Need: The target area will expand from El Paso County to four new Texas-Mexico Border Counties including Hudspeth, Culberson, Presidio, and Brewster Counties. The program will serve a total population of approximately 863,000 people. The target population is primarily Hispanic (ranging from 45.4% to 83% in different counties) and rural with high levels of poverty, lower levels of educational attainment, and high levels of uninsured individuals. A health disparity exists along the Texas-Mexico border which suffers from a higher incidence and mortality for HPV-associated cancers, including cervical cancer for Hispanic women and penile cancer for Hispanic men. Furthermore our target counties ...

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Need: The target area will expand from El Paso County to four new Texas-Mexico Border Counties including Hudspeth, Culberson, Presidio, and Brewster Counties. The program will serve a total population of approximately 863,000 people. The target population is primarily Hispanic (ranging from 45.4% to 83% in different counties) and rural with high levels of poverty, lower levels of educational attainment, and high levels of uninsured individuals. A health disparity exists along the Texas-Mexico border which suffers from a higher incidence and mortality for HPV-associated cancers, including cervical cancer for Hispanic women and penile cancer for Hispanic men. Furthermore our target counties have an inadequate number of physicians. Hudspeth, Culberson, Presidio, and Brewster Counties are designated as whole county medically underserved areas (MUAs) and El Paso County is designated a partial county MUA. Initiation rates of HPV vaccination for our target counties are quite low, particularly among young adults between the ages of 18 and 34, and completion rates are negligible for this age range. Overall, local HPV initiation rates (83%) are somewhat higher than the state rate at 58%, completion rates are low especially among young adults aged 18-26 years. Our culturally tailored program will address the HPV vaccine needs of individuals aged 9-26 years old along the US-Mexico border through outreach, education, navigation, and clinical services. Overall Project Strategy: Tiempo de Vacunarte 2 (TdV2) is a multi-component, culturally appropriate intervention designed to reduce HPV-related cancer burden targeting five border counties in Texas. The program will continue as a community wide effort led by Texas Tech University Health Sciences Center at El Paso (TTUHSC El Paso). It will improve upon the original program and expand to other border counties. Individuals between the ages of 9 and 26 (both males and females) with a self-reported Texas address, uninsured or underinsured who have not completed the HPV vaccine series are eligible to participate. We will continue to partner with all 175 community sites in our network, as well as expand to new sites that include school districts, community centers, clinics, faith-based organizations, food banks, city/county services, local and state health departments, and other community-based organizations. We propose to expand, and enhance the program and integrate it with innovative and sustainable components. We have added key new partnerships to enable us to do this including a private pharmacy and UT Austin Center for Health Communication. Tiempo de Vacunarte 2 program will incorporate innovative strategies which are: 1) expansion and dissemination of our program to four new Texas-Mexico border counties which are Hudspeth, Culberson, Presidio, and Brewster Counties; 2) revised educational delivery strategies; 3) enhanced text message reminders for individuals needing follow-up doses as a means to increase the vaccine completion rate; 4) creation of an innovative partnership with a private pharmacy for vaccine delivery in El Paso County, thereby improving vaccine access; 5) development of a resource library consisting of a toolkit of social media strategies and messages for integration into collaborating partner’s outreach and education; and 6) implementation, adoption, and sustainability of HPV vaccine uptake strategies among our collaborating partners. Specific Goals: Our long term goal is to reduce the burden of HPV-associated cancers in our target border counties. Our specific goals are: 1) Increase uptake of HPV immunization among 9-26 year-olds residing in El Paso, Hudspeth, Culberson, Presidio, and Brewster Counties. 2) Implement culturally appropriate and tailored social media and new media strategies to improve HPV vaccine knowledge, beliefs, and uptake. 3) Increase the implementation of social media and new media strategies for HPV-related cancer prevention within our collaborating partner network. We plan to recruit and educate 2,200 individuals with a completion rate of 45%. We will directly serve 9,050 individuals and provide 3,500 HPV vaccines (clinical services). Significance and Impact: In line with CPRIT prevention program goals to reduce overall cancer incidence, our program aims to prevent and reduce the burden of HPV-associated cancers among the undeserved. We will expand a culturally appropriate HPV educational program that is comprised of innovative components and interweaves sustainability throughout the goals and objectives in order to positively impact cancer prevention among predominantly Hispanic and rural populations along the Texas-Mexico border.

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