The VAX-MOM study: Increasing Influenza and Tdap Vaccinations of Pregnant Women

VAX-MOM 研究：增加孕妇的流感和 Tdap 疫苗接种

• 批准号: 10220817
• 负责人: Cynthia M Rand
• 金额: $ 50万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10220817
• 关键词: VAX; MOM; study; Increasing; Influenza

Infants under 6 months of age are at increased risk of both influenza (flu) and pertussis disease, and pregnant women risk serious illness and premature labor from flu. The Advisory Committee on Immunization Practices recommends that women receive a flu vaccine in flu season, and tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine during each pregnancy (ideally between 27-36 weeks) to lower the risk for flu and pertussis disease for themselves and their infants. However, only half of pregnant women in the US receive a flu and Tdap vaccine, respectively; only 33% of women receive both vaccines. Lack of vaccination stems from a combination of patient (lack of knowledge, vaccine hesitancy), provider (suboptimal communication skills, missed opportunities), and system (e.g. lack of standing orders and patient reminders) factors. An effective intervention is needed to improve flu and Tdap vaccination rates for pregnant women. We will adapt our highly successful QI-based interventions (communication training, provider prompts, provider feedback, and standing orders) and reminder/recall interventions used for other vaccines to the VAX-MOM project. Aim 1 of this project is to measure baseline flu/Tdap vaccination coverage and provider knowledge, attitudes and behaviors for flu/Tdap vaccination in 32 OB/GYN practices in 4 health systems in NY and CA. Aim 2 is to use a clustered RCT (practice randomization) to measure the effect of a multi-component QI intervention (VAX-MOM: training in communication, provider prompts, standing orders + feedback on rates) on vaccination rates and provider attitudes, and to measure costs of the intervention. Aim 3 is to measure the effect of a patient-based reminder/education intervention on vaccination rates of pregnant mothers, using a RCT provided to control practices (with patient randomization) in Year 3. Aim 4 is to develop a translation plan/toolkit for OB/GYN practices and health systems for maternal vaccination. If the VAX-MOM intervention and the patient reminder/education studies are successful, we will have a scalable set of interventions at both the practice level and the health system level to raise maternal vaccination rates.

6个月以下的婴儿患流感（流感）和百日咳疾病的风险增加，以及怀孕 妇女可能会因流感造成严重疾病和过早的劳动。免疫实践咨询委员会 建议女性在流感季节接受流感疫苗和破伤风毒素，减少白喉毒素， 每次怀孕期间（理想情况下是27-36周），细胞百日咳（TDAP）疫苗，以降低风险 流感和百日咳病本身和婴儿。但是，在美国只有一半的孕妇 分别接受流感和TDAP疫苗；只有33％的妇女接受两种疫苗。缺乏疫苗接种 源于患者的组合（缺乏知识，疫苗犹豫），提供者（次优 沟通技巧，错过的机会）和系统（例如缺乏常规订单和患者提醒） 因素。需要有效的干预措施来改善孕妇的流感和TDAP疫苗接种率。我们 将适应我们非常成功的基于QI的干预措施（沟通培训，提供商提示，提供商 反馈和常规订单）和提醒/回忆干预措施用于其他疫苗 项目。该项目的目标1是测量基线流感/TDAP疫苗接种覆盖范围和提供商知识， 在纽约州和CA的4种卫生系统中，32 OB/GYN实践中流感/TDAP疫苗接种的态度和行为。 AIM 2是使用聚类的RCT（练习随机化）来测量多组分Qi的效果 干预（VAX-MOM：沟通培训，提供者提示，常规订单 +对费率的反馈） 疫苗接种率和提供者的态度，并衡量干预成本。目标3是测量 基于患者的提醒/教育干预对怀孕母亲疫苗接种率的影响 在第3年提供了用于控制实践（患者随机分组）的RCT。目标4是开发翻译 OB/GYN实践和卫生系统的计划/工具包用于产妇疫苗接种。如果VAX-MOM干预 并且患者提醒/教育研究成功，我们将在两者中都有一套可扩展的干预措施 实践水平和卫生系统水平提高产妇疫苗接种率。