Racial, Ethnic, and Gender Differences in the Timing of Initiating the HPV Vaccine in the United States: the Case of Southeast Asian Americans.

Despite the availability of the human papillomavirus (HPV) vaccine, non-Latinx (NL) Southeast Asian Americans have the highest incidence of HPV-associated cervical cancer in the US. Little is known about NL-Southeast Asian Americans' HPV vaccination coverage due to being categorized under the "Asian American" monolith. Therefore, this study uses restricted data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) to disaggregate NL-Southeast Asian Americans and compare this population's age-specific probabilities of initiating HPV vaccinations to two Asian American subgroups (NL-East Asian and NL-South Asian Americans) and NL-White, NL-Black, and Latinx Americans. Multinomial logistic regression models examine the differences in the timing of initiating the HPV vaccine series, late (ages 13-26) or never, relative to on-time vaccination (by age 12). NL-Southeast Asian Americans are significantly more likely to never vaccinate and to vaccinate late than NL-White, NL-Black, and Latinx Americans, relative to on-time vaccination. NL-Southeast Asian American boys/men are significantly more likely to never initiate the HPV vaccine than Latinx boys/men, relative to on-time vaccination. NL-Southeast Asian American girls/women are significantly more likely to never vaccinate and vaccinate late than NL-White, NL-Black, and Latinx girls/women, relative to on-time vaccination. There are significant gender differences in uptake among all racial and ethnic groups, except among NL-Southeast and NL-East Asian Americans. Disaggregated data on NL-Southeast Asian Americans helps scholars and public health officials uncover health disparities and improve health interventions. Targeted HPV vaccine promotion and services for this population are needed to mitigate current and future health disparities and promote health equity.

On-time, late, or never: Incorporating intersectionality to predict age-specific probabilities of initiating the HPV vaccine series.

The HPV vaccine's effectiveness in protecting against the human papillomavirus (HPV) is dependent on both the timing of vaccine initiation (by age 12) and number of vaccine doses. This study used an intersectional approach to examine how gender and its intersection with race/ethnicity predict age-specific probabilities of initiating HPV vaccinations for boys/men and girls/women across four racial/ethnic groups: non-Latinx (NL) white, NL-Black, Latinx, and NL-Asian American. Multinomial logistic regression models-with on-time vaccination as the base outcome-examined the timing of initiating HPV vaccinations (never or late) in the 2011-2016 National Health and Nutrition Examination Survey (NHANES). This study finds that the multiplicative interaction term between gender and race/ethnicity produces significant results in the likelihood of initiating HPV vaccine uptake: NL-Asian American boys/men have the highest risk of not vaccinating on time. This finding would have been hidden with a one-dimensional analysis.

Adolescent Technology, Sleep, and Physical Activity Time in Two US Cohorts.

The advent of internet-enabled mobile digital devices has transformed US adolescent technology use over the last decade, yet little is known about how these changes map onto other health-related behaviors. We provide a national profile of how contemporary technology use fits into adolescents' daily health lifestyles compared to the previous generation, with particular attention to whether and for whom technology use displaces time spent in sleep or physical activity. Time diaries were collected from 11-17 year olds in 2002-03 (N=1,139) and 2014-16 (N=527) through the US Panel Study of Income Dynamics Child Development Supplement. Contemporary adolescents spent 40 minutes more per week in technology-focused activities, but their composition was more varied compared to the earlier cohort. Contemporary technology use was predictive of less time in physical activity, and adolescents engaged in frequent video game play spent less time in physical activity compared to peers with other technology use profiles.