Need: Suboptimal HPV vaccination rates remain a significant public health challenge in Texas, despite the proven safety, efficacy, and effectiveness of the vaccine in preventing six types of HPV-related cancers, including anogenital and oropharyngeal cancers. Currently, only 57.5% of adolescents in Texas are up to date on their HPV vaccination series, with even lower rates observed in Bexar County (Centers for Disease Control and Prevention [CDC], 2024). As of 2023, only 57.6% of adolescents ages 13-17 in Bexar County are up to date on the HPV vaccine (CDC, 2024). Moreover, Bexar County has seven service areas designated as medically underserved, encompassing 140 census tracts (Health Resour...
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Need: Suboptimal HPV vaccination rates remain a significant public health challenge in Texas, despite the proven safety, efficacy, and effectiveness of the vaccine in preventing six types of HPV-related cancers, including anogenital and oropharyngeal cancers. Currently, only 57.5% of adolescents in Texas are up to date on their HPV vaccination series, with even lower rates observed in Bexar County (Centers for Disease Control and Prevention [CDC], 2024). As of 2023, only 57.6% of adolescents ages 13-17 in Bexar County are up to date on the HPV vaccine (CDC, 2024). Moreover, Bexar County has seven service areas designated as medically underserved, encompassing 140 census tracts (Health Resources & Services Administration, 2019). Thus, it is essential to support cancer-preventing vaccination services for youth in this region. Barriers to vaccination, such as vaccine hesitancy, limited access to healthcare, and lack of vaccine confidence continue to negatively impact vaccination efforts. Overall Project Strategy: To address these barriers, we propose a multi-component, community-based intervention to increase HPV vaccination rates among adolescents in Bexar County. The project will integrate and adapt the All for Them (AFT) vaccination program—an evidence-informed, culturally appropriate, bilingual initiative—into the context of Bexar County’s community settings. We will leverage successes from the AFT vaccination program to inform our social marketing content, comprehensive vaccination clinics, and health professional continuing education for Community Health Workers (CHW). We will implement our strategies of social marketing and vaccination clinics through community-wide events and after-school programs. CHW training will be developed, credentialed, and disseminated to CHWs across Texas. To achieve these goals, we will partner with UTHealth Houston School of Public Health for the delivery and coordination of the social marketing campaign, partner with UT Health San Antonio’s School of Nursing for the delivery of HPV vaccines, and partner with community organizations for conducting community-wide vaccination services and in after-school programs. Specific Goals: Overall, we anticipate delivering 1,200 HPV vaccines as cancer preventive services and 5,550 people to be served in Bexar County. We will tailor, implement, and evaluate the All for Them (AFT), bilingual, culturally appropriate social marketing campaign and clinical vaccination services for youth in medically underserved areas in Bexar County in community settings to increase HPV vaccination (Goal 1). The AFT social marketing campaign will be delivered to 5,000 residents annually in Bexar County to increase awareness of AFT, HPV vaccination, and offerings of AFT community-wide vaccination events. We will provide 1,000 HPV vaccines through 40 community-wide vaccination clinics to youth in Bexar County over the course of the project. We will adapt, implement, and evaluate the All for Them (AFT), bilingual, culturally appropriate social marketing campaign and clinical vaccination services for youth in medically underserved areas of Bexar County in after-school programs to increase HPV vaccination (Goal 2). The adapted AFT social marketing campaign will be delivered to over 250 parents of youth to increase program awareness and deliver intervention materials and we will deliver 200 HPV vaccines via 8 pre-consented vaccination clinics in participating afterschool programs over the course of the project. We will develop, implement, and evaluate community health worker training to increase HPV vaccination knowledge, positive attitudes, and health navigation skills (Goal 3) among 300 CHWs in Texas. Significance and Impact: This project will have a substantial impact on cancer prevention in Bexar County, Texas, and the state as a whole by addressing HPV vaccination gaps in medically underserved areas. If successful, the program will significantly increase HPV vaccination rates among adolescents in Bexar County, which will lead to a reduction in HPV-related cancers in the region. The integration of a social marketing and educational campaign, mobile comprehensive vaccination clinics, and CHW training creates a comprehensive and sustainable model that can be expanded to other regions in the state. The project’s focus on reaching underserved populations ensures that it addresses the most pressing barriers to vaccination. By increasing community demand for the HPV vaccine, improving access to vaccination services, and building trust in vaccine safety and efficacy, this intervention aims to make meaningful progress toward reducing HPV-related cancer incidence and mortality in Texas.
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