Hispanic men and women, especially those living on the US-Mexico border, bear an unequal burden of HPV-related cancers. The incidence of cervical cancer is higher in Texas- Mexico border counties than in non-border counties (approximately 12.3 per 100,000 vs. 9.5 per 100,000, respectively). The incidence rate for El Paso County, a majority Hispanic County, is about 10.0 per 100,000 women, which exceeds the Healthy People 2020 target of 7.2 per 100,000. The cervical cancer mortality rate among US-Mexico border Hispanic women is the highest in the nation at 5.7/100,000 compared to the national average of 2.4/100,000, age-standardized to the year 2000 population. Also, most penile cancers...

Read More

Hispanic men and women, especially those living on the US-Mexico border, bear an unequal burden of HPV-related cancers. The incidence of cervical cancer is higher in Texas- Mexico border counties than in non-border counties (approximately 12.3 per 100,000 vs. 9.5 per 100,000, respectively). The incidence rate for El Paso County, a majority Hispanic County, is about 10.0 per 100,000 women, which exceeds the Healthy People 2020 target of 7.2 per 100,000. The cervical cancer mortality rate among US-Mexico border Hispanic women is the highest in the nation at 5.7/100,000 compared to the national average of 2.4/100,000, age-standardized to the year 2000 population. Also, most penile cancers (63%) are associated with HPV infection, and Hispanic males have the highest incidence in the country at 1.2 per 100,000 compared to 0.8 per 100,000 among non-Hispanic whites. Despite evidence of the effectiveness and safety of the vaccine, there remains a relatively low uptake of the HPV vaccine. Additionally, adolescents in Texas are less likely to have received the HPV vaccine than in other states. Our Tiempo de Vacunarte 3(TdV3) target area serves approximately one million individuals. It covers El Paso County and the unincorporated areas (colonias) surrounding it, including Hudspeth, Culberson, Presidio, and Brewster counties, serving five of the 32 designated Texas-Mexico border counties. All of our target counties have educational attainment and percent of the insured population, which is lower than the national average, and percent of individuals living below the poverty level, higher than the national average. Furthermore, our target counties have an inadequate number of physicians. Therefore, Hudspeth, Culberson, Presidio, and Brewster counties are designated whole county medically underserved areas (MUAs), and El Paso County is designated a partial county MUA. Overall Project Strategy: TDV3 is a multilevel, multicomponent, culturally tailored, bilingual HPV cancer prevention program aiming to reduce the burden of HPV-associated cancers. The program includes outreach, education, and navigation for all participants ( insured and uninsured) while providing access to no/low-cost HPV vaccine to uninsured or underinsured. We also focus on developing collaborative partnerships and disseminating and implementing effective elements to create sustainable system changes. Service delivery will be facilitated through our ongoing collaborations with community organizations, faith groups, schools, and healthcare providers and through new partners who will facilitate recruitment, education, and vaccine administration. We propose to expand and enhance the program and integrate it with innovative and sustainable components such as: 1) evidence-based school-based vaccine initiative (SBVI) collaborating with school districts and service providers such as Immunize El Paso to provide onsite services; 2) training and empowering community vaccine champions to improve the capacity to advocate for increased HPV vaccine uptake in the community; 3) Expand collaborative partnerships with private pharmacy providers for service delivery, especially in rural counties; 4) expand outreach and messaging through social media and new media; 5) develop and disseminate curriculum for the training of vaccine champions for HPV vaccine outreach and 6) enhance implementation, adoption, and sustainability of HPV vaccine uptake strategies among our collaborating partners. Goals: our program goals are: 1) to Increase the uptake of HPV Vaccine among 9-45-year-olds residing in El Paso, Hudspeth, Culberson, Presidio, and Brewster Counties; 2) Implement collaborative and culturally appropriate school-based vaccination initiative (SBVI) to improve HPV vaccine uptake in adolescents in the border region and 3) Develop and Implement evidence-based culturally tailored HPV vaccine training to improve capacity for HPV vaccines advocacy in the community. We propose to serve over 83,000 individuals providing 40,000 educational services, 40,000 navigation services, and 3640 vaccines. Significance and impact: In line with CPRIT's prevention program goals to reduce overall cancer incidence, our program aims to prevent and reduce the burden of HPV-associated cancers among the underserved. We will expand a multilevel, culturally appropriate HPV cancer prevention program comprised of innovative components that enhance sustainability by building community partnerships and capacity. This intervention will positively impact cancer prevention among predominantly Hispanic and rural populations along the Texas-Mexico border.

Read Less