Multilevel Factors Associated with HPV Vaccine Initiation and Completion among Mexican American Young Adult Women from Federally Qualified Health Centers in Orange County, CA

Latina women experience cancer disparities exacerbated by multilevel factors. An understanding of how multilevel factors influence Latinas' use of prevention services, can inform culturally tailored interventions. Using cross-sectional surveys guided by the NIMHD Health Disparities Research Framework, we sought to identify individual (HPV vaccine hesitancy, HPV knowledge, HPV vaccine conspiracy beliefs), interpersonal (strength of provider communication, mother-daughter communication), and community (negative HPV vaccine messages, number of times offered the HPV vaccine, clinic wait times) factors associated with HPV vaccine initiation and completion among Mexican American young adult women. At the individual level, HPV vaccine hesitancy and HPV vaccine conspiracy beliefs were associated with HPV vaccine initiation and completion. HPV vaccine knowledge was not associated with initiation or completion. At the individual level, strength of provider communication and HPV mother-daughter communication was associated with HPV vaccine initiation. Only HPV mother-daughter communication was associated with HPV vaccine completion. At the community level, longer clinic wait times and number of times the HPV vaccine has been offered was associated with HPV vaccine initiation. Exposure to negative HPV vaccine messages was not associated with HPV vaccine initiation but was associated with HPV vaccine completion. Longer clinic wait times and number of times the HPV vaccine was offered was not associated with completion. Findings suggest multilevel factors that influence HPV vaccine initiation can differ from factors that influence completion, an important factor to consider when designing interventions tailored to meet the needs of this population or when implementing evidence-based strategies for HPV vaccination.