Implementation of Inpatient Postpartum Human Papillomavirus Immunization

住院病人产后人乳头瘤病毒免疫的实施

• 批准号: 10187528
• 负责人: Sangini S. Sheth
• 金额: $ 16.5万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-11 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10187528
• 关键词: 12 year old; 17 year old; Address; Adolescent; Age; Age-Years; Anogenital cancer; Anxiety; Award; Breastfed infant; Caring; Cervical; Cervical dysplasia; Clinical Informatics; Computerized Medical Record; Conduct Clinical Trials; Data; Development; Disease; Dissemination and Implementation; Dose; Excision; FDA approved; Female; Female Adolescents; Focus Groups; Future; Goals; Gynecologist; Health; Health Sciences; Hospitalization; Hospitals; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Hybrids; Immunization; Immunize; Incidence; Influenza; Inpatients; Intervention; Interview; Learning; Lesion; Link; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical Care Costs; Medical Informatics; Mentors; Methods; Minority Groups; Modeling; Modification; Oregon; Oropharyngeal; Outpatients; Pain; Patients; Postpartum Period; Postpartum Women; Pregnant Women; Prevention; Procedures; Process; Qualitative Methods; Research; Research Methodology; Rubella virus vaccine; Scientist; Series; Testing; Training; Translating; Universities; Vaccinated; Vaccination; Vaccines; Visit; Woman; Work; acceptability and feasibility; arm; base; burden of illness; cancer prevention; certificate program; cost estimate; design; dissemination research; dissemination strategy; effectiveness trial; efficacy trial; ethnic minority population; evidence based guidelines; experience; follow-up; implementation fidelity; implementation framework; implementation outcomes; implementation research; implementation science; implementation strategy; implementation tool; implementation trial; improved; influenza virus vaccine; innovation; malignant oropharynx neoplasm; multidisciplinary; obstetric outcomes; postpartum care; preference; premalignant; prevent; programs; racial minority; research to practice; routine care; sexually active; standard of care; success; tool; uptake; usability; vaccine acceptance; vaccine delivery

Project Summary / Abstract Dr. Sheth is an obstetrician and gynecologist whose long-term goal is to optimize the implementation of evidence-based recommendations for prevention of gynecologic cancers. The proposed training and mentored research experience will enable her to achieve her short-term goals of developing expertise in conducting dissemination and implementation (D&I) research on human papillomavirus (HPV) vaccine and of using qualitative methods and medical informatics as research tools. Dr. Sheth has assembled an expert and committed team of mentors and advisors to help her. Dr. Linda Niccolai (primary mentor) is a recognized leader in HPV vaccine research and qualitative methods and Dr. Steven Bernstein (co-mentor) is an expert in D&I research for cancer prevention. Dr. Sheth will complete a certificate program in D&I science through UCSF, take advanced courses at Yale on qualitative methods, clinical informatics and the design and conduct of clinical trials, and complete a course on the design of health IT tools through Oregon Health and Science University. Each year in the U.S., HPV causes approximately 330,000 cases of precancerous cervical dysplasia, and 12,000 cases of cervical cancer. Since 2006, FDA-approved HPV vaccines have been available. Immunization is recommended routinely for all 11-12 year olds, and as catch-up immunization through age 26 years. However, uptake of HPV vaccine in the U.S. is poor: overall, only 43% of adolescents are fully immunized. Sustained efforts for catch-up immunization are critical to address missed opportunities to protect women against HPV-associated diseases. Even among women who have been sexually active before immunization, a substantial burden of disease can be prevented, especially since the current vaccine protects against 9 different HPV types responsible for >80% of cervical cancers. One strategy to improve HPV immunization rates is to vaccinate postpartum women during their hospitalization when there is easy access to patients. This would also reduce the number of visits needed to complete the multi-dose series. Several other vaccines (Tdap, influenza, MMR) have been integrated into postpartum hospital care for catch-up immunization, but not so the HPV vaccine. We aim to promote integration of inpatient postpartum HPV immunization (IPP-HPV) into routine care by developing an electronic medical record (EMR)-based tool modeled on current practices used for other vaccines administered during inpatient postpartum care and on stakeholder preferences. We will evaluate the feasibility of using the EMR-based tool as an implementation strategy for achieving high fidelity and sustainability of IPP- HPV immunization. This study will help inform development of an implementation toolkit for IPP-HPV immunization to use in a subsequent full-scale hybrid implementation and effectiveness trial. Upon completion of this award, Dr. Sheth will have expertise in D&I science research methods. She will have established the groundwork for conducting future studies to translate IPP-HPV immunization into a national model and will be well poised to become an independent clinician-scientist.

项目概要/摘要 Sheth 博士是一名妇产科医生，其长期目标是优化实施 预防妇科癌症的循证建议。拟议的培训和指导 研究经验将使她能够实现发展专业知识的短期目标 人乳头瘤病毒 (HPV) 疫苗及其使用的传播和实施 (D&I) 研究 定性方法和医学信息学作为研究工具。 Sheth 博士召集了一位专家和 致力于帮助她的导师和顾问团队。 Linda Niccolai 博士（主要导师）是一位公认的领导者 Steven Bernstein 博士（联合导师）是 D&I 方面的专家，在 HPV 疫苗研究和定性方法方面拥有丰富的研究经验 癌症预防研究。 Sheth 博士将通过 UCSF 完成 D&I 科学证书课程， 耶鲁大学关于定性方法、临床信息学以及临床设计和实施的高级课程 试验，并通过俄勒冈健康与科学大学完成健康 IT 工具设计课程。 在美国，HPV 每年导致约 330,000 例癌前宫颈发育不良病例， 和 12,000 例宫颈癌病例。自 2006 年以来，FDA 批准的 HPV 疫苗已上市。 建议所有 11-12 岁儿童定期接种疫苗，并在 26 岁之前进行补种免疫 年。然而，美国 HPV 疫苗的接种率很低：总体而言，只有 43% 的青少年完全免疫。 持续努力进行补种免疫接种对于解决错失的保护妇女免受感染的机会至关重要 HPV 相关疾病。即使在免疫前性行为活跃的女性中， 可以预防巨大的疾病负担，特别是因为目前的疫苗可以预防 9 种不同的疾病 HPV 类型导致>80% 的宫颈癌。提高 HPV 免疫率的一项策略是 在易于接触患者的情况下，在住院期间为产后妇女接种疫苗。这也将 减少完成多剂量系列所需的就诊次数。其他几种疫苗（Tdap、流感、 MMR）已被纳入产后医院护理中以进行补种免疫，但 HPV 疫苗却并非如此。 我们的目标是通过以下方式促进住院患者产后 HPV 免疫 (IPP-HPV) 纳入常规护理： 模仿其他疫苗当前使用的做法，开发基于电子病历 (EMR) 的工具 在住院产后护理期间根据利益相关者的喜好进行管理。我们将评估可行性 使用基于 EMR 的工具作为实现 IPP 高保真度和可持续性的实施策略 HPV 免疫。这项研究将有助于为 IPP-HPV 实施工具包的开发提供信息 免疫接种用于随后的全面混合实施和有效性试验。完成后 凭借该奖项，Sheth 博士将拥有 D&I 科学研究方法方面的专业知识。她将建立 为未来研究将 IPP-HPV 免疫转化为国家模式奠定基础，并将 已做好成为一名独立临床医生科学家的准备。

项目成果

Assessing sociodemographic differences in human papillomavirus vaccine impact studies in the United States: a systematic review using narrative synthesis.

评估美国人乳头瘤病毒疫苗影响研究的社会人口统计学差异：使用叙述综合的系统评价。

• DOI: 10.1016/j.puhe.2019.08.010
• 发表时间: 2019-11-04
• 期刊: Public health
• 影响因子: 5.2
• 作者: Lital Avni;Anthony E. Yakely;Sangini S. Sheth;E. Shapiro;L. Niccolai;C. R. Oliveira
• 通讯作者: C. R. Oliveira

Association of Inadvertent 9-Valent Human Papillomavirus Vaccine in Pregnancy With Spontaneous Abortion and Adverse Birth Outcomes.

妊娠期无意接种 9 价人乳头瘤病毒疫苗与自然流产和不良出生结果的关联。

• 发表时间: 2021
• 影响因子: 13.8
• 作者: Kharbanda, Elyse O;Vazquez;DeSilva, Malini B;Naleway, Allison L;Klein, Nicola P;Hechter, Rulin C;Glanz, Jason M;Donahue, James G;Jackson, Lisa A;Sheth, Sangini S;Greenberg, Victoria;Panagiotakopoulos, Lakshmi;Mba
• 通讯作者: Mba

Uptake of Cervical Cancer Screening Among Female Patients Using a Mobile Medical Clinic.

使用流动医疗诊所对女性患者进行宫颈癌筛查的情况。

• 发表时间: 2023-11
• 影响因子: 5.5
• 作者: Degife, Ellelan A;Oliveira, Carlos R;Znamierowski, Elizabeth;Meyer, Jaimie P;Sheth, Sangini S
• 通讯作者: Sheth, Sangini S

Feasibility and Accuracy of a Computer-Assisted Self-Interviewing Instrument to Ascertain Prior Immunization With Human Papillomavirus Vaccine by Self-Report: Cross-Sectional Analysis.

计算机辅助自我访谈工具通过自我报告确定人乳头瘤病毒疫苗既往免疫的可行性和准确性：横断面分析。

• 发表时间: 2020-01-22
• 影响因子: 3.2
• 作者: Oliveira, Carlos R;Avni;Badaro, Geovanna;Sullivan, Erin L;Sheth, Sangini S;Shapiro, Eugene D;Niccolai, Linda M
• 通讯作者: Niccolai, Linda M

Evaluation of an Inpatient Postpartum Human Papillomavirus Immunization Program.

住院患者产后人乳头瘤病毒免疫计划的评估。

• 发表时间: 2020
• 影响因子: 7.2
• 作者: Avni;Oliveira, Carlos R;Torres, Ashlynn;Shapiro, Eugene D;Niccolai, Linda M;Sheth, Sangini S
• 通讯作者: Sheth, Sangini S