PREVENT - Practice-based Approaches to Promote HPV Vaccination

预防 - 基于实践的方法促进 HPV 疫苗接种

• 批准号: 10638515
• 负责人: Deanna Lee Kepka
• 金额: $ 66.67万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-15 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10638515
• 关键词: Address; Adolescent; Adoption; Age; Anogenital cancer; Bundling; Caregivers; Child; Clinic; Clinic Visits; Communication; Data; Disparity; Dose; Effectiveness; Eligibility Determination; Ensure; Evaluation; Face; Hispanic Populations; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papilloma Virus-Related Malignant Neoplasm; Human papilloma virus infection; Incidence; Interdisciplinary Study; Intervention; Linguistics; Maintenance; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical Care Team; Methods; Not Hispanic or Latino; Parents; Patients; Persons; Provider; Public Health; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Reminder Systems; Research; Rural; Rural Population; Series; System; Telephone; Testing; Text Messaging; Time; Translations; Travel; United States; Vaccination; Vaccines; cost; design; disparity reduction; effectiveness testing; ethnic diversity; implementation evaluation; implementation facilitators; implementation outcomes; improved; malignant oropharynx neoplasm; outreach; prevent; primary care practice; public health priorities; rural Hispanic; rural area; rural dwellers; rural healthcare; rural patients; rural setting; safety net; tailored messaging; treatment arm; treatment as usual; uptake; urban area; urban disparity; vaccine acceptance

ABSTRACT Human papillomavirus (HPV) infection is the leading cause of over 36,000 new cancer cases of cervical, ano- genital, and oropharyngeal cancers in the United States each year. While multi-valent vaccinations to prevent HPV infections have been available since 2006, uptake of the vaccine is well below national Healthy People 2030 targets (80% of adolescents at ages 13-15 years up-to-date with HPV vaccination). Adolescent vaccination rates are especially low in rural areas (about 11% lower than in urban areas). Compared to urban residents, rural residents have a higher incidence of HPV-related cancers and face unique barriers to HPV vaccination, including limited access to providers, fewer vaccine reminders, longer travel time to clinics, and less favorable societal norms about HPV vaccination. Moreover, rural adolescents are less likely than their urban counterparts to receive a provider recommendation for the HPV vaccine. Rural healthcare teams are often limited by a lack of systematic methods to identify and track eligible patients and/or their parents for outreach. While much is known about clinic-based approaches to improve HPV vaccination among urban residents, less is known about their effectiveness among rural residents, including rural Hispanic populations, the fastest growing sub-population in rural settings. The proposed study is designed to address these barriers by adapting and testing approaches to effectively communicate the importance of vaccination to improve HPV vaccination rates for rural populations, and the sub-populations within (e.g. Hispanic persons). Our study includes a randomized controlled trial of adapted reminders to address the needs of diverse rural populations. We will create clinic systems to prompt vaccination for eligible children/adolescents and deliver messages to parents/caregivers, whose mode and content is specifically tailored for rural and rural Hispanic populations. Our study, Practice-based Approaches to Promote HPV Vaccination in the Safety Net (PREVENT), incorporates formative patient- and clinic-informed research to design and evaluate an automated data-driven reminder intervention using low-cost approaches (automated phone calls and text messages). We will compare usual care to Automated Patient Reminders, and to a higher-intensity intervention arm using automated messages plus linguistically and culturally tailored interventions to deliver live reminders, Automated Plus Live Patient Reminders. PREVENT’s design and evaluation will involve tailoring message mode and content for parents and caregivers of rural and ethnically diverse rural patients. This study will serve as one of the first to develop and test the effectiveness of strategies to promote HPV vaccination among diverse rural patients in the Mountain West. Our strong research team demonstrates successful partnerships with primary care practices in rural populations. Once implemented into practice, our intervention could reduce rural/urban disparities in HPV-associated cancers in the US.

抽象的 人乳头瘤病毒（HPV）感染是36,000多个新癌症的主要原因 每年在美国的生殖器和口咽癌。而多价疫苗以防止 自2006年以来，HPV感染就一直可用，疫苗的摄取远低于国家健康 People 2030目标（在HPV疫苗接种时，有80％的青少年在13-15岁时最新的青少年）。青少年 农村地区的疫苗接种率尤其低（比城市地区低约11％）。与城市相比 居民，粗糙的居民有更高的HPV相关癌症事件，面临HPV的独特障碍 疫苗，包括访问提供商的机会有限，疫苗提醒较少，前往诊所的较长时间以及 关于HPV疫苗接种的社会规范不太有利。而且，粗糙的青少年比他们 Urban Comparts收到HPV疫苗的提供商建议。农村医疗保健团队是 通常受到缺乏系统的方法来识别和跟踪合格的患者和/或其父母的限制 外展。虽然对基于诊所的改善HPV疫苗接种的方法有很多了解 居民对农村居民的有效性知之甚少，包括西班牙裔农村人口， 在粗糙环境中增长最快的子人群。拟议的研究旨在解决这些问题 通过调整和测试方法有效传达疫苗接种的重要性，通过调整和测试方法进行障碍 为了提高较粗糙的人群的HPV疫苗接种率和内部的子人群（例如西班牙裔 人）。我们的研究包括针对适应性提醒的随机对照试验，以满足 潜水员人口粗糙。我们将创建诊所系统，以促使符合条件的儿童/青少年疫苗接种 并向父母/照顾者传递消息，他们的模式和内容是专门针对农村和农村量身定制的 西班牙裔人口。我们的研究，基于实践的方法来促进安全网中的HPV疫苗接种 （预防），结合形成性的患者和诊所信息，以设计和评估自动化 数据驱动的提醒干预使用低成本方法（自动电话和短信）。我们 将将通常的护理与自动化的患者提醒进行比较，并使用更高强度的干预组 自动化消息以及语言和文化量身定制的干预措施，以提供现场提醒， 自动化加上活的患者提醒。防止设计和评估将涉及裁缝信息 大致和种族多样的粗糙患者的父母和护理人员的模式和内容。这项研究将服务 作为最早开发和测试策略促进HPV疫苗接种的有效性的人之一 山西部的潜水员粗糙的患者。我们强大的研究团队展示了成功的伙伴关系 在农村人群中进行初级保健实践。一旦实施实施，我们的干预可以减少 美国HPV相关癌症的粗糙/城市差异。