Improving Healthcare Providers' Communication about HPV Vaccine

改善医疗保健提供者有关 HPV 疫苗的沟通

• 批准号: 8750208
• 负责人: Melissa B Gilkey
• 金额: $ 18.74万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-17 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8750208
• 关键词: Address; Adolescent; Age; Area; Behavior; Behavior Therapy; Behavioral; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Clinic; Communication; Consensus; Data; Disease; Dose; Educational Intervention; Effectiveness; Family; Feasibility Studies; Federally Qualified Health Center; Female Adolescents; Frequencies; Goals; Guidelines; Health Personnel; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papillomavirus; Influentials; Intervention; K-Series Research Career Programs; Knowledge; Lead; Life; Literature; Low income; Male Adolescents; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical; Medical Records; Melissa; Methods; Minority; Parents; Patients; Perception; Prevention program; Primary Health Care; Principal Investigator; Program Evaluation; Provider; Randomized Clinical Trials; Randomized Controlled Trials; Recommendation; Research; Research Personnel; Resources; Scientist; Self Efficacy; Surveys; Testing; Time; Training; Training Programs; Translating; Translational Research; Trust; United States; Vaccination; Vaccines; Visit; Woman; Work; base; boys; cancer prevention; career; clinical practice; cost; design; evidence base; improved; innovation; killings; multidisciplinary; prevent; programs; public health relevance; quality improvement organization; skills; social cognitive theory; uptake; vaccine delivery

PROJECT SUMMARY/ABSTRACT Despite national guidelines for routine administration of human papillomavirus (HPV) vaccine, only 33% of adolescent girls and 7% of adolescent boys in the U.S. currently receive all three recommended doses. Healthcare providers are highly influential in parents' decisions to get their adolescent children HPV vaccine, and yet providers often fail to recommend it. Further, recommendations providers do deliver are often weak. The overall goal of this study is to develop and evaluate a brief training program to improve providers' communication about HPV vaccine. This study will focus specifically on providers in Federally Qualified Health Centers because the low-income and minority adolescents served by these clinics are more likely to suffer from HPV-related cancers later in life. HPV vaccination is, thus, especially important in this setting. In terms of methods, we will first identify provider communication characteristics associated with HPV vaccine delivery (Aim 1). Using existing data, we will conduct a mixed-methods analysis of 204 audio-recorded medical encounters between providers, adolescent patients, and their parents. We will use findings from this analysis to develop a brief educational intervention for providers practicing in low-resource settings (Aim 2). Informed by social cognitive theory, the training's purpose will be to improve providers' knowledge, skills, and confidence for communicating about HPV vaccine. Finally, we will deliver the training to 16 providers in 4 Federally Qualified Health Centers to investigate the intervention's feasibility (Aim 3). Using audio-recordings of medical encounters and surveys of providers, patients, and parents, we will assess the intervention's ability to improve provider perceptions and recommendation practices as well as its acceptability to providers and families. The proposed study builds on Dr. Melissa Gilkey's prior work in survey research and program evaluation aimed at identifying and overcoming barriers to HPV vaccination. The candidate's long-term career goal is to translate research into evidence-based cancer prevention programs for adolescents. Her immediate career goals are to gain content knowledge in patient-provider communication, skills in developing behavioral interventions, and expertise in conducting randomized clinical trials to test those interventions. The proposed career development award will enable Dr. Gilkey to grow as an independent investigator by providing focused training as well as protected time for research. The proposed program of research will lay the groundwork for Dr. Gilkey's first R01-level study to establish the effectiveness of communication training for raising coverage of HPV vaccine.

项目概要/摘要 尽管国家指南规定了人乳头瘤病毒 (HPV) 疫苗的常规接种，但只有 33% 的人 目前，美国的青春期女孩和 7% 的青春期男孩接受了全部三种推荐剂量。 医疗保健提供者对于父母是否为青春期儿童接种 HPV 疫苗的决定具有很大影响力， 但提供商常常不推荐它。此外，提供者提供的建议往往很弱。 本研究的总体目标是制定和评估一个简短的培训计划，以提高提供者的能力 关于HPV疫苗的交流。这项研究将特别关注联邦合格医疗服务提供者 因为这些诊所服务的低收入和少数族裔青少年更有可能遭受痛苦 在以后的生活中免受 HPV 相关癌症的影响。因此，HPV 疫苗接种在这种情况下尤其重要。 在方法方面，我们将首先确定与 HPV 疫苗相关的提供者沟通特征 交付（目标 1）。利用现有数据，我们将对 204 条医疗录音进行混合方法分析 提供者、青少年患者及其父母之间的接触。我们将使用此分析的结果来 为在资源匮乏环境中执业的提供者制定简短的教育干预措施（目标 2）。通知者： 根据社会认知理论，培训的目的是提高提供者的知识、技能和信心 用于交流 HPV 疫苗。最后，我们将向 4 个联邦州的 16 家提供者提供培训 合格的健康中心调查干预措施的可行性（目标 3）。使用医疗录音 通过与提供者、患者和家长的接触和调查，我们将评估干预措施的改善能力 提供者的看法和推荐做法以及提供者和家庭的接受程度。 拟议的研究以 Melissa Gilkey 博士之前在调查研究和项目评估方面的工作为基础，旨在 识别并克服 HPV 疫苗接种的障碍。候选人的长期职业目标是翻译 对青少年循证癌症预防计划的研究。她的近期职业目标是 获得患者与提供者沟通的内容知识、制定行为干预措施的技能，以及 进行随机临床试验来测试这些干预措施的专业知识。拟议的职业发展 该奖项将使吉尔基博士能够通过提供有针对性的培训以及 受保护的研究时间。拟议的研究计划将为吉尔基博士的第一个研究奠定基础 R01 级研究旨在确定沟通培训对于提高 HPV 疫苗覆盖率的有效性。