D L Albright1, H Y Lee2, J T McDaniel3, D Kroner4, J Davis5, K Godfrey6, Q Li7. 1. Hill Crest Foundation Endowed Chair of Mental Health, School of Social Work, The University of Alabama, Box 870314, Tuscaloosa, AL, 35487-0314, USA. Electronic address: dlalbright@ua.edu. 2. Endowed Academic Chair in Social Work (Health), School of Social Work, The University of Alabama, Tuscaloosa, AL, 35487, USA. Electronic address: hlee94@ua.edu. 3. Department of Public Health and Recreation Professions, Southern Illinois University, 475 Clocktower Drive, Carbondale, IL, 62901, USA. Electronic address: jtmcd@siu.edu. 4. Department of Criminology and Criminal Justice, Southern Illinois University, Carbondale, IL, 62901, USA. Electronic address: dkroner@siu.edu. 5. Missouri School of Dentistry and Oral Health, A.T. Still University, 1500 Park Ave. Street, Louis, MO, 63104, USA. Electronic address: joandavis@atsu.edu. 6. School of Social Work, The University of Alabama, Tuscaloosa, AL, 35487, USA. Electronic address: kkgodfrey@crimson.ua.edu. 7. School of Social Work, The University of Alabama, Tuscaloosa, AL, 35487, USA. Electronic address: qli31@crimson.ua.edu.
Abstract
OBJECTIVES: This study estimated county-level human papillomavirus (HPV) vaccination initiation rates in Alabama and determined whether disparities existed between counties in the Mississippi Delta region (MDR) and Appalachian region (AR). STUDY DESIGN: This study used an observational cross-sectional design. METHODS: We used small area estimation methodology to estimate rates of medical provider-verified HPV vaccine initiation among school-age children in Alabama. Data for the study were retrieved from the 2015 National Immunization Survey (n = 22,205) and the US Census Bureau. RESULTS: The predictive model results showed that older age (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.16, 1.29) was positively associated with vaccination initiation and black (OR = 0.79, 95% CI = 0.71, 0.87), white (OR = 0.56, 95% CI = 0.52, 0.60), and 'other' race/ethnicities (OR = 0.78, 95% CI = 0.70, 0.86), compared with Hispanics, and was negatively associated with vaccination initiation. The median (x̃)-modeled HPV vaccination initiation rate for all Alabama counties was 50.83% (interquartile range = 5.00%). Modeled HPV vaccination initiation rates were lowest in AR counties (x̃ = 49.81%), followed by counties not in the AR or MDR (x̃ = 53.26%) and MDR counties (x̃ = 54.90%). CONCLUSIONS: Culturally sensitive school-based HPV vaccine delivery programs are needed for children living in AR counties in Alabama.
OBJECTIVES: This study estimated county-level human papillomavirus (HPV) vaccination initiation rates in Alabama and determined whether disparities existed between counties in the Mississippi Delta region (MDR) and Appalachian region (AR). STUDY DESIGN: This study used an observational cross-sectional design. METHODS: We used small area estimation methodology to estimate rates of medical provider-verified HPV vaccine initiation among school-age children in Alabama. Data for the study were retrieved from the 2015 National Immunization Survey (n = 22,205) and the US Census Bureau. RESULTS: The predictive model results showed that older age (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.16, 1.29) was positively associated with vaccination initiation and black (OR = 0.79, 95% CI = 0.71, 0.87), white (OR = 0.56, 95% CI = 0.52, 0.60), and 'other' race/ethnicities (OR = 0.78, 95% CI = 0.70, 0.86), compared with Hispanics, and was negatively associated with vaccination initiation. The median (x̃)-modeled HPV vaccination initiation rate for all Alabama counties was 50.83% (interquartile range = 5.00%). Modeled HPV vaccination initiation rates were lowest in AR counties (x̃ = 49.81%), followed by counties not in the AR or MDR (x̃ = 53.26%) and MDR counties (x̃ = 54.90%). CONCLUSIONS: Culturally sensitive school-based HPV vaccine delivery programs are needed for children living in AR counties in Alabama.
Authors: Stephanie A S Staras; Amanda L Kastrinos; Easton N Wollney; Shivani Desai; La Toya J O'Neal; Versie Johnson-Mallard; Carma L Bylund Journal: Implement Sci Commun Date: 2022-09-06