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Shato T, Humble S, Anandarajah A, Barnette A, Brandt HM, Garbutt J, Klesges L, Thompson VS, Silver MI. Influences of sociodemographic characteristics and parental HPV vaccination hesitancy on HPV vaccination coverage in five US states. Vaccine 2023:S0264-410X(23)00517-0. [PMID: 37198022 DOI: 10.1016/j.vaccine.2023.04.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 04/17/2023] [Accepted: 04/30/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND In the United States (US), half of new human papillomavirus (HPV) infections occur among young people aged 15-24 years. Despite the effectiveness of HPV vaccination in protecting against HPV-associated cancers, its coverage among adolescents remains suboptimal. This study examined the association of sociodemographic characteristics and HPV vaccination hesitancy with HPV vaccination coverage in five US states with disproportionately low adolescent coverage rates compared to the national average. METHODS Responses to an online Qualtrics survey from 926 parents of children aged 9-17 years in Arkansas, Mississippi, Missouri, Tennessee, and Southern Illinois in July 2021 were analyzed using multivariate logistic regression to estimate the association of sociodemographic characteristics and HPV vaccination hesitancy with HPV vaccination coverage. RESULTS Of the parents, 78 % were female, 76 % were non-Hispanic White, 61.9 % lived in rural areas, 22 % were classified as HPV vaccine hesitant, and 42 % had vaccinated their oldest child between the ages of 9-17 years against HPV. Children of vaccine hesitant parents were less likely to have received any doses of the HPV vaccine than children of non-vaccine hesitant parents (AOR: 0.17, 95 % CI:0.11-0.27). Male children were less likely to have initiated the HPV vaccine series than female children (AOR: 0.70, 95 % CI:0.50-0.97). Older children (13-17 vs 9-12 years), receiving the meningococcal conjugate or most recent seasonal influenza vaccine were all associated with higher likelihoods of receiving any doses of the HPV vaccine (AOR: 6.01, 95 % CI:3.98-9.08; AOR: 2.24, 95 % CI:1.27-3.95; AOR: 2.41, 95 % CI:1.73-3.36, respectively). CONCLUSIONS Adolescent HPV vaccination coverage remains low in our targeted states. Children's age, sex, and parental vaccine hesitancy were significantly associated with likelihood of HPV vaccination. These findings offer the opportunity for targeted interventions among parents in regions with low vaccine uptake and underscore the importance of developing and implementing strategies to address parental HPV vaccination hesitancy to improve uptake in the US.
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Affiliation(s)
- T Shato
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, United States; Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, United States.
| | - S Humble
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, United States
| | - A Anandarajah
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, United States; Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO 63110, United States
| | - A Barnette
- Saint Francis Medical Center, 211 St. Francis Drive, Cape Girardeau, MO 63703, United States
| | - H M Brandt
- HPV Cancer Prevention Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-3678, United States
| | - J Garbutt
- Department of Medicine and Pediatrics, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, United States
| | - L Klesges
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, United States
| | - V S Thompson
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO 63110, United States; Department of Medicine and Pediatrics, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, United States
| | - M I Silver
- Brown School, Washington University in St. Louis, St. Louis, MO 63130, United States
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Sheikh S, Wanty N, Mccalla S, Santana A, Saxena Beem S, Walker J, Holt D, Howell A, Holtz K, Williams S, Anandarajah A. AB1360-HPR A MODEL TO IMPROVE MINORITY PATIENT RECRUITMENT IN LUPUS CLINICAL TRIALS - THE AMERICAN COLLEGE OF RHEUMATOLOGY MIMICT PROJECT EXPERIENCE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In the US, African Americans and Latinos are underrepresented in lupus clinical trials (LCTs),1despite experiencing the greatest lupus disease burden.2,3Low participation in LCTs results in inadequate data on treatment effectiveness for minority patients, and fewer opportunities for better care and treatment options.1Only one percent of minority patients are referred to clinical trials each year.4Provider barriers to making referrals include limited time and unfamiliarity with lupus and LCT opportunities.4Using US fedral grant funds, the American College of Rheumatology (ACR) developed MIMICT, a two-part model with associated materials to address provider-side LCT referral barriers. The materials include a toolkit for clinical trial sites and an educational toolkit for providers.Objectives:Our objectives are to:•Describe the US LCTs disparities.•Discuss the research methodology to evaluate the two-part MIMICT model.•Assess the feasibility of the model to increase minority involvement in clinical trials.Methods:We designed two studies to evaluate the MIMICT model.The first study used an online, pretest/posttest, two-group evaluation approach to assess the extent to which the educational toolkit increased providers‘ knowledge, attitudes, self-efficacy, and behavioral intentions to refer minority patients to clinical trial. We conducted the study in 2018 with primary care providers (PCPs) and again in 2019/2020 with speciality providers. The second study used a longitudinal, mised methods, case-study approach to explore the real-world use of the toolkits with clinical trial site teams at two university medical centers.Results:In the first study,among MIMCT-exposed PCPs, mean scores indicated statistical significance at p≤0.001 with more knowledge about referring [55.84 (sd=23.51) vs 41.76 (sd=19.98)], more self-efficacy to refer [55.00 (sd=37.22) vs. 37.99 (sd=34.42)], and more intentions to refer [61.36 (43.85) vs. 33.41 (41.16)] African American patients to LCTs among the treatment group than the control group, respectively. This presentation will discuss additional data comparing the study in 2018 and the study in 2019/2020 and look comparatively at outcomes across provider type.In the second study, we found that the driver for successful engagemetn of providers and their subsequent use of the educational toolkit was the development of a trusting relationship between the clinical trial site teams and providers in the community. The development of trust took repeated and varied modes of contact, which we will discuss in-depth.Conclusion:The MIMICT educational toolkit increase knowledge, self-efficacy, and intentions to refer lupus patients to LCTs. However, building trust between LCT sites and local providers takes time and repeated outreach, but the potential benefits to medicine and minority health are substantial.References:[1]The Society for Women’s Health Research. (2011). Dialogues on diversifying clinical trials: successful strategies for engaging women and minorities in clinical trials. Washington, DC: Food and Drug Administration, Office of Women’s Health.[2]Falasinnu, T., Chaichian, Y., Bass, M. B., & Simard, J. F. (2018). The representation of gender and race/ethnic groups in randomized clinical trials of individuals with sytemic lupus erythematosus.Current Rheumatology Reports, 20(4).[3]Pons-Estel, G. J., Alarcon, G. S., Scofield, L., Reinlib, L., & Cooper, G. S. (2010). Understanding the epidemiological progression of systemic lupus erythematosus.Seminars in Arthritis and Rheumatism, 39(4).[4]Korieth, K. (2016). Engaging healthcare providers as research facilitators.The CenterWatch Monthly, 23,1-5.Disclosure of Interests:None declared
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Bekaert B, Massoli C, Anandarajah A, Van de Voorde W, Decorte R. Multiplex DNA amplification and barcoding in a single reaction for 454 Roche sequencing: A comprehensive study on the control region of the mitochondrial genome. Forensic Science International: Genetics Supplement Series 2013. [DOI: 10.1016/j.fsigss.2013.10.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Methods have recently been developed for calculating the double-layer repulsive and the van der Waals attractive forces between two nonparallel clay particles immersed in a fluid system. In the present study, these theories are used in an approximate model of one-dimensional compression to examine the role of particle orientation on the behavior of a montmorillonite. It is shown that consideration of nonparallel fabric could potentially explain the discrepancy observed in the past between experimental and theoretical behaviors. Copyright 1997 Academic Press. Copyright 1997Academic Press
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Affiliation(s)
- A Anandarajah
- Department of Civil Engineering, The Johns Hopkins University, Baltimore, Maryland, 21218-2686
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