Cervical cancer incidence in Los Angeles County is significantly higher than the national average, with highest rates among Latinas and Asian/Pacific Islanders. The discovery of HPV as the primary causal agent in cervical cancer and subsequent development of HPV vaccines have revolutionized the potential for cervical cancer prevention. However, vaccine utilization rates in the US remain unacceptably low among age-eligible girls, including among the highest risk groups.

The UCLA School of Public Health & Jonsson Comprehensive Cancer Center have teamed with the Los Angeles County Department of Public Health, Office of Women’s Health (OWH) to address the unequal burden of cervical cancer in Los Angeles. The primary goal of the study is to evaluate, in a randomized trial, a theoretically driven, culturally sensitive and individually tailored intervention to increase HPV vaccine receipt among underserved, high risk girls in Los Angeles. The intervention will be delivered via the existing OWH telephone education and service referral hotline in six languages (English, Spanish, Cantonese, Mandarin, Korean, Armenian).

The multi-component intervention, directed at mothers of age-eligible girls (11-18 years), will consist of a brief telephone intervention that will deliver basic HPV vaccine information, individually tailored messages to address callers’ barriers to HPV vaccination, and tailored referral to a clinic offering low cost/free vaccine. A tailored print intervention reinforcing the telephone messages will also be mailed to participants. The control group will receive usual care and a standard CDC fact sheet on the HPV vaccine. The primary outcome will be vaccine initiation among age-eligible girls (receipt of at least one vaccine dose) assessed at a 3 month telephone follow-up with mothers. A 9 month follow-up will assess vaccine completion rates (receipt of 3-dose series) and overall patterns of vaccine dose initiation and completion. The study also seeks to characterize HPV related knowledge, beliefs and barriers in the target population, and understand the mediators (e.g., knowledge, barriers reduction) through which the intervention may have achieved its desired effect. Differential effects of the intervention on subgroups of the sample (e.g., more acculturated) will also be assessed.

The study is innovative in that we are partnering with the county health system which is the only realistic source of health care for our target population. The commitment of the county department of public health to increasing HPV vaccine uptake and the utilization of existing county infrastructure (the OWH hotline) for intervention delivery will ensure institutionalization of the intervention upon trial completion.

Project Investigator(s):
Roshan Bastani, PhD
Beth Glenn, PhD
Alison Herrmann, PhD, MS
Catherine Crespi, PhD
Narissa Nonzee, PhD

Research Team:
Cindy Chang, MS

Community Partner(s): Los Angeles County Department of Public Health, Office of Women’s Health (OWH)

Funding Source(s): NIH/National Cancer Institute (NCI) R01 CA154549

Project Status: Complete

Publication(s):

  • Glenn BA, Crespi CM, Herrmann AK, Nonzee NJ, Rosen DL, Park CL, Johnson G, Chang LC, Singhal R, Taylor VM, Bastani R. Effectiveness and feasibility of three types of parent reminders to increase adolescent human papillomavirus (HPV) vaccination. Prev Med. 2023 Apr;169:107448. doi: 10.1016/j.ypmed.2023.107448. Epub 2023 Feb 10. PMID: 36773962; PMCID: PMC10707435.
  • Glenn BA, Nonzee NJ, Herrmann AK, Crespi CM, Haroutunian GG, Sundin P, Chang LC, Singhal R, Taylor VM, Bastani R. Impact of a Multi-Level, Multi-Component, System Intervention on HPV Vaccination in a Federally Qualified Health Center. Cancer Epidemiol Biomarkers Prev. 2022 Oct 4;31(10):1952-1958. doi: 10.1158/1055-9965.EPI-22-0156. PMID: 35914738; PMCID: PMC9581499.
  • Bastani R, Glenn BA, Singhal R, et al. Increasing HPV Vaccination among Low-Income, Ethnic Minority Adolescents: Effects of a Multicomponent System Intervention through a County Health Department Hotline. Cancer Epidemiol Biomarkers Prev. 2022;31(1):175-182. doi:10.1158/1055-9965.EPI-20-1578