Date of Award

Fall 1-9-2015

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Ruiyan Luo, PhD

Second Advisor

Laurie D. Elam-Evans, PhD, MPH

Third Advisor

Connie L. Bish, PhD, MPH


INTRODUCTION: Since 2006, the Advisory Committee for Immunization Practices (ACIP) has recommended routine vaccination of adolescent girls at ages 11 or 12 years with 3 doses of human papillomavirus (HPV) vaccine to prevent cervical cancer. Cervical cancer disparities exist for several populations in the United States. The topic is scantly documented in scholarly literature with modest knowledge of the uptake of the HPV vaccine in the Delta region.

AIM: To examine the HPV vaccination coverage estimates in the counties and parishes that comprise the Delta Regional Authority (DRA) and compare with other non-DRA counties or parishes and the rest of US. This will provide vaccination coverage estimates for adolescent females in the DRA designated Delta region that will provide public health professionals with data for policy and programmatic decision-making.

METHODS: We combined data from multiple survey years (2008-2012) from the National Immunization Survey-Teen (NIS-Teen). We conducted bivariate analyses to describe the distribution across selected socio-demographic characteristics and multivariable logistic regression models to produce adjusted prevalence ratios.

RESULTS: Teens in the DRA had lower HPV vaccine initiation and completion rates compared to Non- DRA counties or parishes and the Rest of the US. The 3-dose HPV vaccination series completion rate among those who had initiated HPV vaccination and had 24 weeks between their first dose and the NIS interview date was 60.9% (95% CI: 55.8 – 65.8) among adolescent females in the DRA compared to 66.9 (95% CI: 63.7-70.0) of adolescent females in the Non-DRA counties and 67.6% (95% CI: 66.2-69.0) in the rest of the US.

CONCLUSION: The low HPV vaccination coverage among adolescents in the DRA showed that it is important to implement additional strategies to increase HPV vaccination coverage that will prevent cancers associated with HPV in the DELTA Region. Stronger provider recommendations and awareness are important for increasing HPV vaccine uptake.