Normalizing preteen HPV vaccination with practice-based communication strategies

通过基于实践的沟通策略使青春期前的 HPV 疫苗接种正常化

• 批准号: 8764042
• 负责人: Joan Roberts Cates
• 金额: $ 67.69万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-15 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8764042
• 关键词: 12 year old; Adolescent; Adopted; Adoption; Age; Anogenital venereal warts; Anus; Biometry; Centers for Disease Control and Prevention (U.S.); Cervical; Characteristics; Child; Child Psychology; Clinical; Communication; Communication Research; Conscious; Contractor; Data; Disease; Dose; Early Intervention; Education; Effectiveness; Electronics; Evaluation; Exposure to; Female; Goals; Group Practice; Health Personnel; Health Services; Healthcare; Hispanics; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Immunization; Influentials; Intention; Intervention; Maintenance; Malignant Neoplasms; Malignant neoplasm of anus; Malignant neoplasm of penis; Malignant neoplasm of vulva; Mission; Modality; Names; North Carolina; Online Systems; Outcome; Parents; Pediatrics; Pharyngeal structure; Phase; Play; Probability; Provider; Public Health; Recommendation; Registries; Reporting; Research; Research Personnel; Role; Science; Series; Sexually Transmitted Diseases; System; Teenagers; Testing; Text; Throat Cancer; Time; United States; Vaccinated; Vaccination; Vaccines; Vagina; Virus; Visit; Vulva; base; boys; clinical care; cost effectiveness; design; disorder prevention; evidence base; girls; handheld mobile device; improved; innovation; male; meetings; preadolescence; prevent; public health relevance; theories

DESCRIPTION (provided by applicant): Despite growing evidence of its effectiveness in protecting against sexually transmitted infection (STI) and certain cancers, vaccination against human papillomavirus (HPV) in the United States has stalled. HPV vaccination completion among females was actually lower in 2012 than in 2011. HPV is the most common STI in the US, causes genital warts, and is associated with cervical, vaginal, vulvar, anal, penile, and throat cancers. HPV vaccine is most effective when given before exposure to the virus, and is recommended for routine administration to 11-12 year old females and males. Health care providers play the primary influential role in parents' decisions to vaccinate, yet too often provie weak recommendations for HPV vaccination. Many parents think their preteens are too young for HPV vaccination and teens are not routinely included in the decision to vaccinate. Missed opportunities to vaccinate against HPV at the same clinical visit with other preteen vaccines are far too frequent. Among unvaccinated girls in 2012, 84% had a health-care encounter where they received another adolescent age vaccine but not HPV vaccine. This research aims to eliminate this gap by transforming clinical care through an improved communication system and ultimately normalizing HPV vaccination at the optimal ages of 11-12. Principles of dissemination (conscious effort to spread an evidence- based innovation, the HPV vaccine) and implementation (adoption of an innovation in specific settings) science are used. The multiple baseline design will include an intervention with communication strategies adapted to rolling groups of practices (n=48) that (1) report to the North Carolina Immunization Registry (NCIR); and (2) agree to use mobile devices and web-based modalities to keep up to date on HPV vaccine and to educate parents and preteens about HPV vaccination. The overall objective is to assess the extent to which providers, parents and preteens respond to these proactive communication strategies by vaccinating preteen girls and boys. The long term goal is to prevent HPV-related disease through early intervention and protection against this STI. The central hypothesis is that providers, parents and preteens are relevant decision makers who can be motivated to complete the HPV vaccination series according to public health recommendations. The aims are to (1) Develop new and adapt existing theory-driven dissemination and implementation strategies to motivate providers, parents and preteens to initiate and complete the HPV vaccine series; (2) Evaluate theory driven dissemination and implementation strategies to stimulate communication among providers, parents and preteens to motivate HPV vaccination and completion of the series; and (3) Determine practice characteristics related to adoption, implementation, and maintenance of these dissemination and implementation strategies to motivate HPV vaccination of preteens. The positive impact is that effective HPV vaccination dissemination and implementation strategies will be available for use in practices to reduce HPV infection and related diseases.

描述（由申请人提供）：尽管越来越多的证据表明其在预防性传播感染（STI）和某些癌症方面的有效性，但美国的人乳头瘤病毒（HPV）疫苗接种已陷入停滞。 2012 年女性 HPV 疫苗接种完成率实际上低于 2011 年。HPV 是美国最常见的性传播感染，会导致生殖器疣，并与宫颈癌、阴道癌、外阴癌、肛门癌、阴茎癌和喉癌相关。 HPV 疫苗在接触病毒之前接种最为有效，建议 11-12 岁女性和男性常规接种。医疗保健提供者在父母是否接种疫苗的决定中发挥着主要影响作用，但往往对 HPV 疫苗接种提供的建议很薄弱。许多家长认为他们的青春期前儿童太小，不适合接种 HPV 疫苗，而且青少年通常不会参与疫苗接种的决定。在同一临床就诊中错过与其他青春期前疫苗一起接种 HPV 疫苗的机会实在是太常见了。 2012 年，在未接种疫苗的女孩中，84% 的女孩在接受医疗保健时接种了另一种青春期疫苗，但没有接种 HPV 疫苗。这项研究旨在通过改进沟通系统来改变临床护理，并最终使 11-12 岁最佳年龄的 HPV 疫苗接种正常化，从而消除这一差距。采用传播原则（有意识地努力传播基于证据的创新，即 HPV 疫苗）和实施（在特定环境中采用创新）科学。多基线设计将包括采用适应滚动实践组 (n=48) 的沟通策略进行干预，这些策略 (1) 向北卡罗来纳州免疫登记处 (NCIR) 报告； (2) 同意使用移动设备和基于网络的方式来了解 HPV 疫苗的最新信息，并对父母和青春期前的儿童进行有关 HPV 疫苗接种的教育。总体目标是评估提供者、父母和青春期前儿童通过为青春期前女孩和男孩接种疫苗对这些主动沟通策略的反应程度。长期目标是通过早期干预和预防这种性传播感染来预防 HPV 相关疾病。中心假设是，提供者、父母和青春期前的儿童是相关决策者，可以激励他们根据公共卫生建议完成 HPV 疫苗接种系列。其目标是 (1) 制定新的并调整现有的理论驱动的传播和实施策略，以激励提供者、父母和青春期前儿童启动和完成 HPV 疫苗系列； (2) 评估理论驱动的传播和实施策略，以刺激提供者、父母和青春期前儿童之间的沟通，从而激励 HPV 疫苗接种和完成该系列； (3) 确定与采用、实施和维护这些传播和实施策略相关的实践特征，以激励青春期前的 HPV 疫苗接种。积极影响是有效的 HPV 疫苗接种传播和实施策略将可用于减少 HPV 感染和相关疾病的实践。