title: Human papillomavirus (HPV) vaccine initiation in minority Americans.
abstract: OBJECTIVE
  Transmission of the human papillomavirus (HPV) is a significant public health concern. HPV is preventable through a series of vaccinations; however, knowledge gaps exist as to which groups are least likely to initiate vaccination. Considering this gap, the aim of this study is to examine HPV vaccine initiation rates in racial minorities, comparing foreign-born individuals to their American-born peers.
  
  
  METHODS
  Population-based data from the 2013 National Health Interview Survey (NHIS), a repeated large-scale household interview survey of a statistically representative sample of the United States civilian non-institutionalized population, were applied. Data were derived from two survey modules: the family and summary adult modules.
  
  
  METHODS
  Sampling weights were employed to logistic regression modelling the outcome of HPV vaccine initiation.
  
  
  RESULTS
  Foreign-born persons, African Americans, males, those lacking health insurance coverage and those without a medical home (usual place to receive care) held statistically lower rates of HPV vaccine initiation. Being college educated was associated with higher odds of HPV vaccine initiation.
  
  
  CONCLUSIONS
  Our findings support the persistence of health disparities in racial minorities and foreign-born persons residing in the United States. Addressing these gaps will likely require both individual-level (e.g. targeted health education) and system-level (e.g. HPV vaccine promoting policies) interventions. Since health insurance coverage and having a medical home were significant associates of HPV vaccine initiation, attempts to coverage may improve HPV vaccine initiation rates. Additionally, policies which require HPV vaccination for school entry could boost coverage across all population groups, including boys, foreign-born persons and racial minorities.
authors.affiliation: City College and the Graduate Center, City University of New York, 160 Convent Avenue, New York, NY 10031, USA. Electronic address: pde@ccny.cuny.edu.
authors.forename: P
authors.initials: P
authors.lastname: De
authors.affiliation: University of Alabama at Birmingham, Department of Health Care Organization and Policy, 517D Ryals Public Health Building, 1665 University Boulevard, Birmingham, AL 35294, USA. Electronic address: budhwani@uab.edu.
authors.forename: H
authors.initials: H
authors.lastname: Budhwani
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000208:ethnology* / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011159:Population Surveillance; D044469:Racial Groups; D012959:Socioeconomic Factors; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: Disparities; HPV vaccine; Immigrant; Race