Advertisement

Journal of Community Health

, Volume 44, Issue 3, pp 544–551 | Cite as

Ancillary Benefit of Increased HPV Immunization Rates Following a CBPR Approach to Address Immunization Disparities in Younger Siblings

  • Tyler LennonEmail author
  • Constance Gundacker
  • Melodee Nugent
  • Pippa Simpson
  • Norma K. Magallanes
  • Christal West
  • Earnestine Willis
Original Paper

Abstract

Increasing HPV vaccination rates may decrease the disproportionately high HPV-associated disease incidence and mortality in African Americans (AA) and lower socioeconomic individuals. Data from a community-based participatory research (CBPR) study addressing immunization disparities among 19–35 month old children was analyzed to identify ancillary benefits in HPV immunization rates for adolescent siblings. Sub-study analysis inclusion criteria: AA (N = 118), 13–17 years old, younger sibling enrolled in parent study, and enrolled ≥ 9 months. Parent/caregiver interventions included: a web-based immunization toolkit with information on age-appropriate vaccines; a multimedia community outreach campaign; and reminder mailings. HPV up-to-date (UTD) status was defined as Wisconsin Immunization Registry (WIR) documentation of at least three HPV vaccines. McNemar’s test compared pre/post intervention HPV status. Two dependent proportions testing compared the proportion of adolescents that became UTD in the study cohort, City of Milwaukee, and State of Wisconsin. Parents/caregivers perceived that 92% of adolescents were HPV-UTD, while only 24% had a WIR-verified HPV-UTD status. Baseline UTD status of the younger siblings 19–35 month old 4:3:1:3:3:1:4 antigen series was 63%, which increased to 86% at study completion. Adolescent’s HPV-UTD immunization status increased from 30 (25%) at enrollment to 54 (46%) at study completion [p = 0.004]. A statistically significant larger proportion of adolescents became HPV-UTD in the study cohort (20%) compared to the City of Milwaukee [14%, p = 0.042] and the State of Wisconsin [14%, p = 0.046]. A culturally-tailored CBPR approach targeting parents/caregivers of younger AA children can have significant ancillary benefit to increase HPV immunization rates in adolescent siblings.

Keywords

Human papilloma virus (HPV) Health disparities Immunizations Community-based participatory research (CBPR) Adolescents 

Notes

Acknowledgements

We wish to acknowledge the CHIMC team for their contributions to the work described in this manuscript. Primary partners in this research study were Medical College of Wisconsin; Children’s Hospital of Wisconsin Immunization Committee; City of Milwaukee Health Department; State of Wisconsin Department of Health Services - Immunization Program; United Neighborhood Centers of Milwaukee – COA Youth & Family Center, Next Door, Neighborhood House of Milwaukee, Silver Spring Neighborhood Center & Norcott Neighborhood House; Milwaukee County WIC Program; & Diederich College of Communication: Marquette University. Research reported in this publication was sponsored by the National Institute On Minority Health And Health Disparities of the National Institutes of Health under Award Number R24MD001812. Co-Author Dr. Gundacker is currently completing a Pediatric Academic Fellowship which is supported by the Health Resources and Services Administration [HRSA] of the U.S. Department of Health and Human Services [HHS] under grant number T32HP10030. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, HRSA, HHS, or the U.S. Government.

Compliance with Ethical Standards

Conflict of interest

Authors of this manuscript verify that they have no conflicts of interest.

References

  1. 1.
    Satterwhite, C. L., Torrone, E., Meites, E., et al. (2013). Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2008. Sexually Transmitted Diseases, 40(3), 187–193.CrossRefGoogle Scholar
  2. 2.
    McQuillan, G., Kruszon-Moran, D., Markowitz, L. E., et al. (2017). Prevalence of HPV in adults aged 18–69: United States, 2011–2014. NCHS data brief, no 280. Hyattsville: National Center for Health Statistics.Google Scholar
  3. 3.
    Viens, L. J., Henley, S. J., Watson, M., et al. (2016). Human papillomavirus-associated cancers—United States, 2008–2012. Morbidity and Mortality Weekly Report, 65(26), 661–666.CrossRefGoogle Scholar
  4. 4.
    Petrosky, E., Bocchini, J., Hariri, S., et al. (2015). Use of 9-valent human papillomavirus (HPV) vaccine: Updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR Morbidity and Mortality Weekly Report, 64(11), 300–304.Google Scholar
  5. 5.
    Markowitz, L. E., Dunne, E. F., Saraiya, M., et al. (2014). Human papillomavirus vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report, 63(RR05), 1–30.Google Scholar
  6. 6.
    Markowitz, L. E., Dunne, E. F., Saraiya, M., et al. (2007). Quadrivalent human papillomavirus vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep., 56(RR-2), 1–24.Google Scholar
  7. 7.
    Centers for Disease Control and Prevention. (2011). Recommendations on the use of quadrivalent human papillomavirus vaccine in males—Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report, 60(50), 1705–1708.Google Scholar
  8. 8.
    Reagan-Steiner, S., Yankey, D., Jeyarajah, J., et al. (2016). National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2015. Morbidity and Mortality Weekly Report, 65, 850–858.CrossRefGoogle Scholar
  9. 9.
    Wisconsin Immunization Program. (2017). Vaccination coverage among Wisconsin adolescents aged 13 through 18 years, by vaccine, county of residence and year. Accessed July 26, 2017, from https://www.dhs.wisconsin.gov/publications/p02004.pdf.
  10. 10.
    Brisson, M., Drolet, M., & Malagón, T. (2013). Inequalities in human papillomavirus (HPV)–associated cancers: Implications for the success of HPV vaccination. Journal of the National Cancer Institute, 105(3), 158–161.CrossRefGoogle Scholar
  11. 11.
    Jeudin, P., Liveriht, E., del Carmen, M. G., & Rebecca, B. (2013). Race, ethnicity and income as factors for HPV vaccine acceptance and use. Human Vaccines & Immunotherapeutics, 9(7), 1413–1420.CrossRefGoogle Scholar
  12. 12.
    Wisconsin Department of Health Services. (2014). Wisconsin cancer data bulletin. Accessed July 26, 2017, from https://www.dhs.wisconsin.gov/publications/p0/p00379.pdf.
  13. 13.
    Gelman, A., Miller, E., Schwarz, E. B., et al. (2013). Racial disparities in human papillomavirus vaccination: Does access matter? Journal of Adolescent Health, 53(6), 756–762.CrossRefGoogle Scholar
  14. 14.
    Fu, L. Y., Bonhomme, L. A., Cooper, S. C., et al. (2014). Educational interventions to increase HPV vaccination acceptance: A systematic review. Vaccine, 32(17), 1901–1920.CrossRefGoogle Scholar
  15. 15.
    Griffin, S., Glover, S. H., Williams, A. W., & Brandt, H. M. (2009). Participatory evaluation of community-based HPV and cervical cancer prevention and control efforts. Journal of the South Carolina Medical Association, 105(7), 309–317.Google Scholar
  16. 16.
    Findley, S. E., Irigoyen, M., Sanchez, M., et al. (2006). Community-based strategies to reduce childhood immunization disparities. Health Promotion Practice, 7(3), 191S–200S.CrossRefGoogle Scholar
  17. 17.
    Minkler, M., Blackwell, A. G., Thompson, M., & Tamir, H. (2003). Community-based participatory research: Implications for public health funding. American Journal of Public Health, 93(8), 1210–1213.CrossRefGoogle Scholar
  18. 18.
    Viswanath, K., Breen, N., Meissner, H., et al. (2006). Cancer knowledge and disparities in the information age. Journal of Health Communication., 11(S1), 1–17.CrossRefGoogle Scholar
  19. 19.
    U.S. Census Bureau. (2016). Population estimates. Accessed March 23, 2017, from https://www.census.gov/quickfacts/fact/table/milwaukeecitywisconsin/RHI125216.
  20. 20.
    Willis, E., Sabnis, S., Hamilton, C., et al. (2016). Improving immunization rates through community-based participatory research: Community health improvement for Milwaukee’s children program. Progress in Community Health Partnerships, 10(1), 19–30.CrossRefGoogle Scholar
  21. 21.
    Willis, E., Ngui, E., Johnson, C., et al. (2008). Navigating the complexity of relationships in community-based participatory research (CBPR). In B. Stanton et al. (Ed.), The uncharted path from clinic-based to community-based research (1st ed., pp. 161–181). New York: Nova Science Publishers.Google Scholar
  22. 22.
    Gray-Murray, J., Leary, M., Watts, M., et al. (2012). Field methods for discovering practical wisdom: The microdynamics of going beyond technical rationality in real-world practice. International Quarterly of Community Health Education, 33(1), 39–53.CrossRefGoogle Scholar
  23. 23.
    Nguie, E., Hamilton, C., Nugent, M., et al. (2015). Evaluation of a social marketing campaign to increase awareness of immunizations for urban low-income children. WMJ, 114(1), 10–15.Google Scholar
  24. 24.
    O’Fallon, L. R., & Dearry, A. (2002). Community-based participatory research as a tool to advance environmental health sciences. Environmental Health Perspective, 110(S2), 155–159.CrossRefGoogle Scholar
  25. 25.
    Straus, S., Tetroe, J., & Graham, I. D. (2009). Knowledge translation in health care: Moving forward from evidence to practice (1st ed.). Hoboken: BMJ.CrossRefGoogle Scholar
  26. 26.
    Graham, I. D., Logan, J., Harrison, M. D., et al. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26(1), 13–24.CrossRefGoogle Scholar
  27. 27.
    Community Health Improvement for Milwaukee’s Children. (2014). CHIMC moving towards a healthy community. Accessed July 12, 2017, from http://www.chimcmke.org/.
  28. 28.
    Immunization Action Coalition. (2018). Immunization coalitions network. Accessed March 5, 2018, from https://www.immunizationcoalitions.org/.
  29. 29.
    Milwaukee Succeeds. (2016) Milwaukee succeeds, cradle to career. Accessed March 5, 2018, from http://milwaukeesucceeds.org/.
  30. 30.
    Niccolai, L. M., & Hansen, C. E. (2015). Practice- and community-based interventions to increase human papillomavirus vaccine coverage: A systematic review. JAMA Pediatrics, 169(7), 686–692.CrossRefGoogle Scholar
  31. 31.
    Rutten, L. J. F., St. Sauver, J. L., Beebe, T. J., et al. (2017). Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children. Vaccine, 35(45), 6122–6128.CrossRefGoogle Scholar
  32. 32.
    Vadaparampil, S. T., Malo, T. L., Sutton, S. K., et al. (2016). Missing the target for routine human papillomavirus vaccination: Consistent and strong physician recommendations are lacking for 11- to 12-year-old males. Cancer Epidemiology and Prevention Biomarkers, 25(10), 1435–1446.CrossRefGoogle Scholar
  33. 33.
    Brown, B., Gabra, M. I., & Pellman, H. (2017). Reasons for acceptance or refusal of Human Papillomavirus Vaccine in a California pediatric practice. Papillomavirus Research, 3, 42–45.CrossRefGoogle Scholar
  34. 34.
    Meites, E., Kempe, A., & Markowitz, L. E. (2016). Use of a 2-dose schedule for human papillomavirus vaccination—Updated recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report, 65, 1405–1408.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PediatricsJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of PediatricsMedical College of WisconsinMilwaukeeUSA
  3. 3.Global Health News Wire, Use Our IntelViennaUSA
  4. 4.Community Forward Team MemberMilwaukeeUSA
  5. 5.Center for the Advancement of Underserved Children, Department of PediatricsMedical College of WisconsinMilwaukeeUSA

Personalised recommendations