Correlates of HPV vaccine initiation, completion, and dosing intervals among female and male adolescents in inner-city community health centers for 2011-2013
View File(s)
- Author(s)
- Details
-
Rula M. Btoush, RN; Diane R. Brown; Jennifer Bucalo; Dennis Carmody
- Sigma Affiliation
- Omicron Pi
Visitor Statistics
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Country | Visits |
---|
Top Visiting Cities
City | Visits |
---|
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Btoush, Rula M. by View
Title | Page Views |
---|
Popular Works for Btoush, Rula M. by Download
Title | Downloads |
---|
View Citations
Citations
Session presented on Friday, July 24, 2015:
Purpose: The human Pepillomavirus (HPV) infection is a known risk factor for the development of several cancers. According the CDC, between 2004 and 2008, there was a national average of 33,369 HPV-associated cancers annually, including cervical, vulvar, vaginal, penile, anal, and oropharyngeal cancers. There are pervasive disparities in national morbidity and mortality rates in the US for HPV-related cancers among Black and Hispanic. Cervical cancer, in particular, is more common among Black and Hispanic women and results in disproportionately higher mortality for Black women. In addition to race/ethnicity, incidence rates of penile, cervical, and vaginal cancers increase with higher poverty rates. Cervical cancer and other HPV-related cancers are preventable diseases through the 3-dose series of the HPV vaccine. Healthy People 2020 objective IID-11.4 is to increase the vaccination coverage level of 3 doses of HPV vaccine for females by age 13 to 15 years to 80%. However, HPV vaccination rates remain dramatically low in the US, particularly in underserved areas. Further, knowledge is still lacking on the correlates of HPV vaccination among underserved populations. Therefore, the purpose of this study was to examine the correlates of HPV vaccine initiation, completion, and dosing intervals for 2011-2013 among female and male adolescents in inner-city community health centers.
Methods: This is a descriptive, correlational study using electronic health records data for 6,691 adolescents seen at a multi-site community health center in 2011-2013. The study site is a federally qualified health center, providing services at seven sites in predominantly minority, low-income urban areas. Only five centers were included in this study; the two excluded centers do not provide pediatric services. The inclusion criteria were being 10-20 years old and having had at least one pediatric, OB/GYN, inteRN medicine, or nurse visit in 2011-2013. In the study sample, 59% were female; 91% were Black or Hispanic adolescents; 25% were non-English speakers; 31% were uninsured; and 69% were seen by a pediatric healthcare provider (HCP). The outcome variables are HPV vaccine initiation (receives at least one dose vs. did not receive any doses), completion of the 3-dose series (received 3 or more doses vs. received only 1-2 doses), and dosing intervals (in months). The predictor variables include gender, age, race/ethnicity, language, insurance status, and specialty of HCP. The EHR data were imported into SPSS statistical software for analysis. Bivariate and multivariate analyses were conducted to examine the associations between the study predictors and HPV vaccine initiation. The study analyses were conducted for the whole study sample as well as through subset analyses for female, male, Black, and Hispanic adolescents. For the bivariate analyses, we conducted chi-square tests for HPV vaccine initiation and completion, and t-tests for dosing intervals. Multivariate analyses included logistic regression for HPV vaccine initiation, linear regression for dosing intervals, and calculation of adjusted odds ratios (aOR) and 95% confidence intervals (CI). We also examined in the regression analyses the effect of any interactions among study predictors on HPV vaccination along with post-hoc analyses to further explore the interactions that were statistically significant.
Results: Over half of the adolescents in the study (54%) have initiated the HPV vaccine. In the bivariate analysis, HPV vaccine initiation was associated with all the study predictors. The multivariate analysis revealed that odds of HPV vaccine initiation were higher for male versus female adolescents (aOR=1.15; 95% CI=1.02, 1.30), non-English versus English speakers (aOR=1.804; 95% CI=1.55, 2.11), and among insured versus uninsured adolescents (aOR=1.13; 95% CI=0.98, 1.30). The odds of initiation were lower among older versus younger adolescents (aOR=0.77; 95% CI=0.67, 0.88), those seen by a non-pediatric HCP versus a pediatric HCP (aOR=0.23; 95% CI=0.20, 0.27), and among Hispanic versus Black adolescents (aOR=0.69; 95% CI=0.60, 0.80). Only 27% of the adolescents in the study have completed the HPV vaccine 3-dose series. In the bivariate analysis, HPV vaccine completion was associated with all the study predictors except gender. The multivariate analysis revealed that odds of HPV vaccine completion were higher insured versus uninsured adolescents (aOR=1.45; 95% CI=1.21, 1.73) and Hispanic versus Black adolescents (aOR=1.19; 95% CI=1.01, 1.42). The odds of HPV vaccine completion were lower for adolescents seen by a non-pediatric HCP versus a pediatric HCP (aOR=0.54; 95% CI=0.43, 0.67). The mean dosing intervals were 6.6 months between dose 1 and 2 (SD=6.9) and 12.6 months between dose 1 and 3 (SD=8.7). The bivariate and multivariate analyses show that the dosing intervals were significantly longer among older adolescents and English speakers. More findings will be presented on subset analyses for female, male, Black, and Hispanic adolescents as well as for the effect of interactions among study predictors on HPV vaccination.
Conclusion: Improving HPV vaccination in low income urban areas is critical to reducing disparities in cervical and other HPV-related cancer in the US, especially among Black, Hispanic, and low-income populations. This study informs the development of targeted intervention to improve HPV vaccination among underserved populations in the US and around the globe. This study has potential for engaging in scholarly conversations with global partners regarding HPV vaccination and cancer health disparities. This study was funded by the New Jersey Health Foundation - School of Nursing's Research Endowment.
Research Congress 2015 Theme: Question Locally, Engage Regionally, Apply Globally. Held at the Puerto Rico Convention Center.
Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository.
Type | Presentation |
Acquisition | Proxy-submission |
Review Type | Abstract Review Only: Reviewed by Event Host |
Format | Text-based Document |
Evidence Level | N/A |
Research Approach | N/A |
Keywords | HPV Vaccination; Cancer Prevention; Health Promotion |
Name | 26th international Nursing Research Congress |
Host | Sigma Theta Tau International |
Location | San Juan, Puerto Rico |
Date | 2015 |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Related items
Showing items related by title, author, creator and subjects.
-
Knowledge and attitudes towards HPV vaccination among Latina mothers in an urban, low-income area
Btoush, Rula M.; Munet-Vilaro, Frances; Brown, Diane R.; Bucalo, Jennifer (2016-03-17)Session presented on Friday, July 24, 2015: Purpose: Cervical cancer and other HPV-related cancers are preventable diseases through the 3-dose series of the HPV vaccine. Healthy People 2020 objective IID-11.4 is to increase ... -
The work environment and healthcare provider recommendation of the HPV vaccine
Btoush, Rula M.This study examines healthcare providers' recommendation of the HPV vaccine and their knowledge, beliefs, perceived barriers, and cues to action for recommending and discussing the HPV vaccine with parents, using an anonymous ... -
Cognitive concepts predicting medication adherence and asthma control in inner-city adolescents
Rhee, Hyekyun; Grape, Annette; Harrington, Donald; Tumiel-Berhalter, Laurene; Sloand, Elizabeth; Wicks, Mona (2017-07-27)Participants will have the opportunity to learn how cognitive processes affect medication adherence and symptom control in inner-city adolescents with asthma. Participants will also have a chance to ask the researcher about ... -
Wellness with children in the inner-city
De Natale, Mary Lou (2016-07-13)Session presented on Saturday, July 23, 2016 and Sunday, July 24, 2016: Purpose: Working in the inner city community with vulnerable children is often overwhelming to health care providers. Taking the first step in ... -
A decade of parent-child sex communication: A systematic review, 2003-2013
Flores, Dalmacio Dennis; Barroso, Julie (2016-03-17)Session presented on Sunday, July 26, 2015: Purpose: Conversations between parents and children about sex can result in the transmission of family expectations, societal values, and role modeling of sexual health risk ...