Hispanics are the largest racial/ethnic minority population in the United States (US) and experience several disparities related to human papillomavirus (HPV), including Hispanic women having the highest cervical cancer incidence rate of any racial/ethnic group in the country. HPV vaccine is recommended for adolescents and young adults in the US, and estimates of HPV vaccine coverage among Hispanic adolescents vary, though recent national data suggest that vaccine coverage is similar to or slightly higher than other racial/ethnic groups. However, a key and recurring limitation of existing HPV vaccine research is that Hispanics have been aggregated and examined as a single, homogeneous group in analyses. Hispanics are in fact a heterogeneous population, with the term ?Hispanic? referring to persons of Mexican, Cuban, Puerto Rican, Dominican, Central American, South American, or other Spanish descent. There are striking differences between these Hispanic subgroups on immigration histories, demographics, and health behaviors and outcomes, and aggregating them in past HPV vaccine research has likely masked important subgroup differences. Unmasking and accounting for these subgroup disparities is an important component of planning health promotion programs for Hispanics (e.g., HPV vaccine interventions and surveillance efforts). Our long-term goal is to understand how HPV vaccination outcomes differ across Hispanic subgroups and then apply this understanding to increase vaccine coverage. The proposed study will take the first step in achieving this goal by analyzing existing data from the 2012-2016 National Immunization Survey-Teen (NIS-Teen) to identify existing HPV vaccination disparities across Hispanic subgroups. The NIS-Teen is considered the gold standard of US vaccination data, and analyses will include a large, national sample of Hispanic adolescents (n=16,381) and be well-powered to identify subgroup disparities. The proposed study will determine how Hispanic subgroups differ in terms of current HPV vaccine coverage among adolescents (Aim 1), multi-level correlates of HPV vaccine coverage (Aim 2), potential barriers to parents vaccinating their children against HPV (Aim 3), and the validity of parent-reported HPV vaccination data (Aim 4). Each study aim will address a unique research question and together will provide a novel and comprehensive understanding of how HPV vaccination outcomes differ across Hispanic subgroups. We anticipate that Hispanic subgroup differences will be identified within each study aim. The resulting subgroup-specific data will greatly impact both the development (i.e., current HPV vaccine coverage, correlates, and barriers) and evaluation (i.e., validity of parent-reported data) of HPV vaccine interventions and surveillance efforts for Hispanics.
A key and recurring limitation of existing HPV vaccine research is that Hispanics have been aggregated and examined as a single, homogeneous group in analyses, an approach that has likely masked disparities between Hispanic subgroups. The proposed study will analyze existing data on a national sample of Hispanic adolescents to determine how outcomes related to HPV vaccination differ across Hispanic subgroups. Findings will provide subgroup-specific epidemiological data that will greatly impact both the development and evaluation of HPV vaccine interventions and surveillance efforts for Hispanics.
