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


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.


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



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.


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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

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