Abstract
Improving human papillomavirus (HPV) vaccination rates is a public health priority and a crucial cancer prevention goal. We designed a survey to estimate HPV vaccination coverage and understand factors associated with HPV vaccination among American Indian adolescents aged 9 to 17 years in Cherokee Nation, United States. The final survey contains 37 questions across 10 content areas, including HPV vaccination awareness, initiation, reasons, recommendations, and beliefs. This process paper provides an overview of the survey development. We focus on the collaborative process of a tribal–academic partnership and discuss methodological decisions regarding survey sampling, measures, testing, and administration.
Highlights
American Indian and Alaska Native women bear a disproportionate burden of cervical and other human papillomavirus (HPV)-associated cancers nationally and in Oklahoma [1,2]
As HPV vaccination coverage and factors differ by tribe, and in the absence of any study assessing these factors in Cherokee Nation, we developed a survey to address this research gap
Based on the literature review, we identified and examined adult- and adolescentdirected surveys with questions on HPV vaccination, including the National Immunization Survey (NIS)–Teen (2019) [23], National Health Interview Survey (NHIS) (2019) [24], Health Information National Trends Survey (HINTS) (2018) [25], National Survey of Family Growth (NSFG) (2015–2017) [26], National Health and Nutrition Examination Survey (NHANES) (2017–2018) [27], Behavioral Risk Factor Surveillance System (BRFSS)
Summary
American Indian and Alaska Native women bear a disproportionate burden of cervical and other human papillomavirus (HPV)-associated cancers nationally and in Oklahoma [1,2]. From 2013 to 2017, the incidence of HPV-associated cancers nationally was 1.2 times higher in American Indian and Alaska Native (15.9 per 100,000) than nonHispanic White (13.7 per 100,000) women [1]. This incidence rate was significantly higher than the rate in White (rate ratio [RR]: 1.6; 95% confidence interval [CI]: 1.5, 1.8) and African American (RR: 1.5; 95% CI: 1.3, 1.8) women [2].
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