Uptake of the human papillomavirus (HPV) vaccine among adolescents has trailed that of other recently recommended adolescent vaccines. Numerous studies have documented a number of wide-ranging barriers to receipt of HPV vaccine, but to date, there has not been a comprehensive program targeted to all components of the adolescent health care decision making population to address these low vaccination levels. This mentored training program will utilize instruction in behavioral sciences to lead to development of a multi- pronged, comprehensive intervention toolkit with components targeted to physician offices/practices, individual health care providers, adolescents, and their parents, t improve uptake of the human papillomavirus vaccine. To date, my training in epidemiology has focused on quantitative analysis of infectious disease and vaccine-related studies. Previously, I conducted research to better understand the barriers to HPV vaccine acceptance, while serving as the Assistant to Chair of the National Vaccine Advisory Committee. Having witnessed how vaccine policy decisions are made, and the types of information that needed to make these recommendations, I am seeking to leverage this experience to move to a new phase of my career, seeking training in a new field (behavioral sciences) and using this to develop methods to address suboptimal adolescent vaccine rates in the US. Through this mentored research, I anticipate obtaining evidence that can be utilized to develop additional R01 grant applications to continue studying behavioral interventions to improve adolescent health. These future studies will be a primary component of my research portfolio as I transition to working as an independent investigator in a tenure-track academic appointment. Through this career development award, I will obtain education in behavioral science and health education through coursework and directed readings, with a focus on developing and implementing materials to effect behavioral change with regard to adolescent health care decision making. Over a four-year period, I will (a) utilize in-class education and directed readings to better understand these behavioral science methods, (b) conduct key informant interviews and focus groups to clarify barriers to HPV vaccination and identify the best ways to mitigate these barriers, and (c) develop a toolkit with components directed at four levels of the adolescent health care decision making system (medical office/practice, healthcare providers [physicians and nursing staff], adolescents, and their parents). The final component of the research will be an evaluation of the effectiveness of this toolkit in improving HPV vaccine uptake, as measured through differences between baseline and follow-up surveys. These activities will occur within community-level pediatric practices in the state of GA.

Public Health Relevance

Even though the human papillomavirus (HPV) vaccine has been shown to be safe and effective in numerous clinical trials and post-licensure studies, HPV vaccine uptake among US adolescents has trailed that of other recently recommended adolescent vaccines. Currently in the US, even with widespread cervical cancer screening, there are still over 10,000 new cases of cervical cancer diagnosed each year, many of which could be prevented with greater use of the HPV vaccine. This mentored research will include creating and evaluating a new multi-level (medical office/provider practice, healthcare provider, adolescent patient, parent) behavioral intervention toolkit that will be designed to improve HPV vaccination rates among 11-12 year old girls seeking care in pediatric medical offices in the state of Georgia.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Scientist Development Award - Research & Training (K01)
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Microbiology and Infectious Diseases B Subcommittee (MID)
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David, Hagit S
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Emory University
Public Health & Prev Medicine
Schools of Public Health
United States
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