PROJECT SUMMARY In the US, human papillomavirus (HPV) vaccines have the potential to prevent 33,700 HPV cancers each year, but vaccine coverage rates remain low in the southeast, which has the highest rates of HPV-related cancers. Vaccination rates are particularly low in Alabama. Vaccines for Children (VFC), a program administered by the Centers for Disease Control and Prevention (CDC), provides free vaccines for administration to children under 18 years and who are enrolled in Medicaid or are uninsured. Adults aged 19- 45 enrolled in Medicaid or uninsured are eligible to receive free HPV vaccine through the Family Planning Program of the Alabama Department of Public Health (ADPH). To improve the benefits of these programs in Alabama’s Barbour, Bullock, Lowndes, and Macon Counties, we will conduct a health communication campaign targeting adults ages18 and older to explore the use of these programs through primary care physicians and local health centers as HPV vaccination sites. We have developed an electronic application (app), Protect Me from HPV, to help participants access information about HPV and HPV-related cancers, and to complete surveys. The Apple store and the office of External Affairs and General Counsel at Tuskegee University (TU), approved the app. Patent acquisition for this application is in progress. We developed an anonymous 44-item survey to identify barriers/facilitators to HPV vaccination, it will be distributed within these counties by TU specific-investigators, 2 primary care physicians, and 9 local health centers, which were identified in these counties through the ADPH as VFC and Family Planning Programs providers. From each facility, 5-15 physicians, nurses, and staff members will be invited to complete the survey, which will include questions covering general services offered, current HPV vaccines administered and frequency of administration, workflows supporting vaccination and participation in these programs, whether/how they recommend the HPV vaccine, how their patients currently obtain such vaccines and barriers/facilitators to HPV vaccination. Second, we will utilize 70-item-pre- and 63-item-post-surveys during short and long-term educational interventions. This study will take place in each county. We will use results from the analysis of initial surveys from a one-day short-term educational intervention to revise the educational strategies based on participants’ feedback. In each county, a 2nd 63-item post-survey will be administered 3 months after the first workshop and once a year for 4 years in each county to evaluate the effect of long-term education intervention. During this period, HPV health communication campaigns targeting participants will be continued. Third, the feasibility test will allow us to identify areas for improvement of the app. Our goal is to improve HPV vaccination rates in Alabama’s Black Belt Counties (BBCs). The proposed research will provide a foundation to explore the use of community pharmacies as HPV vaccination sites via federally funded programs in BBCs. (See the attached IRB approval).