Project Grant F31CA318452

EXPANDING HPV-RELATED CANCER PREVENTION INTO SALONS: LEVERAGING TRUSTED COMMUNITY SETTINGS TO IMPROVE VACCINATION IN RURAL AND HEALTH PROFESSIONAL SHORTAGE AREAS - PROJECT SUMMARY: HUMAN PAPILLOMAVIRUS (HPV)-RELATED CANCERS REMAIN A PREVENTABLE PUBLIC HEALTH THREAT IN THE UNITED STATES, ACCOUNTING FOR TENS OF THOUSANDS OF NEW CANCER DIAGNOSES EACH YEAR. ALTHOUGH AN EFFECTIVE HPV VACCINE HAS BEEN AVAILABLE SINCE 2006, PREVENTING MORE THAN 90% OF HPV-RELATED CANCERS, VACCINE UPTAKE IN THE U.S. REMAINS BELOW THE HEALTHY PEOPLE 2030 TARGET OF 80%. RURAL COUNTIES CONSISTENTLY LAG BEHIND URBAN AREAS AND, IN INDIANA, WHERE OVER HALF OF ALL COUNTIES ARE DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS), THE HPV VACCINE SERIES COMPLETION RATE IS ONLY 55.2%, WITH SUBSTANTIAL COUNTY-LEVEL VARIATION. EXTENDING CANCER-PREVENTION EFFORTS INTO TRUSTED COMMUNITY SETTINGS IS ESSENTIAL FOR IMPROVING VACCINE UPTAKE. SALON PROFESSIONALS REPRESENT AN INNOVATIVE YET UNDERUTILIZED GROUP OF COMMUNITY PARTNERS. AS RECURRING SERVICE PROVIDERS WITH TRUST-BASED RELATIONSHIPS, THEY ROUTINELY ENGAGE PARENTS AND YOUNG ADULTS IN CONVERSATIONS THAT NATURALLY LEND THEMSELVES TO BRIEF HEALTH-PROMOTION MESSAGING. PRIOR RESEARCH SHOWS SALON PROFESSIONALS REACH INDIVIDUALS WHO ARE OVERLOOKED BY TRADITIONAL HEALTHCARE SYSTEMS, PARTICULARLY IN RURAL AND HPSAS. BUILDING ON PILOT WORK SUPPORTING THE FEASIBILITY OF SALON-BASED HEALTH PROMOTION, THE OVERALL OBJECTIVE OF THIS PROJECT IS TO ASSESS THE FEASIBILITY AND ACCEPTABILITY OF ENGAGING SALON PROFESSIONALS TO DELIVER BRIEF HPV VACCINATION MESSAGES AS A PRIMARY STRATEGY FOR PREVENTING CANCERS. USING AN EXPLANATORY SEQUENTIAL MIXED- METHODS DESIGN, THE STUDY WILL ACHIEVE THIS OBJECTIVE VIA TWO SPECIFIC AIMS. AIM 1 WILL IDENTIFY FACTORS INFLUENCING SALON PROFESSIONALS' WILLINGNESS TO DELIVER BRIEF HPV VACCINATION MESSAGES TO THEIR CLIENTS AND ASSESS DIFFERENCES BY RURALITY. AIM 2 WILL EXPLORE SALON PROFESSIONALS' EXPERIENCES WITH AND PERCEPTIONS OF DELIVERING HPV-CANCER PREVENTION MESSAGES TO PARENTS AND YOUNG ADULTS. THIS RESEARCH IS INNOVATIVE BECAUSE IT EXTENDS EVIDENCE-BASED HPV CANCER-PREVENTION STRATEGIES INTO SALON SETTINGS, USING AN IMPLEMENTATION- INFORMED MIXED-METHODS DESIGN TO ASSESS READINESS AMONG PROFESSIONALS WHO ROUTINELY ENGAGE FAMILIES ACROSS RURAL AND HPSA REGIONS. INTEGRATING THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH (CFIR)- GUIDED SURVEY AND QUALITATIVE DATA OFFERS A NOVEL APPROACH TO IDENTIFYING MULTILEVEL DETERMINANTS SHAPING REAL- WORLD FEASIBILITY AND MOVING BEYOND TRADITIONAL CLINIC-BASED MODELS. THIS FELLOWSHIP PROVIDES COMPREHENSIVE TRAINING IN IMPLEMENTATION SCIENCE, MIXED-METHODS RESEARCH, AND COMMUNITY-ENGAGED CANCER PREVENTION. COURSEWORK AND INTERDISCIPLINARY MENTORSHIP WILL STRENGTHEN MY SKILLS IN IMPLEMENTATION-FRAMEWORK APPLICATION, MIXED-METHODS ANALYSIS, AND COMMUNITY-BASED INTERVENTION DEVELOPMENT, ULTIMATELY STRENGTHENING MY DEVELOPMENT AS AN INDEPENDENT RESEARCHER. INDIANA UNIVERSITY OFFERS AN EXCEPTIONAL TRAINING ENVIRONMENT WITH EXTENSIVE EXPERTISE IN BEHAVIORAL SCIENCE, EPIDEMIOLOGY, AND IMPLEMENTATION RESEARCH. THIS PROJECT IS SIGNIFICANT BECAUSE IT WILL GENERATE FOUNDATIONAL EVIDENCE TO INFORM A SCALABLE SALON-BASED BEHAVIORAL INTERVENTION TO INCREASE HPV VACCINATION AND REDUCE DOWNSTREAM CANCER INCIDENCES.