HPV Latino Survey Workgroup: Update

1. HPV Latino Survey Workgroup:Update CPCRN Spring Meeting South Carolina March 22, 2012 Roshan Bastani & Jennifer Allen

2. Background • Collaboration among 3 CPCRN sites: • University of California, Los Angeles • University of Texas, Houston • University of Washington, Seattle • Initiated in November in 2008 • Used the Health Behavior Framework to develop a set of 24 core HPV vaccine survey items

3. Summary of Progress • Surveyed Latino parents of girls ages 9–18 in Los Angeles (N=274), Seattle area-Yakima Valley (N=90), Houston (N=83), • Data collection and descriptive analysis are complete • Drafted a collaborative manuscript based on data collected • Identifying next steps based on study results

4. Funded HPV Projects • University of Washington, Seattle (with UCLA CPCRN) • NCI R21, HPV Vaccination in the Cambodian Community, 2011-2013 • University of Texas, Houston • CPRIT-funded HPV Research Project, 2010-2013 • CPRIT-funded , 2-1-1 Cancer Prevention Project, 2010-2012 • Cervical Cancer Free America: GSK funded project, 2011-2013 • University of California, Los Angeles (with Seattle CPCRN) • NCI R01, Increasing HPV Vaccine Uptake in Low Income Ethnic Minority Population, 2012 - 2017

5. HPV Latino Survey Results • Panel presentation under review for the 2012 CDC National Cancer Conference • Understanding HPV vaccination among Latino adolescent girls in three U.S. regions (Glenn, Coronado, Fernandez, Taylor, Bastani) • HPV vaccine use among low income, Latino adolescent girls in Los Angeles County (Glenn, Tsui, Taylor, Bastani) • HPV vaccine use among Latino adolescent girls in the rural Yakima Valley (Coronado, Taylor) • HPV vaccine use among urban and rural adolescent Latinas in Texas (Savas, Carmack, Fernandez) • Paper submission is pending

6. Other updates • Policy sub-group: paper under review at Health Affairs • Cognitive testing sub-group: work complete and paper published

7. Summary of Key Findings • Moderate rates of vaccine awareness, but low rates of uptake and intent to vaccinate across samples • Attitudinal barriers were not frequently endorsed • Areas to target in interventions: • Increase awareness, enhance beliefs about vaccine’s efficacy and safety • Provide information on where to get vaccine (e.g., VFC providers) • Likely important to engage health care providers in the process

8. Proposed Ideas for Cross-site Projects • Implement the survey in additional populations • i.e. Asian subgroups, African Americans, rural populations • Adapt evidence-based interventions for other vaccines or preventive health services to promote uptake of the HPV vaccine among Latinos or other groups • System/Provider-based Interventions • Include HPV vaccine promotion in work with FQHCs • Use of 2-1-1 for HPV vaccine education (similar to Texas) • Deliver HPV vaccine and testing education to women seeking cancer screening, particularly women with vaccine-eligible daughters

11. Recently Funded HPV Grants • University of Washington, Seattle • Receipt of a R21, 2011-2013 • University of Texas, Houston • CPRIT-funded HPV Research Project, 2010-2013 • CPRIT-funded , 2-1-1 Cancer Prevention Project, 2010-2012 • Cervical Cancer Free America: GSK funded project, 2011-2013 • University of California, Los Angeles • Submission of R01 that has received a fundable score, 2011-2016

12. UW: HPV Vaccination in the • Cambodian Community • NCI R21 proposal funded July 2011 (w/UCLA site) • Collaboration with an established Cambodian Community Coalition • Primary goal: • To conduct mixed-methods research that could be used to inform the development, implementation, and evaluation of culturally appropriate HPV vaccination interventions targeting Cambodian women with daughters in the 9–17 age group • Components: • 25 qualitative interviews • Community-based survey of 200 mothers • Retest survey with 50 quantitative survey participants

13. Houston: HPV Vaccination in the Hispanic Community • Cancer Prevention Research Institute of Texas (CPRIT) funded Research Project • Primary Goal • To evaluate, in a group randomized control trial, the effectiveness and cost effectiveness of two lay health worker-delivered programs to increase vaccine uptake among Hispanic girls ages 11-17 • Recruiting 1,809 parents in 27 clinics in Houston • Intervention components (targeting parents): • Print fotonovelas • A self directed, tailored interactive (TIV) program that runs on iPads; Now known as “For Our Daughters”

14. Increasing Breast, Cervical, and Colorectal Cancer Screening & HPV Vaccinations among Underserved Texans: A Collaboration with the 2-1-1 Program • CPRIT-funded Research Project to develop, deliver and determine the effectiveness and cost effectiveness of a Cancer Control Navigator program implemented within the Gulf Coast & Weslaco 2-1-1 Help Line Programs • Increase cervical cancer screening with the Pap test and the initiation and completion of the HPV vaccine series, thereby reducing or eliminating cervical cancer in Texas • Form a statewide coalition of key partners (investigators, healthcare systems, cancer centers, providers, community groups, agencies, and policymakers) • Implement educational interventions and activities in identified areas Cervical Cancer Free America: GlaxoSmithKline

15. UCLA: Increasing HPV Vaccine Uptake in a • Low Income Ethnic Minority Population • NCI R01 2012-2017, with Seattle site, based on CPCRN survey findings • Collaboration with the Los Angeles County Department of Public Health (LADPH), Office of Women's Health • Primary goal: Randomized trial to test a theoretically driven intervention to increase HPV vaccine receipt among underserved, high risk girls in LA • Will assess implementation outcomes (i.e., reach, etc) • Intervention delivered by LADPH staff through their telephone hotline in English, Spanish, Cantonese, Mandarin, Korean, Armenian. Targets caregivers of 9-18 yr old girls • Brief telephone intervention and companion print materials • Referral to a convenient clinic offering low cost/free vaccine • Intervention designed to be feasible for delivery by a county health department, and integrated into their infrastructure. Will facilitate sustainability and dissemination. Can be adapted for other outcomes.