Grant Number:	5R21CA204767-02 Interpret this number
Primary Investigator:	Ramaswamy, Megha
Organization:	University Of Kansas Medical Center
Project Title:	Correctional and Public Health Links to Bolster HPV Vaccine and Cancer Prevention
Fiscal Year:	2017

 DESCRIPTION (provided by applicant): Adults with criminal justice histories are 4-5 times more likely to get human papillomavirus (HPV) cancers compared to those without these histories, but little has been done on the front end to bolster HPV vaccination efforts among justice-involved female and male youth. Given the pathways to HPV cancer risk among justice- involved youth - early smoking, risky sexual behavior, low educational attainment, poverty, and criminal justice encounters over the life course, developing sustainable strategies to improve cancer prevention for this group of young people is important. Our project objective is to assess a pilot implementation strategy that links county juvenile detention facilities with county health departments to provide HPV vaccination for incarcerated young women and men. To meet this objective, we propose a two-aim investigation. In Aim 1, we will pilot test our implementation strategy, Vaccines in Correctional Settings for Cancer Prevention (VCCaP pronounced Vee-Cap), where health department staff will provide an HPV vaccine clinic once per week in one Kansas county detention center for the six-month pilot implementation period. In Aim 2, we will collect information about the barriers and facilitators of such a potential linkage throughout a four-state region (Kansas, Missouri, Nebraska, and Iowa), directly informing a subsequent R01 project to scale up our implementation strategy to the region. For both aims, we will use the Consolidated Framework for Implementation Research (CFIR) as a guide to collect qualitative and quantitative data on intervention characteristics (e.g. interest in promoting intervention among jail and health department administrators); outer setting (e.g. patient perception of need in pilot setting); inner setting (e.g. norms, values of organizations that would impede or facilitae intervention success); characteristics of individuals (e.g. beliefs about HPV vaccine and implementation strategy); and process of implementation (e.g. depth of implementation and vaccine uptake in pilot setting). Our region has the lowest HPV vaccination coverage in the country, with Kansas having the worst coverage of all 50 states. Since a recent study demonstrated that state cancer rates correlate directly with state HPV vaccination rates, innovative implementation strategies, especially among groups at high HPV risk are urgently needed. We know that HPV vaccine is an effective intervention for prevention of high-risk HPV infection and related cancers. What we do not have is information about the best implementation strategy to reach high-risk youth, particularly those in criminal justice settings. Our ultimate goal is to create a sustainable model for linkages between the correctional facilities present in most counties in the U.S. and local health departments to address the cancer and sexual health disparities that justice-involved youth face. Targeting HPV vaccination for ultimate primary prevention in a sustainable and scalable way may result in the highest short- and long-term public health gains for young people at a critical time in their lives.





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