title: Inequalities in vaccination coverage for young females whose parents are informal caregivers.
abstract: The effects of caregiver strain and stress on preventive health service utilization among adult family members are well-established, but the effects of informal caregiving on children of caregivers are unknown. We aimed to assess whether inequalities in vaccination coverage (specifically human papillomavirus [HPV] and influenza) exist for females aged 9 to 17 years whose parents are informal caregivers (i.e., care providers for family members or others who are not functionally independent) compared with females whose parents are not informal caregivers. Data from the 2009 Behavioral Risk Factor Surveillance System were analyzed using Poisson regression with robust variance to estimate overall and subgroup-specific HPV and influenza vaccination prevalence ratios (PRs) and corresponding 95% confidence limits (CL) comparing females whose parents were informal caregivers with females whose parents were not informal caregivers. Our unweighted study populations comprised 1645 and 1279 females aged 9 to 17 years for the HPV and influenza vaccination analyses, respectively. Overall, both HPV and influenza vaccination coverage were lower among females whose parents were informal caregivers (HPV: PR = 0.72, 95% CL: 0.53, 0.97; Influenza: PR = 0.89, 95% CL: 0.66, 1.2). Our results suggest consistently lower HPV and influenza vaccination coverage for young females whose parents are informal caregivers. Our study provides new evidence about the potential implications of caregiving on the utilization of preventive health services among children of caregivers.
authors.affiliation: a Center for Data and Informatics; Delaware Health and Social Services; Dover, DE USA.
authors.forename: Tabatha N
authors.initials: TN
authors.lastname: Offutt-Powell
authors.forename: Rohit P
authors.initials: RP
authors.lastname: Ojha
authors.forename: Tara M
authors.initials: TM
authors.lastname: Brinkman
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Tota
authors.forename: Bradford E
authors.initials: BE
authors.lastname: Jackson
authors.forename: Karan P
authors.initials: KP
authors.lastname: Singh
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers; D002648:Child; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents; D005791:Patient Care; D012959:Socioeconomic Factors; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines; D053918:Papillomavirus Vaccines
keywords: adolescents; children; human papillomavirus vaccine; influenza vaccination; informal caregiver; risk perception; strain