PCOM2 - The Physician Communication Intervention, Version 2.0

PCOM2 - 医生沟通干预，版本 2.0

• 批准号: 10367487
• 负责人: Sean T O'Leary
• 金额: $ 58.62万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-15 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10367487
• 关键词: 12 year old; Address; Adolescent; Affect; Age; Anogenital cancer; Anogenital venereal warts; Cervical; Characteristics; Clinical; Cluster randomized trial; Communication; Cost Analysis; Custom; Data; Disease; E-learning; Educational process of instructing; Ensure; Failure; Fostering; Geography; Goals; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papilloma Virus-Related Malignant Neoplasm; Human Papillomavirus; Human papilloma virus infection; Infection prevention; Intervention; Kansas; Lead; Libraries; Link; Locales; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Manuals; Methods; Motivation; Pap smear; Parents; Patients; Physicians; Population; Practical Robust Implementation and Sustainability Model; Primary Health Care; Process; Provider; Public Health; Randomized; Randomized Clinical Trials; Recommendation; Reporting; Research; Risk; Rural; Series; Services; Sexually Transmitted Diseases; Techniques; Testing; Trainers Training; Training; Translating; Treatment Efficacy; Vaccinated; Vaccination; Vaccines; Vagina; Virus; Work; care providers; comparative effectiveness trial; comparative efficacy; contextual factors; dissemination science; implementation science; improved; malignant oropharynx neoplasm; motivational enhancement therapy; patient population; penis; prevent; prototype; recruit; vaccine acceptance; vaccine hesitancy; virtual; virtual intervention

PROJECT SUMMARY/ABSTRACT Human Papillomaviruses (HPV) infect >90% of the population and cause >30,000 cervical, anogenital, and oropharyngeal cancers annually. HPV vaccines have been available in the US since 2006 but only 54% of 11- 12 years-olds are vaccinated - well below national goals of 80%. As the title of the PAR to which this applica- tion responds suggests (PAR-19-360), “Linking the Provider Recommendation to Adolescent HPV Vaccine Up- take” is a key strategy for increasing adolescent HPV vaccination. Many studies show that a primary driver of low adolescent HPV vaccination is a poor quality HPV vaccine recommendation from providers. While many interventions to address this have been developed, few have been found in rigorous trials to increase vaccina- tion and also be feasible to implement in busy clinical settings. An exception is the Physician Communication, or PCOM, intervention developed by our group. PCOM focuses on teaching providers to use a 2-step verbal communication process for their recommendation:1) start the vaccine discussion using a “presumptive” format (i.e. “Let's get the HPV vaccine done today”) and 2) use motivational interviewing (MI) techniques to address parental vaccine hesitancy, if needed. In a large, cluster-randomized trial, PCOM increased adolescent HPV vaccine initiation rates among 11-12 year olds by 8 percentage points (PP) more than controls– a relatively large effect size for a vaccination intervention. Limiting broad dissemination of PCOM is the significant level of research team facilitation needed to teach practices how to use the PCOM components. To address this, we propose to develop a “Virtual” version of the PCOM intervention (“PCOM-Virtual”) and test it for non-inferiority to the original PCOM intervention (“PCOM-Standard”) for increasing adolescent HPV vaccination. By using Dissemination & Implementation (D&I) science principles throughout the process and collecting information on how contextual practice, provider and patient factors influence PCOM use, we anticipate creating a “shelf ready” version of PCOM with an associated “User Manual” to foster dissemination. Our Aims are to: 1. Develop the “PCOM-Virtual” intervention using principles of D&I Science from existing prototypes. 2. Compare the efficacy of “PCOM-Virtual” vs. “PCOM-Standard” in improving adolescent HPV vac- cine utilization. A cluster-randomized non-inferiority trial will be conducted in 30 primary care practices in Kansas – a locale with some of the lowest adolescent HPV vaccination rates nationally. 3. Examine whether practice, patient and provider characteristics are associated with variability in the efficacy of PCOM-Virtual and PCOM-Standard. Mixed methods and the PRISM framework will facili- tate understanding how context influences the interventions' implementation to inform a User Manual. By creating an easily implementable version of the PCOM intervention, and disseminating it widely we believe we can have a substantial impact on adolescent HPV vaccination levels.

项目摘要/摘要 人类乳头瘤病毒（HPV）感染了> 90％的人口，导致30,000个颈椎，肛门生殖器和 每年口咽癌。自2006年以来，美国已在美国使用HPV疫苗，但只有11--11- 12岁的人接种疫苗 - 远低于80％的国家目标。作为此应用程序的标题 - Tion反应表明（Par-19-360），“将提供商的建议与青少年HPV疫苗联系起来 取”是增加青少年HPV疫苗接种的关键策略。许多研究表明， 青春期低的HPV疫苗是提供商质量较差的HPV疫苗建议。而很多 已经开发了解决此问题的干预措施，在严格的试验中很少有人发现疫苗 在繁忙的临床环境中实施，也是可行的。例外是医师的沟通， 或PCOM，我们小组开发的干预措施。 PCOM专注于教授提供者使用2步口头 他们建议的沟通过程：1）使用“假定”格式开始疫苗讨论 （即“让我们立即完成HPV疫苗”）和2）使用动机采访（MI）技术来解决 父母疫苗犹豫不决。在大型群集随机试验中，PCOM增加了青少年HPV 11-12岁的疫苗启动率比对照多8个百分点（PP） - 相对较高 疫苗接种干预的效果大小。限制PCOM的广泛传播是显着的水平 研究团队的促进需要教授实践如何使用PCOM组件。为了解决这个问题，我们 提出开发PCOM干预（“ PCOM-VIRTUAL”）的“虚拟”版本并进行非效率测试的建议 用于增加青少年HPV疫苗接种的原始PCOM干预措施（“ PCOM标准”）。通过使用 整个过程中的传播与实施（D＆I）科学原则，并收集有关 上下文实践，提供者和患者因素如何影响PCOM的使用，我们预计创建一个“货架 PCOM的Ready”版本带有相关的“用户手册”，以促进传播。我们的目的是： 1。使用现有原型的D＆I科学原理开发“ PCOM-VIRTUAL”干预措施。 2。比较“ PCOM-VIRTUAL”与“ PCOM标准”在改善青少年HPV vac-的效率 电影利用率。将在30种初级保健实践中进行集群随机试验 堪萨斯州 - 全国青少年HPV疫苗接种率最低的地方。 3。检查练习，患者和提供者特征是否与可变性有关 PCOM-VIRTUAL和PCOM标准的效率。混合方法和棱镜框架将促进 泰特（Tate）理解上下文如何影响干预措施的实现以告知用户手册。 通过创建易于实现的PCOM干预版本，并广泛地将其传播 我们可以对青少年HPV疫苗接种水平产生重大影响。