County-level estimates of human papillomavirus vaccine coverage among young adult women in Texas, 2008.

Texas public health journal Pub Date : 2013-01-01

Jan M Eberth, Xingyou Zhang, Monir Hossain, Jasmin A Tiro, James B Holt, Sally W Vernon

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Abstract

Purpose: The purpose of this study is to describe the county-level geographic distribution of human papillomavirus (HPV) vaccine coverage among young women aged 18-26 in Texas using multilevel, small area estimation.

Methods: Multilevel (individual, county, public health region) random-intercept logit models were fit to HPV vaccination data (receipt of ≥ 1 dose Gardasil®) from the 2008 Behavioral Risk Factor Surveillance System and a number of secondary sources. Using the parameters from the final model, we simulated HPV vaccine coverage in each county.

Results: Indirect county-level estimates ranged from 1.9-23.8%, with a weighted state average of 11.4%. The counties with the highest and lowest coverage estimates were Orange County, TX and Webb County, TX respectively. Significant correlations were observed between HPV vaccination and age, Hispanic ethnicity, and the percentage of uninsured at the county and public health region levels.

Conclusions: Small area analyses have been used in a variety of settings to assess a variety of health outcomes, and as shown in this study, can be used to highlight geographic disparities and opportunities for intervention in HPV vaccine coverage.

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2008年德克萨斯州年轻成年妇女中人乳头瘤病毒疫苗覆盖率的县级估计。

目的:本研究的目的是用多层次、小面积估计的方法描述德克萨斯州18-26岁年轻女性HPV疫苗覆盖率的县级地理分布。方法:采用多层次(个人、县、公共卫生区域)随机截取logit模型拟合来自2008年行为风险因素监测系统和一些二手来源的HPV疫苗接种数据(接种≥1剂Gardasil®)。使用最终模型的参数，我们模拟了每个县的HPV疫苗覆盖率。结果:间接县级估计值范围为1.9-23.8%，加权州平均值为11.4%。覆盖率估计最高和最低的县分别是德克萨斯州的奥兰治县和德克萨斯州的韦伯县。观察到HPV疫苗接种与年龄，西班牙裔种族以及县和公共卫生区域未投保百分比之间存在显著相关性。结论:小区域分析已在各种环境中用于评估各种健康结果，并且如本研究所示，可用于突出HPV疫苗覆盖率的地理差异和干预机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Texas public health journal

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