Cancer Control Research5R03CA144734-02
HPV VACCINE PRACTICES AMONG PHYSICIANS SERVING HIGH RISK, MINORITY POPULATIONS
DESCRIPTION (provided by applicant): In the United States, cervical cancer rates have declined in recent years, however ethnic and minority groups remain disproportionately affected. In Brooklyn, New York, an area with large immigrant populations and ethnically diverse communities, cervical cancer rates are significantly higher than national rates with some communities doubling the national incidence rate. Almost all cervical cancers are caused by the human papilloma virus (HPV), and it is estimated that 6.2 million persons are newly infected every year. Although most infections with HPV are asymptomatic and self-limited, persistent infection with genital HPV infection can cause cervical cancer. Approximately 100 HPV serotypes have been identified; however there are two high-risk serotypes, HPV-16 and HPV-18 that cause approximately 70% of all cervical cancers. A quadrivalent HPV vaccine was licensed for use in the United States for females aged 9-26 years for prevention of HPV infection (Types 6, 11, 16, and 18) and related cervical cancer in 2006. To date, most studies have focused on patient and parental barriers to vaccine acceptance. This study is unique in that it focuses on another key stakeholder in the HPV vaccine initiative- the physician and specifically those serving high risk populations. Physicians are often the primary and first source of information for parents and patients regarding vaccine awareness and knowledge. As such, the aims of this study are 1) To assess the self-reported rates of physician utilization of the HPV vaccine among their minority, high risk patient population, 2) To assess physicians' knowledge of, attitudes towards, beliefs regarding, and barriers to recommending the HPV vaccine, 3) To understand physician behaviors that affect the utilization of the HPV vaccine among high risk minority populations and 4) To propose a set of possible strategies to increase rates of HPV vaccination among high risk minority populations. The long term goal of the study is to improve utilization of the HPV vaccine, reducing HPV infection and cervical cancer among high risk, minority populations. A cross-sectional study will be utilized, and will include a random sample of pediatricians, adolescent medicine physicians and family practitioners that serve Brooklyn areas with high rates of cervical cancer. Five constructs will be addressed in a mailed, self administered survey: Knowledge about HPV, HPV vaccine and cervical cancer, Attitudes and beliefs towards the HPV vaccine, Physician barriers toward the HPV vaccine, Perceived patient barriers for the HPV vaccine and Evaluation of the perceived best modalities that could effect change in current HPV vaccine and cervical cancer prevention practices among their high risk patient population. PUBLIC HEALTH RELEVANCE: The majority of those affected by cervical cancer in the United States are from minority populations or foreign-born. Infection with the Human Papilloma Virus (HPV) is the most important risk factor for cervical cancer. In 2006, a vaccine to protect women against HPV was licensed and recommended for use in women as young as 9 years old. This study seeks to identify the issues that affect providers' utilization of the HPV vaccine with their high risk patients in order to develop strategies to assure that the populations most at risk for cervical cancer are given an opportunity to receive this important vaccine.