavirus vaccine (HPVV) is a safe, effective method to prevent HPV-related cancers but remains underutilized among Vietnamese-Americans; unfortunately, limited research has examined this population specifically or examined determinants of HPVV beyond those at the individual level. This proposal represents the first step in addressing this gap in the literature by examining healthcare practice-, provider-, and patient- level factors in relation to HPVV decision-making and behaviors among Vietnamese-Americans, with the ultimate goal of informing interventions to improve HPVV rates in this population. This proposal will advance NCI?s mission of cancer health equity by exploring structural, social, and cultural barriers to HPVV for a high- risk minority group and by supporting the development of a junior investigator devoted to a research career addressing cancer risk and related behaviors among minority populations.