학술논문

Increasing HPV Vaccination among Low-income, Ethnic Minority Adolescents: Effects of a Multicomponent System Intervention through a County Health Department Hotline
Document Type
article
Source
Cancer Epidemiology Biomarkers & Prevention. 31(1)
Subject
Biomedical and Clinical Sciences
Health Services and Systems
Public Health
Health Sciences
Paediatrics
Pediatric
Cervical Cancer
Sexually Transmitted Infections
Prevention
Infectious Diseases
Pediatric Research Initiative
Immunization
Clinical Research
Clinical Trials and Supportive Activities
HPV and/or Cervical Cancer Vaccines
Cancer
Vaccine Related
3.4 Vaccines
Prevention of disease and conditions
and promotion of well-being
Good Health and Well Being
Adolescent
Ethnic and Racial Minorities
Female
Hotlines
Humans
Los Angeles
Male
Papillomavirus Infections
Papillomavirus Vaccines
Poverty Areas
Human papillomavirus (HPV)-associated cancers
including cer-
Medical and Health Sciences
Epidemiology
Biomedical and clinical sciences
Health sciences
Language
Abstract
BackgroundIntroduction of the human papillomavirus (HPV) vaccine in 2006 was a game-changing advance in cancer control. Despite the vaccine's potential cancer prevention benefits, uptake remains low. We utilized a randomized design to evaluate a multicomponent intervention to improve HPV vaccine uptake among low-income, ethnic minority adolescents seeking services through a county health department telephone hotline.MethodsHotline callers who were caregivers of never-vaccinated adolescents (11-17 years) were randomized by call-week to intervention or control conditions. The intervention included brief telephone and print education, delivered in multiple languages, and personalized referral to a low-cost/free vaccine provider. Participants completed baseline (n = 238), 3-month (n = 215), and 9-month (n = 204) telephone follow-up surveys.ResultsHPV vaccine initiation rates increased substantially by 9-month follow-up overall, although no differences were observed between intervention and control groups (45% vs. 42%, respectively, P > 0.05). We also observed significant improvements in perceived HPV risk, barriers to vaccination, and perceived knowledge in both study conditions (P < 0.05).ConclusionsA low-intensity county hotline intervention did not produce a greater increase in HPV vaccination rates than routine practice. However, 44% of unvaccinated adolescents in both conditions received at least one dose of the vaccine, which can be viewed as a successful public health outcome. Future studies should evaluate more intensive interventions that address accessing and utilizing services in complex safety net settings.ImpactStudy results suggest the need for investigators to be aware of the potential priming effects of study participation, which may obscure the effect of low-intensity interventions.