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Trends in HPV Vaccination of US Adolescent Females: How Policies, Education, and Health Care Providers Influence Immunization Rates

Grant, Jennifer Lyn (2013)
Dissertation (88 pages)
Committee Chair / Thesis Adviser: Howard, David H
Committee Members: Frew, Paula ; Thomas, Tami Lynn
Research Fields: Health Sciences, Public Health
Keywords: Vaccines
Program: Laney Graduate School, Health Services and Research Health Policy
Permanent url: http://pid.emory.edu/ark:/25593/f4mjs

Abstract

In my first paper, The Impact of State Immunization Financing Policies on HPV Vaccination Rates among US Adolescent Females, I examine the impact of expanded enrollment eligibility for The Vaccines for Children (VFC) program on HPV vaccine series initiation and completion among US adolescent girls. The VFC program provides certain vaccines at a reduced or no cost to eligible children. It was designed to help ensure all children receive recommended vaccinations on schedule, even if their parents are not be able to afford them. Specifically, I hypothesized that adolescent girls living in states in which all recommended vaccines were provided free of cost to all children in the state would be more likely to initiate and complete the HPV vaccine series than their peers living in states with more restricted VFC eligibility requirements.

In my second paper, Maternal Educational Inequalities in HPV Vaccine Utilization among US adolescent females- The relative roles of economics and awareness, I evaluate the relative influences of household-level socioeconomic status, specific health knowledge, and general healthcare utilization and timeliness in mediating the relationship between maternal educational attainment and HPV vaccine utilization among adolescent girls.

In my third and final paper, Factors Associated with Health Care Provider Recommendation of the Human Papillomavirus Vaccine and effect of provider recommendation on vaccine series initiation and completion, I examine the relative influences of adolescent and household sociodemographic characteristics and characteristics of their health-seeking behavior on the likelihood of receiving a health care provider recommendation of the HPV vaccine for US Adolescent girls. I also estimate the effect of provider recommendation on vaccine series initiation and completion

Table of Contents

Table of Contents
Paper One: The Impact of State Immunization Financing Policies on HPV Vaccination Rates among US adolescent females
INTRODUCTION 1
METHODS 7
RESULTS 13
DISCUSSION 23
Paper Two: Maternal Educational Inequalities in HPV Vaccine Utilization among US adolescent females- The relative roles of economics and awareness
INTRODUCTION 30
METHODS 35
RESULTS 42
DISCUSSION 53
Paper Three: Factors Associated with Health Care Provider Recommendation of the Human Papillomavirus Vaccine, and effect of provider recommendation on vaccine series initiation and completion
INTRODUCTION 59
METHODS 62
RESULTS 64
DISCUSSION 70

REFERENCES 74

Files

application/pdf Dissertation 88 pages (4.2 MB) [Access copy of Dissertation/Thesis]
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