HPV Vaccine Coverage in Texas Counties: An Application of Multilevel, Small Area Estimation
Source: University of Texas School of Public Health Cancer Education and Career Development Program (R25CA057712)
Period: May 2007-January 2011
Role: Predoctoral Fellow
The purpose of this study is to describe the county-level geographic distribution of human papillomavirus (HPV) vaccine coverage among adolescent females in Texas using multilevel small area estimation.
Local data on HPV vaccine coverage are important for planning health promotion programs, identifying target populations for services and evaluating the impact of policies and programs designed to improve vaccine uptake. National health surveys provide much of the data used to conduct population-based public health research in the United States. Whereas these surveys provide estimates at the national, state and sometimes county levels, their ability to provide local estimates is limited owing to costs, sample size constraints and privacy protections. Thus, researchers often rely on small area estimation (SAE), a set of indirect estimation techniques for producing small area estimates using data collected for larger areas and census tabulations for the small area of interest. This study used multilevel, SAE to describe the county-level geographic distribution of HPV vaccine coverage (≥1 dose HPV4) among females aged 11 to 17 years living in Texas. The methodological framework used can be used by other researchers to analyze their own health outcome(s) of interest using a variety of national and state-based population surveys.
Eberth JM, Hossain Md M, Tiro JA, Zhang X, Holt J, Vernon SW. Human papillomavirus vaccine coverage among females aged 11 to 17 in Texas counties: an application of multilevel, small area estimation. Women’s Health Issues. 2013 Mar; 23(2):e131-141. DOI: 10.1016/j.whi.2012.12.005. PMCID: PMC3850179.
Eberth JM, Zhang X, Hossain Md M, Tiro JA, Holt JB, Vernon SW. County-level estimates of human papillomavirus vaccine coverage among young adult women in Texas, 2008. Texas Public Health Journal. Winter 2013; 65(1):37-40. PMCID: PMC3901306.
Eberth JM, Hossain Md M, Vernon SW, Tiro JA. A demonstration of multilevel, small area modeling: estimating HPV vaccine coverage in Texas counties. Annals of Epidemiology. 2010 September;20(9):718.
Eberth JM, X Zhang, J Holt, JA Tiro, SW Vernon, Hossain Md M. A demonstration of multilevel, small area modeling: estimating HPV vaccine coverage in Texas counties. American College of Epidemiology Meeting. San Francisco, CA. 2010 Sep. [Poster]