Date of Conferral

2018

Degree

Ph.D.

School

Health Services

Advisor

Ji Shen

Abstract

The human papilloma virus (HPV) is the most frequent cause of sexually transmitted diseases (STDs) and cancers for U.S. adults. The Affordable Care Act (ACA), enacted in 2010, eliminated copay expenses for childhood immunizations and expanded access to health care. The purpose of this secondary data analysis study was to determine if there was an association between ACA and the usage of HPV vaccine among adolescent females in Georgia. Data concerning HPV vaccinations from 2011 to 2015 were obtained from the National Immunization Survey-Teen dataset. Andersen's BM of health care use was applied to ascertain the factors that enhanced the usage of HPV vaccine. Multiple logistic regression analysis was used to determine if there was any association between ACA and HPV vaccination. The study results showed a significant association between ACA and provider visit (p<.05). Also, provider visit was significantly associated with HPV vaccination rate (p<.05). Adolescent females with health insurance had a higher rate of provider visit after the passage of ACA. From 2011 to 2015, 87.2% of insured adolescent females visited their provider. The rate of HPV vaccination increased among the insured adolescent females who visited the provider from 35.3% in 2011 to 53.9% in 2015. Provider visit was identified as the most influencing factor that enhanced usage of HPV vaccine. The knowledge gained from the results contributed to social change by providing insight on how, through increased provider visits, ACA has improved the HPV vaccination rate among teenage females in Georgia. The conclusion will assist in developing effective strategies and policies that will achieve the Healthy People 2020 goal of 80% of herd immunity against HPV.

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