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S30 Poster Abstracts / 48 (2011) S18–S120

HPV vaccine receipt; and HCP recommendation of the HPV vac-cine was associated with about 18 times the adjusted odds ofHPVvaccine receipt. In separatemultivariable analyses adjustingfor 11 covariates, adolescent females who were African-Ameri-can, had parents whowere not high-school graduates, were un-insured, had no preventive visit in the past year, and lived in theMidwestern, Southern, or Western regions of the US had loweradjusted odds of an HCP recommendation for HPV vaccination.Adolescent females who received the tetanus/TD/Tdap or men-ingitis vaccines and who have a personal doctor or nurse hadabout double the adjusted odds of receiving an HCP recommen-dation for HPV vaccination.Conclusions: Most adolescent females have not received theHPV vaccine. HCP recommendation has a significant impact onreceipt of the HPV vaccine in adolescent females. African-Amer-ican race, lower parental educational attainment, uninsurance,no preventive visits in the past year, and certain US regions areassociatedwith lower odds of HCP recommendation for theHPVvaccine. HCP recommendation of the HPV vaccination may sub-stantially improve HPV vaccination rates in adolescent females.Sources of Support: None.

24.

INTERVENTION DEVELOPMENT TO IMPROVE ADOLESCENTS’EXPERIENCE OF SCHOOL-BASED HPV VACCINATIONSpring Cooper Robbins, PhD, S. Rachel Skinner,MBBS PhD FRACP, Kate Mahendran, MPH.The University of Sydney

Purpose: Australia has implemented a nation-wide programproviding HPV vaccine to year 7 girls (aged 11-12 years)through schools. There are few published studies that explorevaccination from an adolescent perspective. Our previous re-search identified three distinct areas as salient to the adoles-cents’ experience: 1) lack of understanding about HPV andHPV vaccination; 2) adolescent desire for involvement in de-cision-making about HPV vaccination; and 3) fear of HPV vac-cination. We aimed to develop an intervention to addressadolescents’ fear and their low levels of understanding andpromote involvement in consent.Methods: Formative qualitative research was conducted inpublic, private, and Catholic schools in the Sydney area. Youngadolescent girls were interviewed in focus groups, and teach-ers and parents were interviewed individually. Content anal-ysis was used to identify important gaps in understanding andskills and the best way to promote understanding, and self-efficacy with vaccination in an intervention linked to school-based vaccination.Results:Various strategies for achieving a quality interventionaimed at adolescents will be presented. Formative data fromour research explains adolescents’ contributions to the designof amulti-level intervention linked to schools; teachers’wantsand needs of supportive materials, and parental attitudes andneeds toward supportive materials.Conclusions:Weare in the first stages of evaluating themateri-als developed through this formative work. This is some of thefirstwork inHPV school-based vaccination to be basedpurely onidentified adolescent needs that then responds to these needs by

directly involving the adolescents in intervention development.

ources of Support: Partial funding in the form of an unre-tricted research grant fromGSK.More funding is pending anday need to be reported by the time of the conference.

SESSION I: HEALTH SERVICES AND PROVIDERBEHAVIOR

25.

RACIAL/ETHNIC DISPARITIES AMONG US ADOLESCENTS INMEDICAL AND ORAL HEALTH, ACCESS, AND USE OF SERVICES:WHAT ARE THE TRENDS OVER TIME?May Lau, MD, MPH2, Rosa Avila, MSPH1, Huain, PhD2, Glenn Flores, MD2. 1National Centeror Health Statistics 2University of Texas -Southwestern

Purpose: Little is known about racial/ethnic (R/E) disparitiesin health and healthcare of adolescents and whether thesedisparities have changed over time. The goal of this study wasto examine adolescent R/E disparities in medical and oralhealth, access to care, and use of services, and to determinewhether these disparities changed over time.Methods: The National Survey of Children’s Health was a ran-dom-digit-dial telephone survey conducted by the NationalCenter for Health Statistics in 2003 and 2007 of a nationallyrepresentative sample of households with children 0-17 yearsold. Interviews were conducted in English or Spanish. Dispar-ities were examined for 40 measures of medical and oralhealth, access, and use of services for all youth 10-17 years oldin both survey waves. Bivariable and multivariable analyseswere used to identify disparities in African American (AA),Latino (L), Asian/Pacific Islander (API), American Indian/AlaskaNative (AI/AN), and multiracial (MR) youth compared withwhites. Z-scores to be used to examine time trends from 2003to 2007.Results: Data were available for 94,729 youth. Significant dis-paritieswere noted formanymeasures in the 2007wave. Afteradjusting for eight socioeconomic factors in multiple logisticregression analyses of the 2007 wave, persistent disparitieswere noted for one or more R/E minority groups. For example,compared to white adolescents, minority adolescents weremore likely to have the following: suboptimal health statusand teeth condition, overweight/obesity, no health insurance,nopersonal doctor or nurse (PDN), insufficient time spentwithhealthcare providers, problems obtaining specialty care, andno specialty or mental health care in the past year. Comparedwith white youth in 2007, L, AA, and MR youth had aboutdouble the odds of suboptimal health status and teeth condi-tion, and L, AA, AI/AN, and MR youth had significantly greaterodds of being uninsured and having no PDN. Certain dispari-ties were especially prominent for specific R/E groups: for Ls,having suboptimal health status; for AAs, having suboptimalteeth condition, being overweight/obese, and having sporadicinsurance; for APIs, having no specialty andmental health carein the past year; for AI/ANs, needing more medical care thanothers, having behavior problems, no health insurance, noPDN, insufficient time spent with healthcare providers, andproblems getting specialty care; and for MR youth, having

asthma and ADHD.Most R/E health and health care disparities

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S31Poster Abstracts / 48 (2011) S18–S120

persisted between 2003 and 2007, and two significantlywors-ened: problems obtaining specialty care in AAs, and ADHD inMRs.Conclusions: US adolescents experience many R/E disparitiesn medical and oral health, access to care, and use of services.lmost all disparities persisted over time, and someworsened.he study findings may be useful in directing future researchnd targeting policy to eliminate adolescent R/E disparities inealth and healthcare.ources of Support: None.

26.

THE PRIMARY LANGUAGE SPOKEN AT HOME ANDDISPARITIES IN MEDICAL AND ORAL HEALTH, ACCESS TOCARE, AND USE OF SERVICES IN US ADOLESCENTS: HASANYTHING CHANGED OVER THE YEARS?May Lau, MD, MPH2, Rosa Avila, MSPH1, Huain, PhD2, Glenn Flores, MD2. 1National Centeror Health Statistics 2University of Texas -Southwestern

Purpose: Little is known about disparities and their trendsver time in adolescents from non-English-primary-languageNEPL) homes compared with adolescents from English pri-ary-language (EPL) homes, and even less is known aboutisparities amongNEPL adolescents. The goal of this studywaso examine disparities and their trends over time in medicalnd oral health, access to care, and use of health services inEPL adolescents.ethods: TheNational Survey of Children’s Health, conductedy the National Center for Health Statistics, was a random-igit-dial telephone survey in 2003 and 2007 of a nationallyepresentative sample of households with children 0-17 yearsld. From each household, a single child was selected at ran-omas the index child for the survey. Bivariable andmultivari-ble analyses were performed for all adolescents 10-17 yearsld to identify disparities in 40 measures of medical and oralealth, access to care, and use of services. AmongNEPL adoles-ents, sub-analyses compared Latinos, Asian/Pacific IslandersAPIs), and whites. Z-scores were used to analyze time trendsn disparities from 2003-2007.esults: Data were available on 94,729 adolescents in bothurvey waves. In multivariable analyses adjusting for eightociodemographic factors, NEPL (vs. EPL) adolescents in 2007ad significantly greater adjusted odds of suboptimal healthtatus and teeth condition, no health insurance, no personaloctor/nurse (PDN), and no specialist and routine preventiveental visit in the past year. In a 2007 sub-analysis, comparedithNEPLwhite adolescents, NEPL Latinos had greater odds ofuboptimal health status (odds ratio [OR], 4.8; 95% confidencenterval [CI], 2.5-9.9) and teeth condition (OR, 2.4; 95% CI,.1-5.4), no health insurance (OR, 2.7; 95% CI, 1.1-6.5), andnmet dental care needs (OR, 16.2; 95% CI, 1.7-154.1); NEPLPIs had greater odds of nomental health visit in the past yearOR, 7.2; 95% CI, 1.4-36.3); and NEPL Latinos and APIs hadreater odds of no PDN (OR, 3.9; 95% CI, 1.5-10.1; OR, 5.7; 95%I, 1.4-22.8) and nopreventive dental care in the past year (OR,.7; 95% CI, 1.4-15.4; OR, 4.4; 95% CI, 1.2-16.1). Almost allisparities for NEPL (vs. EPL) adolescents persisted between

003 and 2007. Two disparities significantly worsened, NEPL

vs. EPL) adolescents needing more medical care than others,nd for NEPL Latinos (vs. whites), having ADHD.onclusions: NEPL adolescents experience multiple dispari-ies inmedical and oral health, access to care, and use of healthervices, and almost all disparities persisted over time. Com-aredwithNEPLwhite adolescents, NEPL Latinos andAPIs alsoace many disparities, most of which have continued overime. Results of this study may help guide policy to improveealth and healthcare disparities in NEPL adolescents, includ-ng reducing language barriers.ources of Support: None.

27.

YOU CAN HELP PEOPLE: ADOLESCENTS’ VIEWS ON ENGAGINGYOUNG PEOPLE IN LONGITUDINAL RESEARCHSpring Cooper Robbins, PhD, MargotRawsthorne, Karen Paxton, BHealth Science,Catherine Hawke, S. Rachel Skinner, MBBS, PhD,FRACP, Katharine Steinbeck, MBBS, PhD, FRACP.The University of Sydney

Purpose: We sought to discover adolescents’ thoughts aboutparticipation in longitudinal research and to identify recruit-ment and retention strategies that were meaningful to them.Methods: We conducted 7 focus groups with 10-15 year olds(mixed and single gender) in two large rural centers in thestate of New South Wales, Australia. All focus groups andinterviews were digitally recorded, transcribed verbatim, andanalyzed by the research team.Results: Adolescents discussed both external and internal fac-tors thatwere salient to their involvement in the focus groups,as well as factors that may influence their involvement in alarger longitudinal study. Adolescents had a positive view ofresearch at the outset of the focus groups butwere reluctant toengage in research that involved collection of biological spec-imens.Conclusions: Effective recruitment of adolescents requires anappreciation of motivators, as well as time and resources toextend potential participants’ understanding.Sources of Support: NHMRC.

28.

PEDIATRIC RESIDENT KNOWLEDGE OF ADOLESCENTMEDICINE AND RELATIONSHIP TO SELF-EFFICACYJennifer Woods, MD, MS3, Tracie Pasold, PhD4,eatrice Boateng, PhD2, Devon Hensel, PhD1.

1Indiana University School of Medicine 2UAMS3University of Arkansas for Medical Sciences4University of Arkansas for Medical Sciences/Arkansas Children’s Hospital

Purpose:Residentmedical knowledge is commonlymeasuredwith achievement tests, but assessment in an actual clinicalsetting is often limited. The objective of this researchwas (1) toassess pediatric resident knowledge during two adolescentmedicine educationmodules and (2) to compare resident self-efficacy with knowledge levels.Methods: Pediatric residents (n � 24) beginning their adoles-

cent medicine rotation participated in an adolescent medi-