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防止性传播感染（STI）和某些癌症中有效性，但美国对人乳头瘤病毒（HPV）的疫苗接种已停滞不前。在2012年，女性的HPV疫苗接种完成实际上比2011年低。HPV是美国最常见的STI，导致生殖器疣，并且与宫颈，阴道，外阴，肛门，阴茎和喉咙癌有关。 HPV疫苗在暴露于病毒之前给予最有效的疫苗，并建议常规给予11-12岁的女性和男性。卫生保健提供者在父母对疫苗接种的决定中起着主要的影响力作用，但经常证明对HPV疫苗接种的建议较弱。许多父母认为他们的青春期太年轻，无法进行HPV疫苗接种，而青少年通常不包括在疫苗接种的决定中。在与其他青春期疫苗的同一次临床访问中，错过了接种HPV接种的机会。在2012年未接种疫苗的女孩中，有84％的人发生了一次医疗保健遭遇，他们接受了另一种青春期疫苗，但没有接受HPV疫苗。这项研究旨在通过改进的通信系统转化临床护理，并最终在11-12的最佳年龄范围内将HPV疫苗接种归一化，从而消除这一差距。使用了传播的原则（有意识地传播基于证据的创新，HPV疫苗）和实施（在特定环境中采用创新）。多个基线设计将包括与适应滚动实践群体（n = 48）的交流策略的干预，（1）向北卡罗来纳州免疫注册表（NCIR）报告； （2）同意使用移动设备和基于Web的模式来了解HPV疫苗的最新信息，并向父母和青春期有关HPV疫苗接种的教育。总体目的是评估提供者，父母和青春期通过接种青春期女孩和男孩来应对这些积极主动的沟通策略的程度。长期目标是通过早期干预和防止这种性传播感染来防止与HPV相关的疾病。中心假设是，根据公共卫生建议，提供者，父母和青春期是相关的决策者，可以激励他们完成HPV疫苗接种系列。目的是（1）开发新的并适应了现有的理论驱动的传播和实施策略，以激发提供者，父母和青春期来启动和完成HPV疫苗系列； （2）评估理论驱动传播和实施策略，以刺激提供者，父母和青春期的沟通，以激励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有关的实践特征，以激发青春期的HPV疫苗接种。积极的影响是有效的HPV疫苗接种传播和实施策略将用于减少HPV感染和相关疾病的实践。