Latino Adolescent-Mother Language Concordance, Neighborhood Deprivation, and Vaccinations in Community Health Centers.

Abstract

Context: Latino adolescents face multilevel barriers (e.g. language, neighborhood deprivation) to preventive care, including recommended vaccinations. There is little research on the association between Latino adolescent-mother preferred language concordance and vaccination completion and if it varies by neighborhood deprivation. Objective: To better understand the social/family factors associated with Latino adolescent vaccination completion by studying the association of adolescent-mother language concordance and neighborhood social deprivation with adolescent vaccination completion. Study Design and Analysis: Retrospective observational study comparing human papilloma virus (HPV), meningococcal, and influenza vaccination rates in dyads from Latino families of three types (English-preferring Latino adolescents with English-preferring mothers, Spanish-preferring Latino adolescents with Spanish-preferring mothers, and English-preferring Latino adolescents with Spanish- preferring mothers) with those of English-preferring non-Hispanic white adolescent-mother pairs, adjusting for mother and adolescent demographics and healthcare utilization and stratifying by social deprivation of the family's neighborhood. Setting: Multistate electronic health record (EHR)-based dataset of patients from 389 community health centers (CHCs) across 17 states from the OCHIN Network. Population Studied: Latino and non-Latino adolescent-mother dyads. Outcome Measures: Adolescent HPV and meningococcal vaccinations and yearly influenza vaccination rate. Results: Our sample included 56,542 adolescent-mother dyads. Compared with Non-Hispanic white dyads, all three groups of Latino dyads had higher odds of adolescent HPV and meningococcal vaccines and higher rates of flu vaccines, and Latino dyads with Spanish-preferring mothers had higher vaccination odds/rates than did Latino dyads with English-preferring mothers. While there was some evidence of variation by neighborhood social deprivation in influenza vaccination rates, these effects were minor in comparison to differences by ethnicity and language concordance. Conclusions: In a multistate analysis of vaccinations among Latino and non-Latino adolescents, English-preferring adolescents with Spanish- preferring mothers had the highest completion rates and English-preferring non-Hispanic white dyads had the lowest. Further research can seek to understand why this language dyad may have an advantage in adolescent vaccination completion.