Project 2: Testing Multi-Level Interventions to Improve HPV Vaccination

项目 2：测试多层次干预措施以改善 HPV 疫苗接种

基本信息

批准号：
10381631
负责人：
ELECTRA D. PASKETT
金额：
$ 24.33万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-11 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10381631
关键词：
12 year old 21 year old Address Adolescent and Young Adult Affect Age American Anogenital venereal warts Anus Appalachian Region Attitude Cancer Etiology Centers for Disease Control and Prevention (U.S.)Cervical Cervix Uteri Child Clinic Clinical Communities Cost of Illness Direct Costs Disease Exposure to Female Focus Groups Health Health Care Costs Health Personnel Health system Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Human Papilloma Virus-Related Malignant Neoplasm Human Papillomavirus Human papilloma virus infection Incidence Infection prevention Influentials Interdisciplinary Study Intervention Knowledge Low Income Population Malignant neoplasm of cervix uteri Meningococcal vaccine Neisseria meningitidis Oropharyngeal Outcome Parents Patients Persons Population Prevention Prevention program Process Provider Randomized Recommendation Rectum Recurrence Research Risk Savings Series Site Subgroup Surveys Testing Time Treatment-Related Cancer Underserved Population United States Vaccination Vaccines Vagina Vulva Woman age group aged base burden of illness cancer prevention cervical cancer prevention chronic infection cost effective intervention effectiveness evaluation effectiveness outcome effectiveness testing implementation framework implementation study implementation trial improved intervention program male men mortality penis prevention service primary outcome programs respiratory satisfaction secondary outcome social health determinants therapy design underserved area uptake vaccine acceptance young adult

项目摘要

PROJECT SUMMARY – PROJECT 2 Prior research has demonstrated that health care provider recommendation is the most influential factor affecting HPV vaccine uptake and completion among adolescents and young adults. However, many providers are not recommending the vaccine at opportunistic times such as the targeted ages of 11-12 when most children receive Tdap and meningococcal vaccines. To improve the uptake of the HPV vaccine among 11-12 year olds – the age group of focus for the Centers for Disease Control and Prevention (CDC) – a multi-disciplinary research team across four Appalachian states will test the effectiveness of a health system-based intervention, as part of an integrated clinic-based cervical cancer prevention program (with Projects 1 and 3), that is directed to three levels of influence – clinic, provider, and patient. Using a delayed intervention design in a group randomized implementation trial, we will examine outcomes of effectiveness, acceptability, and sustainability along the Implementation Science Framework. We will also test in a secondary aim whether interventions targeted to the 13-26 year olds increases catch-up vaccination. This study is part of the Program Project, “Improving Uptake of Cervical Cancer Prevention Services in Appalachia,” and as such, is intricately integrated with the Cores of the Program. The interventions to be tested have been developed in conjunction with community partners, address multi-level factors within the Social Determinants of Health that impact disparities in HPV-related disease, and have been piloted in Appalachian populations. Specific aims are to: 1) Primary Outcome: Test the effectiveness of a multi-level intervention directed at clinics, providers, and patients (parents of children aged 11-12) to improve HPV vaccine initiation and completion in health systems in four Appalachian states (KY, OH, WV, and VA) among children aged 11-12, and assess the effectiveness of the intervention program among subgroups, e.g., females vs males; 2) Secondary Outcomes: Assess: a) sustainability of the intervention; b) cost impacts of the intervention; c) changes in clinic practices that occur as a result of the intervention in terms of staff responsibilities for the vaccination process and reducing missed opportunities for vaccination; and d) whether interventions directed to 13-26 year olds increases catch-up vaccination; and 3) Secondary Outcomes: Examine: a) changes in knowledge and attitudes of providers via educational session pre-post surveys and b) satisfaction with the intervention at the multiple levels. If effective, this multi-level intervention will be disseminated to our clinical and community partners as well as other partners throughout Appalachia to facilitate the uptake of effective interventions throughout health systems and clinics in Appalachia to help reduce the burden of HPV-preventable diseases.

项目摘要 – 项目 2 先前的研究表明，医疗保健提供者的推荐是影响健康的最有影响力的因素。青少年和年轻人的 HPV 疫苗接种和完成情况然而，许多提供者并未做到这一点。建议在机会时期接种疫苗，例如大多数儿童接种疫苗的目标年龄为 11-12 岁 Tdap 和脑膜炎球菌疫苗。提高 11-12 岁儿童对 HPV 疫苗的接种率。疾病控制与预防中心 (CDC) 的重点小组——一个多学科研究小组作为一项计划的一部分，阿巴拉契亚四个州将测试基于卫生系统的干预措施的有效性基于临床的宫颈癌综合预防计划（项目1和项目3），针对三个层次影响力——诊所、提供者和患者在随机分组中使用延迟干预设计。实施试验后，我们将审查实施过程中的有效性、可接受性和可持续性的结果我们还将测试次要目标干预措施是否针对 13-26 岁的人增加了补种疫苗接种的机会本研究是“提高疫苗接种率”计划项目的一部分。阿巴拉契亚的宫颈癌预防服务”因此与该项目的核心错综复杂地结合在一起。待测试的干预措施是与社区合作伙伴共同制定的，地址健康社会决定因素中影响 HPV 相关疾病差异的多层次因素，以及已在阿巴拉契亚人群中进行试点，具体目标是： 1) 主要成果：测试有效性。针对诊所、提供者和患者（11-12 岁儿童的父母）进行多层次干预，以改善四个阿巴拉契亚州（肯塔基州、俄亥俄州、西弗吉尼亚州和弗吉尼亚州）卫生系统中 HPV 疫苗的启动和完成 11-12 岁儿童，并评估干预计划在亚群体（例如女性）中的有效性与男性相比；2) 次要结果：评估：a) 干预措施的可持续性；b) 干预措施的成本影响； c) 因工作人员职责方面的干预而发生的临床实践变化； d) 是否采取干预措施，以促进疫苗接种过程并减少错过疫苗接种的机会；针对 13-26 岁的人群增加补种疫苗接种；以及 3) 次要结果：检查：a) 变化 b) 通过教育课程前调查了解提供者的知识和态度，以及 b) 对服务的满意度如果有效的话，这种多层次的干预将传播到我们的临床和临床。社区合作伙伴以及整个阿巴拉契亚地区的其他合作伙伴，以促进有效性的吸收阿巴拉契亚地区整个卫生系统和诊所的干预措施，以帮助减轻可预防的 HPV 的负担疾病。