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Principal Investigator: ANA CRISTINA TERRA DE SOUZA LINDSAY
Organization: UNIVERSITY OF MASSACHUSETTS BOSTON
Fiscal Year: 2024
Award: $190,625
Funding agency: National Institute on Minority Health and Health Disparities
PROJECT SUMMARY
Human papillomavirus (HPV) is the most common sexually transmitted virus in the United States (U.S.). HPV infection is
linked to cancers of the cervix, vulva, vagina, penis, anus, and oropharynx, thus representing a significant public health
concern. The HPV vaccine is the most efficient and cost-effective mechanism for combating HPV infection and its cancer-
related consequences. Nonetheless, HPV vaccination rates for age-eligible adolescents remain suboptimal in the U.S.
Scientific evidence underscores the critical influence of sociocultural and contextual factors on parents’ acceptability and
uptake of the HPV vaccination. Sociocultural values, family expectations, health literacy, beliefs, attitudes, and knowledge
influence parents’ behaviors and decisions, healthcare-seeking and utilization, and health outcomes. Black women are
disproportionally affected by HPV-associated morbidity and mortality, with the second-highest cervical cancer incidence
rate, the second highest after non-Hispanic Whites and the highest cancer mortality rate. However, there is a lack of data
for African ethnic minority subgroups such as Cape Verdeans (CV) in the U.S, an ethnic minority group of mixed West
African and Portuguese roots. The U.S. is home to the largest CV population outside the country of Cape Verde, with an
estimated 265,000 CV immigrants and their descendants living in the U.S. CVs primarily reside (~90%) in Massachusetts
and Rhode Island. Understanding HPV and HPV vaccination knowledge, attitudes, and behaviors (KAB) of specific ethnic
minoritized and immigrant subgroups, such as CV, will make it possible to meet particular subgroup needs and improve
knowledge and practices, thereby improving health status and outcomes by decreasing cancer risk. Though recent research
has shown an increase in HPV uptake, but not necessarily HPV vaccine completion, among minority populations including
African Americans and Blacks, no data exist to show that this is the case for CV adolescents living in the U.S. Also, there
remains a paucity of data regarding HPV knowledge, attitudes, and behaviors of CV parents living in the U.S. Therefore,
the proposed study will focus on Cape Verdeans, a population group currently underrepresented in cancer health disparity
research, and seeks to: 1) explore the KAB regarding HPV and HPV vaccination (intention, hesitancy, barriers, initiation,
and completion) among CV mothers and fathers (Phase 1: Focus Groups); and 2) explore CV parents’ HPV KAB, health
communication, sociocultural factors, their intention to have their sons and daughters undergo HPV vaccination, HPV
vaccine hesitancy, barriers to HPV vaccination, and parent-reported receipt of HPV vaccine or refusal of the vaccine (Phase
2: Survey Administration). The proposed community-engaged research is innovative in that it will: 1) engage CVs, an
understudied ethnic minority and immigrant subpopulation currently underrepresented in HPV research, 2) include fathers
who are under-represented in HPV research, and 3) establish a partnership with Catholic and Protestant churches to further
assist with the important goal of addressing HPV vaccine myths and disseminating accurate HPV vaccine information to
CV communities. Moreover, it will provide a solid basis for the design of future linguistically and culturally tailored
education interventions to promote the HPV vaccine among CVs in the U.S. Moreover, this research will build further
research capacity to engage underserved, minority CV parents in future HPV and cancer prevention interventions.
Terms: <18 year old><18 years of age><Acculturation><Address><Adolescent><Adolescent Youth><African><African American group><African American individual><African American people><African American population><African Americans><African ancestry><African descent><Age><Anal Cancer><Anal Cancers><Anus Cancer><Application Context><Attitude><Awareness><Belief><Black Populations><Black group><Black individual><Black people><Blacks><Cancer Prevention Intervention><Cancers><Cape Verde><Cervical Cancer><Cervix Cancer><Child Rearing><Church><Communities><Country><Cultural Assimilation><Data><Daughter><Death Rate><Disproportionate number of females><Disproportionate number of women><Disproportionately affects females><Disproportionately affects women><Disproportionately impacts females><Disproportionately impacts women><Disproportionately in females><Disproportionately in women><Education for Intervention><Educational Intervention><Eligibility><Eligibility Determination><Ethnic Origin><Ethnicity><Family><Fathers><Focus Groups><Funding Mechanisms><Future><Gender><Genotype><Goals><HPV><HPV Vaccination><HPV Vaccine><HPV induced cancer><HPV infection><HPV malignancy><HPV vaccination acceptability><HPV vaccination acceptance><HPV vaccination confidence><HPV vaccination hesitancy><HPV vaccination uptake><HPV vaccine acceptability><HPV vaccine acceptance><HPV vaccine confidence><HPV vaccine hesitancy><HPV vaccine hesitant><HPV vaccine uptake><HPV+ cancer><HPV-Related Malignancy><HPV-associated cancer><HPV-associated malignancy><HPV-related cancer><Health><Health Disparities Research><Health Knowledge Attitudes Practice><Health Status><Health disparities related research><Healthcare><Home><Human Papilloma Virus><Human Papilloma Virus Vaccination><Human Papilloma Virus Vaccine><Human Papilloma Virus-Related Malignancy><Human Papilloma Virus-Related Malignant Neoplasm><Human Papilloma Virus-associated cancer><Human Papilloma Virus-associated malignancy><Human Papilloma Virus-related cancer><Human Papillomavirus><Human Papillomavirus Vaccination><Human papilloma virus infection><Human papillomavirus Vaccine><Human papillomavirus cancer><Human papillomavirus induced cancer><Human papillomavirus infection><Human papillomavirus malignancy><Human papillomavirus-Related Malignancy><Human papillomavirus-Related Malignant Neoplasm><Immigrant><Incidence><Individual><Individuals from minority><Individuals of minority><Infectious Human Wart Virus><Instruction Intervention><Intention><Investments><Justice><Knowledge><Knowledge Attitudes Practice><Knowledge, Attitudes, and Behaviors><Legal Guardians><Length><Level of Health><Linguistic><Linguistics><Link><Literature><Logistic Regressions><Malignant Anal Neoplasm><Malignant Anal Tumor><Malignant Cervical Neoplasm><Malignant Cervical Tumor><Malignant Neoplasm of the Cervix><Malignant Neoplasms><Malignant Oropharyngeal Neoplasm><Malignant Oropharyngeal Tumor><Malignant Penile Neoplasm><Malignant Penile Tumor><Malignant Tumor><Malignant Tumor of the Anus><Malignant Tumor of the Cervix><Malignant Tumor of the Cervix Uteri><Malignant Tumor of the Penis><Malignant Uterine Cervix Neoplasm><Malignant Uterine Cervix Tumor><Malignant Vagina Neoplasm><Malignant Vagina Tumor><Malignant Vaginal Neoplasm><Malignant Vaginal Tumor><Malignant Vulva Tumor><Malignant Vulvar Neoplasm><Malignant Vulvar Tumor><Malignant neoplasm of anus><Malignant neoplasm of cervix uteri><Malignant neoplasm of penis><Malignant neoplasm of vulva><Massachusetts><Minority><Minority Groups><Minority People><Minority Population><Minority individual><Morbidity><Morbidity - disease rate><Mothers><Non-Hispanic><Nonhispanic><Not Hispanic or Latino><Oropharnyx Cancers><Oropharyngeal Cancer><Oropharyngeal Carcinoma><Oropharynx Cancer><Oropharynx Carcinoma><Outcome><Parenting><Parenting behavior><Parents><Penile Cancer><Penis Cancer><Phase><Population><Population Group><Portuguese><Prevalence><Preventative intervention><Protestant><Protocol Screening><Public Health><Race><Races><Racial Equity><Reporting><Research><Residencies><Rhode Island><Science><Solid><Son><Subgroup><Survey Instrument><Surveys><Testing><Training Intervention><United States><Uterine Cervix Cancer><Vaccines><Vagina Cancer><Vaginal Cancers><Vulva Cancer><Vulvar Cancer><accept HPV vaccination><accept HPV vaccine><accept human papilloma virus vaccination><accept human papilloma virus vaccine><age 18 years><ages><anal squamous cell carcinoma><black female><black women><cancer disparity><cancer health disparity><cancer risk><cancer-related health disparity><carcinogenicity><care seeking><childrearing><community engaged participatory research><community engaged research><community partnered research><community-engaged study><community-partnered study><contextual factors><cost effective><design><designing><disparity in cancer><eighteen year old><eighteen years of age><ethnic minority><ethnic minority group><ethnic minority individual><ethnic minority people><ethnic minority population><expectation><female bias><female preponderance><health care><health communication><health disparities science><health level><health literacy><hesitant to HPV vaccination><hesitant to human papilloma virus vaccination><hesitant to vaccination><homes><human papilloma virus vaccination acceptability><human papilloma virus vaccination acceptance><human papilloma virus vaccination confidence><human papilloma virus vaccination hesitancy><human papilloma virus vaccination uptake><human papilloma virus vaccine acceptability><human papilloma virus vaccine acceptance><human papilloma virus vaccine confidence><human papilloma virus vaccine hesitancy><human papilloma virus vaccine hesitant><human papilloma virus vaccine uptake><human papillomavirus associated malignancy><human papillomavirus-associated cancer><human papillomavirus-related cancer><improved><innovate><innovation><innovative><instructional intervention><intervention for prevention><juvenile><juvenile human><malignancy><malignant oropharynx neoplasm><malignant oropharynx tumor><member><mortality><mortality rate><mortality ratio><neoplasm/cancer><parent><parent influence><parental influence><precancer><precancerous><premalignant><prevent><preventing><prevention intervention><preventional intervention strategy><preventive intervention><psychosocial><racial><racial background><racial disparities in health><racial health disparity><racial origin><refuse vaccination><refuse vaccine><sexually transmitted virus><social cultural factor><social culture><social culture determinant><socio-cultural><sociocultural><sociocultural determinant><sociocultural factor><uptake><vaccination hesitancy><vaccination refusal><vaccine hesitancy><vaccine hesitant><vaccine refusal><vulval cancer><wart virus><women's preponderance>