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Promotora Outreach, Education and Navigation Support for HPV Vaccination to Hispanic Women with Unvaccinated Daughters

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Abstract

Cervical cancer disparities persist in the predominantly Hispanic population of South Texas, and Hispanic girls are less likely to initiate and complete the three-dose human papillomavirus (HPV) vaccine series. Culturally relevant interventions are needed to eliminate these disparities and improve HPV vaccine initiation and completion. We enrolled 372 Hispanic women from South Texas’ Cameron and Hidalgo counties with a daughter, aged 11–17, who had not received HPV vaccine. All participants received an HPV vaccine educational brochure in their preferred language (English or Spanish) and were invited to participate in the Entre Madre e Hija (EMH) program, a culturally relevant cervical cancer prevention program. EMH participants (n = 257) received group health education, referral and navigation support from a promotora (a trained, culturally competent community health worker). Those who declined participation in EMH received the brochure only (n = 115). Eighty-four percent of enrolled participants initiated the HPV vaccine, and no differences were observed between EMH program and brochure-only participants. Compared to brochure-only participants, EMH participants were more likely to complete the vaccine series [adjusted odds ratio (adj. OR) = 2.24, 95 % CI (1.25, 4.02)]. In addition, participants who were employed and insured had lower odds of completing the vaccine series [adj. OR = 0.45, 95 % CI (0.21–0.96); adj. OR = 0.36, 95 % CI (0.13–0.98), respectively]. All enrolled participants had high vaccine initiation rates (>80 %); however, EMH program participants were more likely to complete the vaccine series. HPV vaccine promotion efforts that include referral and navigation support in addition to education show promise.

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Acknowledgments

This paper is part of a project funded by the Cancer Prevention and Research Institute of Texas (PP110057). Additional support was received through the Cancer Therapy and Research Center (CTRC) P30 Cancer Center Support Grant from the National Cancer Institute (CA054174). The work was done at the Institute for Health Promotion Research at the UT Health Science Center at San Antonio (UTHSCSA). The content is solely the responsibility of the authors and does not necessarily represent the official views of CPRIT. In addition to these sponsors, we would like to recognize the efforts of our promotoras and our community partners, the Texas A&M University Colonias Program and Kappa Delta Chi at University of Texas-Pan American. We would also like to thank Gabriella Villanueva, Edna Villarreal, and Eva M. Reyes at UTHSCSA’s Regional Academic Health Center in Harlingen, for their assistance with data management and quality control.

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Authors and Affiliations

  1. University of Texas Health Science Center at San Antonio, Institute for Health Promotion Research, 7411 John Smith Drive, Suite 1000, San Antonio, TX, 78229, USA

    Deborah Parra-Medina, Daisy Y. Morales-Campos, Cynthia Mojica & Amelie G. Ramirez

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  1. Deborah Parra-Medina
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  2. Daisy Y. Morales-Campos
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  3. Cynthia Mojica
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  4. Amelie G. Ramirez
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Correspondence to Deborah Parra-Medina.

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Parra-Medina, D., Morales-Campos, D.Y., Mojica, C. et al. Promotora Outreach, Education and Navigation Support for HPV Vaccination to Hispanic Women with Unvaccinated Daughters. J Canc Educ 30, 353–359 (2015). https://doi.org/10.1007/s13187-014-0680-4

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