Project 2: Testing Multi-Level Interventions to Improve HPV Vaccination

项目 2：测试多层次干预措施以改善 HPV 疫苗接种

基本信息

批准号：
10268465
负责人：
ELECTRA D. PASKETT
金额：
$ 33.03万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-11 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10268465
关键词：
12 year old 21 year old Address Adolescent and Young Adult Affect Age American Anogenital venereal warts Anus Appalachian Region Attitude Cancer Etiology Centers for Disease Control and Prevention (U.S.)Cervical Cervix Uteri Child Clinic Clinical Communities Cost of Illness Direct Costs Disease Exposure to Female Focus Groups Health Health Care Costs Health Personnel Health system Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Human Papilloma Virus-Related Malignant Neoplasm Human Papillomavirus Human papilloma virus infection Incidence Infection prevention Influentials Interdisciplinary Study Intervention Knowledge Low Income Population Malignant neoplasm of cervix uteri Meningococcal vaccine Oropharyngeal Outcome Parents Patients Population Prevention Prevention program Process Provider Randomized Recommendation Rectum Recurrent respiratory papillomatosis Research Risk Savings Series Site Subgroup Surveys Testing Time Treatment-Related Cancer Underserved Population United States Vaccination Vaccines Vagina Vulva Woman age group aged base burden of illness cancer prevention cervical cancer prevention chronic infection cost effective intervention effectiveness evaluation effectiveness outcome effectiveness testing implementation framework implementation study implementation trial improved intervention program male men mortality penis prevention service primary outcome programs satisfaction secondary outcome social health determinants therapy design underserved area uptake vaccine acceptance young adult

项目摘要

Prior research has demonstrated that health care provider recommendation is the most influential factor affecting HPV vaccine uptake and completion among adolescents and young adults. However, many providers are not recommending the vaccine at opportunistic times such as the targeted ages of 11-12 when most children receive Tdap and meningococcal vaccines. To improve the uptake of the HPV vaccine among 11-12 year olds – the age group of focus for the Centers for Disease Control and Prevention (CDC) – a multi-disciplinary research team across four Appalachian states will test the effectiveness of a health system-based intervention, as part of an integrated clinic-based cervical cancer prevention program (with Projects 1 and 3), that is directed to three levels of influence – clinic, provider, and patient. Using a delayed intervention design in a group randomized implementation trial, we will examine outcomes of effectiveness, acceptability, and sustainability along the Implementation Science Framework. We will also test in a secondary aim whether interventions targeted to the 13-26 year olds increases catch-up vaccination. This study is part of the Program Project, “Improving Uptake of Cervical Cancer Prevention Services in Appalachia,” and as such, is intricately integrated with the Cores of the Program. The interventions to be tested have been developed in conjunction with community partners, address multi-level factors within the Social Determinants of Health that impact disparities in HPV-related disease, and have been piloted in Appalachian populations. Specific aims are to: 1) Primary Outcome: Test the effectiveness of a multi-level intervention directed at clinics, providers, and patients (parents of children aged 11-12) to improve HPV vaccine initiation and completion in health systems in four Appalachian states (KY, OH, WV, and VA) among children aged 11-12, and assess the effectiveness of the intervention program among subgroups, e.g., females vs males; 2) Secondary Outcomes: Assess: a) sustainability of the intervention; b) cost impacts of the intervention; c) changes in clinic practices that occur as a result of the intervention in terms of staff responsibilities for the vaccination process and reducing missed opportunities for vaccination; and d) whether interventions directed to 13-26 year olds increases catch-up vaccination; and 3) Secondary Outcomes: Examine: a) changes in knowledge and attitudes of providers via educational session pre-post surveys and b) satisfaction with the intervention at the multiple levels. If effective, this multi-level intervention will be disseminated to our clinical and community partners as well as other partners throughout Appalachia to facilitate the uptake of effective interventions throughout health systems and clinics in Appalachia to help reduce the burden of HPV-preventable diseases.

先前的研究表明，医疗保健提供者的建议是影响最大的因素青少年和年轻人的HPV疫苗吸收和完成。但是，许多提供商不是在大多数孩子接受的机会时，在机会主义时期（例如，有针对性的年龄）推荐疫苗 TDAP和脑膜炎球菌疫苗。为了改善11-12岁的HPV疫苗的摄取 - 年龄疾病控制与预防中心（CDC）的重点小组 - 多学科研究团队在四个阿巴拉契亚州，将测试基于卫生系统的干预措施的有效性，作为基于诊所的综合宫颈癌预防计划（带有项目1和3），该计划针对三个级别影响力 - 诊所，提供者和患者。在随机分组中使用延迟干预设计实施审判，我们将研究有效性，可接受性和可持续性的结果实施科学框架。我们还将在次要目标中测试是否针对 13-26岁的年轻人增加了追赶疫苗接种。这项研究是计划项目的一部分，“改善了阿巴拉契亚州的宫颈癌预防服务”，因此，与程序。要测试的干预措施已与社区合作伙伴共同开发，地址在健康的社会决定因素中，影响与HPV相关疾病的分布的社会决定因素，以及在阿巴拉契亚人口被驾驶。具体目的是：1）主要结果：测试有效性针对诊所，提供者和患者（11-12岁儿童的父母）的多层次干预措施以改善在阿巴拉契亚四个州（KY，OH，WV和VA）的HPV疫苗倡议和完成 11-12岁的儿童，并评估亚组中干预计划的有效性，例如女性 VS男性； 2）次要结果：评估：a）干预的可持续性； b）成本影响干涉; c）由于员工责任而导致干预导致的诊所实践的变化进行疫苗接种过程并减少错过的疫苗接种机会； d）是否干预针对13-26岁的年轻人增加了追赶疫苗接种； 3）次要结果：检查：a）更改通过教育会议前调查和b）满意干预多个层次。如果有效，这种多层次干预措施将被传播到我们的临床和社区合作伙伴以及整个阿巴拉契亚的其他合作伙伴，以促进有效的吸收阿巴拉契亚州的整个卫生系统和诊所的干预措施，以帮助减少可预防的燃烧疾病。