Physicians' Intentions to Administer HPV Vaccine

医生接种 HPV 疫苗的意图

• 批准号: 8073054
• 负责人: ANDRZEJ KULCZYCKI
• 金额: $ 7.25万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-15 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8073054
• 关键词: 12 year old; Acute; Adherence; Adopted; Adoption; Advisory Committees; Age; Alabama; Anogenital cancer; Anogenital venereal warts; Attitude; Awareness; Behavior; Behavior Control; Cervical; Characteristics; Data; Developed Countries; Disease; Faculty; Family; Family Practice; Female; Happiness; Health; Health Care Costs; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Immunization; Intention; Intervention; Knowledge; Lead; Licensure; Malignant neoplasm of cervix uteri; Measures; Mississippi; Morbidity - disease rate; Patient ambiguity; Patients; Pattern; Perception; Physicians; Planning Theory; Population; Prevention strategy; Primary Care Physician; Provider; Public Health; Questionnaires; Recommendation; Research; Role; Schedule; Series; Sexually Transmitted Diseases; Specific qualifier value; Suggestion; Surveys; Techniques; Testing; United States; United States Food and Drug Administration; Vaccination; Vaccines; Virus; Work; base; burden of illness; design; early experience; experience; girls; health disparity; improved; meetings; minority health; mortality; public health relevance; response; socioeconomics

DESCRIPTION (provided by applicant): Cervical cancer, genital warts, and other health conditions associated with human papillomavirus (HPV) exact substantial morbidity, mortality, and expenses. In 2006, the Food and Drug Administration (FDA) approved a quadrivalent HPV vaccine for females ages 9-26, and the Advisory Committee on Immunization Practices (ACIP) recommended routine vaccination for girls ages 11-12. Modest vaccination rates to date, however, indicate problems with increasing coverage and adherence to the recommended vaccine schedule, and may presage difficulties in realizing the vaccine's public health promise. Provider-oriented issues and challenges related to vaccine implementation may have been underestimated and remain insufficiently studied, especially with regard to primary care physicians (PCPs), who are well suited to provide vaccine to most young females. The broad objective of this study is to identify the appropriate constellation of factors that differentially relate to clinicians' stated intentions to administer HPV vaccine as recommended. Our central hypothesis is that clinicians' attitudes, subjective norms, and perceptions of issues as barriers significantly influence their intentions to administer the vaccine and, ultimately, their behavior, as predicted by the theory of planned behavior (TPB). We propose four specific aims: 1) to develop a theoretically-informed survey questionnaire for the assessment of TPB-based and other measures of PCPs' intentions to administer the HPV vaccine; 2) to implement the survey questionnaire among PCPs in Alabama and Mississippi; 3) to examine PCP characteristics and TPB-based measures regarding intention to administer HPV vaccine under different conditions; and 4) to identify groups of PCPs who can be differentiated with respect to the patterns of functional relations between the TPB-factors and intentionality. Using nominal group technique meetings and other steps, the survey instrument will be developed, pre-tested and piloted with PCPs and family practice residents and faculty. At least 300 complete survey responses will be collected from PCPs to allow examination of our hypotheses and relationships between relevant variables and intentionality under different patient conditions. Intentionality will be operationalized through a series of behaviorally anchored case vignettes. PCPs' awareness and attitudes regarding ACIP recommendations will also be evaluated. The study will be administered in two states with high HPV-associated disease burdens, acute PCP shortages, and low HPV immunization rates. The proposed research will yield important information to improve understanding of theoretical predictors and provider-based barriers to HPV vaccination in actual practice. This should also suggest useful direction for developing provider-based strategies to increase the likelihood of vaccine administration that could be studied in future research. PUBLIC HEALTH RELEVANCE: HPV vaccination offers an effective prevention strategy for reducing the substantial morbidity and healthcare costs caused by persistent HPV infection, so long as problems besetting current modest vaccination rates are better understood and overcome. The proposed study will examine factors that differentially relate to clinicians' stated intentions to administer HPV vaccine, using new measures of intentionality and clinicians' evaluative perceptions of professional recommendations. Our work will help inform future research and the design of strategies to improve the likelihood that physicians would adopt recommendations for administering HPV vaccine.

描述（由申请人提供）：宫颈癌，生殖器疣和与人乳头瘤病毒（HPV）相关的其他健康状况（HPV）确切的大量发病率，死亡率和费用。 2006年，食品药品监督管理局（FDA）批准了9-26岁女性的四价HPV疫苗，并批准了免疫实践咨询委员会（ACIP）推荐的常规疫苗，以11-12岁的女孩进行常规疫苗接种。然而，迄今为止，适度的疫苗接种率表明覆盖范围和遵守建议疫苗时间表的覆盖范围和依从性增加，并且可能会在实现疫苗的公共卫生承诺方面遇到困难。与疫苗实施相关的面向提供者的问题和挑战可能已经被低估了，并且研究不足，尤其是在初级保健医生（PCP）方面，他们非常适合为大多数年轻女性提供疫苗。这项研究的广泛目的是确定与临床医生根据建议使用HPV疫苗的意图有差异化因素的适当因素。我们的核心假设是，临床医生的态度，主观规范和对问题的看法显着影响其疫苗管理疫苗的意图，并最终影响其行为，如计划的行为理论（TPB）所预测的那样。我们提出了四个具体目的：1）开发理论上知名的调查问卷，以评估基于TPB的PCP和其他措施管理HPV疫苗的意图； 2）在阿拉巴马州和密西西比州的PCP中实施调查问卷； 3）检查有关在不同条件下管理HPV疫苗的意图的基于PCP特征和基于TPB的措施； 4）识别可以在TPB因子和故意性之间的功能关系模式方面分歧的PCP组。使用名义小组技术会议和其他步骤，将开发，预先测试并通过PCP，家庭实践居民和教职员工进行调查工具。在不同患者条件下，将至少从PCP收集至少300个完整的调查响应，以允许检查我们的假设和相关变量与故意性之间的关系。意图将通过一系列行为锚定的案例小插图来实现。还将评估PCPS对ACIP建议的意识和态度。该研究将在HPV相关疾病负担高，急性PCP短缺和HPV免疫率低的两个州进行。拟议的研究将产生重要信息，以提高对实际实践中HPV疫苗接种的理论预测因子和基于提供商的障碍的理解。这还应该为制定基于提供者的策略的有用指导，以增加可以在未来研究中研究的疫苗给药的可能性。 公共卫生相关性：HPV疫苗接种提供了一种有效的预防策略，可以减少持续的HPV感染引起的大量发病率和医疗保健成本，只要可以更好地理解并克服困扰当前适度的疫苗接种率的问题。拟议的研究将研究与临床医生所陈述的管理HPV疫苗的意图有关的因素，并采用新的意图和临床医生对专业建议的评估看法。我们的工作将有助于为未来的研究和设计策略的设计，以提高医生采取建议进行HPV疫苗的建议的可能性。

项目成果

Primary Care Physicians' Adherence to Guidelines and Their Likelihood to Prescribe the Human Papillomavirus Vaccine for 11- and 12-Year-Old Girls.

• DOI: 10.1016/j.whi.2015.07.012
• 发表时间: 2016-01
• 期刊: Women's health issues : official publication of the Jacobs Institute of Women's Health
• 作者: Kulczycki A;Qu H;Shewchuk R
• 通讯作者: Shewchuk R