The incidence rate of cervical cancer (CC) is higher among African American (AfAm) women compared to white women and AfAm women are twice as likely to die of the disease. Alarmingly, rates of CC incidence and mortality among AfAm women in Michigan are not only twice that of white women in the state but incidence is higher than that of AfAm women nationwide . This is despite the fact that in Michigan, Pap test, the primary screening test for CC, is higher among AfAm women compared to white women.
Another pathway to reducing racial disparities in CC outcomes is vaccination against the human papillomavirus (HPV). There is consensus among advisory and advocacy groups for routine vaccination among females age 11-12 years, with administration to girls as young as 9 years and “catch up” vaccinations (for missed doses in the 3-dose series) for girls up to 18 years of age. Such recommendations reflect an acknowledgement of HPV vaccination as a primary strategy to prevent CC. These recommendations also place much of the responsibility of vaccine-related decision making on parents, who generally make healthcare decisions for children. Despite these recommendations, a number of reports indicate that rates of HPV vaccine uptake (e.g., initiation and series completion) is lower among AfAm girls. Compared to girls, there is a death of data describing uptake among boys, regardless of race. Consistent barriers to HPV vaccine uptake identified in the scientific literature are low HPV vaccine-related knowledge and lack of physician guidance about the vaccination decision (e.g., no prior discussion with a physician about vaccination or no physician recommendation), suggesting that interventions addressing barriers to vaccine uptake should focus on increasing knowledge in this area and encouraging parents to have discussions with a healthcare provider
The broad goals of the proposed research are to improve the quality of AfAm parents’ decision making related to HPV vaccination, to increase the level of shared decision making between AfAm parents and healthcare providers, and to increase overall access to HPV vaccination. We will draw upon the reach of the Witness Project of Detroit to move this work forward.