Abstract C91: Exploring the role of social determinants on HPV vaccine intentions and uptake among ethnoracial minority college students
Authors: Hernandez Natalie D. , Cooper Dexter , Kolar Stephanie , Wheldon Christopher 
Published: February 2019

Background: HPV-related diseases and cancers disproportionately affect low-income and ethnoracial minorities. HPV vaccines have the potential to reduce ethnoracial disparities in HPV-related diseases and cancers; however, HPV vaccine uptake has remained sub optimal. To achieve the greatest impact, public health campaigns should focus on improving HPV vaccine coverage where it is weakest. They should also explore more subtle but potentially significant determinants of HPV vaccine initiation and completion. The social determinants of health approach may be useful in explaining the disparities in HPV vaccine uptake rates.

Methods: Ethnoracial minority male and female college students (n=956) recruited from a large public university in the southeast US completed a 20-minute web-based survey in the fall of 2011. Survey items were adapted from previous research of psychosocial HPV studies among men and women, and were based on constructs from the Health Belief Model and Social Cognitive Theory. This analysis examined self-reported data on participants' sociodemographics, HPV knowledge, HPV vaccine status, intent to receive HPV vaccination, and the importance of health provider recommendation for the HPV vaccine. Univariate analyses examined the sample distribution; bivariate analyses were conducted to examine the relationship between sociodemographics and HPV knowledge, intent, and importance of provider recommendation; and multinomial logistic regression analysis examined associations between the importance of a provider to recommend the HPV vaccine and HPV-related variables previously listed in the bivariate analysis.

Results: The mean age of the sample was 23.6 years (SD=6.629) years. The sample was mostly women (74.4%), Hispanic or Latino/a (46.3%), not married (75.4%), insured (76.9%), and completed 2 years or less of college (41.9%). Frequency distributions indicated that 88.5% reported that they were knowledgeable about HPV, 79.7% reported that they were knowledgeable about the HPV vaccine, and 62.1% had a place where they could receive the vaccination. In addition, 29.6% of the sample reported receiving at least 1 dose while 22.7% of the sample reported that they intend to get the HPV vaccine. Bivariate analyses showed that participants most likely to have previous HPV knowledge were women (91.8%; p &lt; 0.001) and participants with an undergraduate or graduate degree (92.2%; p = 0.036). Participants who were most likely to have previous HPV vaccine knowledge were most likely to be women (86.8%; p &lt; 0.001), possess an undergraduate or graduate degree (88.7%; p=0.001), and married (87.7%; p &lt; 0.001). Participants who reported having received at least one dose were more likely to be women (37.7%; p &lt;0.001), have completed 2 years of college or less (35.7%; p &lt;0.001), and not married (31.8%; p=0.01). Those who had 2 years of college or less (27.9%; p&lt;0.001) and not married (25.2%; p=0.01) were more likely to intend to get the HPV vaccination compared to participants with more education and married, respectively. Participants who indicated that the importance for a health care provider to recommend the HPV vaccine was very important were most likely to have 2 years of college or less (52.9%; p=0.02).Multinomial logistic regression analysis showed that participants who do not believe that the provider recommendation is important or somewhat important were less likely to have received a dose of the vaccine (p&lt;0.001), and less likely to have a place to receive the vaccination (p=.008; p=.003, respectively).

Conclusions: As ethnoracial minorities continue to grow in the United States over the next several decades, it is imperative that we not only improve HPV vaccination rates overall, but also focus on high-risk populations to prevent HPV-related disparities. Taking a social determinants of health approach in HPV-related disease and cancer prevention will be necessary to achieve equity and eliminate HPV-related disparities.

Citation Format: Natalie D. Hernandez, Dexter Cooper, Stephanie Kolar, Christopher Wheldon. Exploring the role of social determinants on HPV vaccine intentions and uptake among ethnoracial minority college students [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C91.