While individual- and provider-level factors for low Human Papillomavirus (HPV) vaccination rates in the United States (U.S.) have been well examined, the role of community-level geographic factors in HPV vaccine initiation and 3-dose completion in the U.S. is unknown. Geographic and neighborhood factors could influence vaccination through several pathways linked to material resources of the neighborhood, availability and ease of access to health-care facilities and services, social capital (e.g., socia contagion, similar norms of behavior), and residential segregation. Using data from the National Immunization Survey-Teen (NIS-Teen), an annual survey conducted by the Centers for Disease Control and Prevention to monitor vaccination uptake in the U.S., associations between HPV vaccination among adolescent girls and boys and community-level geographic factors including poverty, rural/urban residence, and racial composition will be examined. Zip code and county- level geographic identifiers are not available in the public-use NIS-Teen datasets, and therefore these geographic identifiers will be accessed and linked via the restricted use NIS-Teen files to provide a novel examination of geographic factors' role in HPV vaccination. First, we will identify community-level geographic factors that are independent predictors of both vaccine initiation and series completion, among U.S. teen girls and boys separately. Next, we will investigate how geographic and community level socioeconomic factors impact and interact with individual level factors associated with HPV vaccine initiation and completion. This will be the first study to provide much needed information on the influence of community-level geographic factors on HPV vaccine initiation and completion among a nationally representative sample of adolescents in the U.S. Given the low rates of HPV vaccination in the U.S., the results from the proposed study will help inform public health practice and the development of geographically targeted interventions to improve HPV vaccination in the United States.
Few teens in the United States are receiving protection against HPV-related cancers because receipt and 3-dose completion of the Human Papillomavirus Vaccine (HPV) vaccine is far below national goals. This study will examine how contextual factors such as regional demographic characteristics, geographic location, and access to healthcare services influence rates of receipt of the HPV vaccine among eligible girls and boys (ages 13-17 years) using NIS-TEEN data. Findings from this study will guide targeted interventions to improve HPV vaccination in sub- regions of the United States.
| Henry, Kevin A; Swiecki-Sikora, Allison L; Stroup, Antoinette M et al. (2017) Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States. BMC Public Health 18:19 |
| Warner, Echo L; Ding, Qian; Pappas, Lisa M et al. (2017) White, affluent, educated parents are least likely to choose HPV vaccination for their children: a cross-sectional study of the National Immunization Study - teen. BMC Pediatr 17:200 |
