Interventions to Increase HBV Vaccination in STD Clinics

增加性病诊所乙肝疫苗接种的干预措施

• 批准号: 6553324
• 负责人: GREGORY D. ZIMET
• 金额: $ 60.23万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-05 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6553324
• 关键词: active immunization; behavior prediction; behavioral /social science research tag; clinical research; communicable disease control; educational resource design /development; health behavior; health education; hepatitis B virus group; hepatitis vaccine; human subject; human therapy evaluation; therapy compliance

DESCRIPTION (provided by applicant): The objective of this study is to evaluate interventions to increase acceptance of, and follow through with, hepatitis B virus (HBV) immunization among patients attending sexually transmitted disease (STD) clinics in Chicago, IL and Indianapolis, IN. This research will have implications for the design of interventions that may increase HBV vaccine uptake in at-risk groups. The interventions may also be applicable to other STD vaccines as they become available. The first specific aim is to assess the effect of message framing on vaccine acceptance. Prospect theory will be used to guide the development of the message-framing interventions. This theory suggests that positively framed messages (i.e., benefits of getting vaccine) are more effective than negatively framed messages (i.e., dangers of not getting vaccine) in stimulating preventive health behaviors. Research on Prospect Theory and engagement in health behaviors suggests also that the effects may be moderated by other attitudinal factors, including perceived risk of the behavior and degree of involvement in the message. The second aim is to evaluate the effect of provider-based interventions. Prior research suggests that recommendations by health providers are very important in patients' decisions regarding acceptance of healthcare procedures. The third aim is to examine the effect of the interventions on follow-through with the second and third recommended vaccination. During Year 1 of the proposed plan, the message framing interventions will be developed and pilot tested and healthcare providers in Chicago and Indianapolis will be trained in the provider-based interventions. During Years 1-5, 3,344 patients (18 years and older) will be recruited and followed from Chicago and Indianapolis STD clinics during routine medical visits. An audio computer-assisted self-interview (A-CASI) will cover demographics, risk behaviors, and perceived risk associated with vaccination. Subjects then will be randomized to receive a gain-framed, loss-framed, or information only message regarding HBV immunization (also delivered by A-CASI). Upon completion of the message-framing intervention, subjects will be complete additional attitude questions via A-CASI, then will be randomly assigned to one of two provider intervention conditions: 1. vaccine-offered or 2. vaccine-recommended. For both conditions free HBV immunization will be provided by a nurse practitioner. Debriefing interviews will be carried out. Subsequently, postcard reminders will be sent and phone call reminders made for follow-up appointments for those receiving the first and second doses of vaccine. Outcome measures of interest include: (1) acceptance vs. rejection; (2) compliance with two doses vs. one dose only; and (3) completion of immunization vs. two doses only. The relationships of the interventions, socio-demographics, attitudes and behaviors to the outcome measures will be assessed with multiple logistic regression (MLR) and path analysis via structural equation modeling.

描述（由申请人提供）：这项研究的目的是评估干预措施，以增加对参加性传播疾病（STD）诊所（IL和印第安纳波利斯）的性传播疾病（STD）诊所的乙型肝炎病毒（HBV）免疫接种。 这项研究将对可能增加高危组中HBV疫苗的摄取的干预措施的设计产生影响。 干预措施也可能适用于其他性病疫苗可用的。 第一个具体目的是评估消息框架对疫苗接收的影响。 前景理论将用于指导框架干预措施的发展。该理论表明，积极的框架信息（即获取疫苗的好处）比构成构造的消息（即未获取疫苗的危险）在刺激预防健康行为方面更有效。 对前景理论和对健康行为的参与的研究还表明，这种影响可能会受到其他态度因素的调节，包括感知的行为风险和参与信息的程度。第二个目的是评估基于提供者的干预措施的效果。 先前的研究表明，健康提供者的建议在患者有关接受医疗保健程序的决定中非常重要。 第三个目的是检查干预措施对第二和第三建议疫苗接种的影响。 在拟议计划的第1年中，将制定信息框架干预措施，并在芝加哥和印第安纳波利斯的医疗保健提供者进行试点测试，并将在基于提供者的干预措施中接受培训。 在1 - 5年内，在常规医疗就诊期间将招募3,344例患者（18岁及以上），并从芝加哥和印第安纳波利斯性病诊所招募并遵循。 音频计算机辅助的自我面试（A-CASI）将涵盖人口统计，风险行为以及与疫苗接种相关的风险。 然后，受试者将被随机分配以接收有关HBV免疫的增益，损失或信息的信息（也由A-CASI提供）。 消息框架干预完成后，受试者将通过A-CASI完成其他态度问题，然后将其随机分配给两个提供者干预条件之一：1。疫苗或2个。疫苗征收。 对于这两种情况，护士从业者将提供免费的HBV免疫。 将进行汇报采访。 随后，将发送明信片的提醒，并致电提醒，以便为接受第一剂和第二剂疫苗的人进行后续约会。 感兴趣的结果度量包括：（1）接受与拒绝； （2）仅遵守两剂与一剂的符合； （3）仅完成免疫和仅两剂。通过多个逻辑回归（MLR）（MLR）和路径分析，通过结构方程建模来评估干预措施，社会人口统计学，态度和行为的关系。