Abstract Background: American Indian and Alaska Native (AIAN) populations face disproportionately high rates of HPV-related cancers and mortality, with the lowest HPV vaccination coverage (≥1 dose) among adolescents of all racial-ethnic groups. Barriers include vaccine misinformation, mistrust in healthcare systems, and a lack of culturally relevant communication. Few interventions have addressed these issues using community-engaged, multilevel strategies in primary care. This study explored provider-level barriers within a Tribal Health Program (THP) operating nine clinics in Southern California to inform a culturally grounded, narrative-based intervention to improve HPV vaccine uptake among AIAN adolescents. Methods: This community-based participatory research (CBPR) pilot used qualitative methods to assess provider perspectives in partnership with Tribal Health Program (THP) leadership and guided by a Community Advisory Board (CAB) of AIAN parents, community members, and clinic staff. CAB members helped shape study goals, co-develop interview guides, and advise on recruitment and culturally appropriate implementation. Tribal leadership supported planning and implementation to ensure smooth provider engagement. Twelve virtual interviews were conducted with THP providers and staff. Interviews were recorded, transcribed, and analyzed in Atlas.ti using team-based coding and intercoder agreement to identify culturally relevant themes. Results: The 12 providers and staff participants included medical assistants, pediatric nurse practitioners, and a pediatrician working across several THP clinics. Findings highlighted key challenges, including limited provider training on culturally appropriate communication, uncertainty about how to address HPV vaccine misinformation, and difficulty navigating sensitive topics such as the association of the vaccine with sexual activity. Participants stressed the importance of culturally grounded materials and communication strategies that center cancer prevention. As part of the CBPR process, findings from the provider interviews will be shared with the CAB and Tribal health leadership to validate interpretations, ensure cultural relevance, and inform next steps for intervention development. Conclusions: This pilot study demonstrates the importance of integrating clinic voices through CBPR to inform HPV vaccine uptake strategies in AIAN communities. Engaging Tribal leadership and a CAB reflects both community priorities and systems-level support. Findings will guide the development of a multilevel clinic-based intervention that incorporates narrative messages, provider communication training, and educational materials grounded in AIAN cultural values. This work will inform a future NIH grant proposal and contribute to efforts to reduce HPV-related cancer disparities in AIAN communities through culturally centered, equity-driven implementation science. Citation Format: Claradina Soto, Morgan Gill, Jennifer Tsui. Identifying HPV vaccination barriers in tribal healthcare settings: A community-partnered qualitative study among providers serving American Indian and Alaska Native families abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B066.
Soto et al. (Thu,) studied this question.
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