HPV vaccine practices among Physicians Serving High Risk, Minority Populations

为高危人群、少数民族人群提供服务的医生的 HPV 疫苗接种实践

基本信息

批准号：
7942749
负责人：
Abraham Aragones
金额：
$ 7.95万
依托单位：
SUNY DOWNSTATE MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-29 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7942749
关键词：
9 year old Address Adherence Adolescent Medicine Affect Age Area Attitude Awareness Behavior Behavioral Belief Cancer Etiology Caring Communities Cross-Sectional Studies Education Family Family Physicians Feedback Female Genital Human Papilloma Virus Infection Goals Health Personnel Human Papilloma Virus Vaccine Human Papillomavirus Human papilloma virus infection Human papillomavirus 16 Human papillomavirus 18 Immigrant Incidence Infection Knowledge Licensing Life Linguistics Mails Malignant neoplasm of cervix uteri Minority Minority Groups Modality Nature New York Parents Patient Self-Report Patients Perception Persons Physicians Population Prevention Preventive Provider Recommendation Research Research Methodology Research Personnel Risk Risk Factors Sampling Self-Administered Serotyping Services Source Surveys System United States Vaccination Vaccines Woman Work aged cervical cancer prevention design ethnic minority population girls health disparity high risk improved mortality patient population pediatrician prevent public health relevance racial and ethnic disparities sexually active therapy development vaccine evaluation

项目摘要

DESCRIPTION (provided by applicant): In the United States, cervical cancer rates have declined in recent years, however ethnic and minority groups remain disproportionately affected. In Brooklyn, New York, an area with large immigrant populations and ethnically diverse communities, cervical cancer rates are significantly higher than national rates with some communities doubling the national incidence rate. Almost all cervical cancers are caused by the human papilloma virus (HPV), and it is estimated that 6.2 million persons are newly infected every year. Although most infections with HPV are asymptomatic and self-limited, persistent infection with genital HPV infection can cause cervical cancer. Approximately 100 HPV serotypes have been identified; however there are two high-risk serotypes, HPV-16 and HPV-18 that cause approximately 70% of all cervical cancers. A quadrivalent HPV vaccine was licensed for use in the United States for females aged 9-26 years for prevention of HPV infection (Types 6, 11, 16, and 18) and related cervical cancer in 2006. To date, most studies have focused on patient and parental barriers to vaccine acceptance. This study is unique in that it focuses on another key stakeholder in the HPV vaccine initiative- the physician and specifically those serving high risk populations. Physicians are often the primary and first source of information for parents and patients regarding vaccine awareness and knowledge. As such, the aims of this study are 1) To assess the self-reported rates of physician utilization of the HPV vaccine among their minority, high risk patient population, 2) To assess physicians' knowledge of, attitudes towards, beliefs regarding, and barriers to recommending the HPV vaccine, 3) To understand physician behaviors that affect the utilization of the HPV vaccine among high risk minority populations and 4) To propose a set of possible strategies to increase rates of HPV vaccination among high risk minority populations. The long term goal of the study is to improve utilization of the HPV vaccine, reducing HPV infection and cervical cancer among high risk, minority populations. A cross-sectional study will be utilized, and will include a random sample of pediatricians, adolescent medicine physicians and family practitioners that serve Brooklyn areas with high rates of cervical cancer. Five constructs will be addressed in a mailed, self administered survey: Knowledge about HPV, HPV vaccine and cervical cancer, Attitudes and beliefs towards the HPV vaccine, Physician barriers toward the HPV vaccine, Perceived patient barriers for the HPV vaccine and Evaluation of the perceived best modalities that could effect change in current HPV vaccine and cervical cancer prevention practices among their high risk patient population. PUBLIC HEALTH RELEVANCE: The majority of those affected by cervical cancer in the United States are from minority populations or foreign-born. Infection with the Human Papilloma Virus (HPV) is the most important risk factor for cervical cancer. In 2006, a vaccine to protect women against HPV was licensed and recommended for use in women as young as 9 years old. This study seeks to identify the issues that affect providers' utilization of the HPV vaccine with their high risk patients in order to develop strategies to assure that the populations most at risk for cervical cancer are given an opportunity to receive this important vaccine.

描述（由申请人提供）：在美国，宫颈癌发病率近年来有所下降，但种族和少数群体仍然受到不成比例的影响。在纽约布鲁克林这个拥有大量移民人口和种族多元化社区的地区，宫颈癌发病率明显高于全国发病率，有些社区的发病率是全国发病率的两倍。几乎所有宫颈癌都是由人乳头瘤病毒（HPV）引起的，估计每年新增感染者有 620 万人。虽然大多数HPV感染是无症状且具有自限性，但持续感染生殖器HPV感染可导致宫颈癌。已鉴定出大约 100 种 HPV 血清型；然而，有两种高危血清型，HPV-16 和 HPV-18，约占所有宫颈癌的 70%。 2006 年，四价 HPV 疫苗获准在美国用于 9-26 岁女性，用于预防 HPV 感染（6、11、16 和 18 型）和相关宫颈癌。迄今为止，大多数研究都集中在患者和家长接受疫苗的障碍。这项研究的独特之处在于它关注 HPV 疫苗计划的另一个关键利益相关者——医生，特别是那些为高危人群提供服务的人。医生通常是父母和患者有关疫苗意识和知识的主要和第一个信息来源。因此，本研究的目的是 1) 评估少数族裔高危患者群体中医生自我报告的 HPV 疫苗使用率，2) 评估医生对 HPV 疫苗的了解、态度和信念，以及推荐 HPV 疫苗的障碍，3) 了解影响高危少数群体中 HPV 疫苗使用的医生行为，以及 4) 提出一套可能的策略，以提高高危少数群体中的 HPV 疫苗接种率。该研究的长期目标是提高 HPV 疫苗的利用率，减少高危少数群体中的 HPV 感染和宫颈癌。将利用一项横断面研究，其中包括为布鲁克林宫颈癌高发地区提供服务的儿科医生、青少年医学医生和家庭医生的随机样本。邮寄、自我管理的调查将涉及五项内容：有关 HPV、HPV 疫苗和宫颈癌的知识、对 HPV 疫苗的态度和信念、医生对 HPV 疫苗的障碍、感知到的患者对 HPV 疫苗的障碍以及感知到的评估可能影响高危患者群体中当前 HPV 疫苗和宫颈癌预防实践的最佳方式。公共卫生相关性：在美国，大多数宫颈癌患者来自少数族裔或外国出生的人。感染人乳头瘤病毒（HPV）是宫颈癌最重要的危险因素。 2006 年，一种保护女性免受 HPV 感染的疫苗获得许可，并推荐用于年仅 9 岁的女性。本研究旨在确定影响提供者对高危患者使用 HPV 疫苗的问题，以便制定策略，确保宫颈癌风险最高的人群有机会接种这种重要的疫苗。