Identifying the multi-level factors influencing provider recommendations of adolescent vaccines: A mixed methods study

确定影响青少年疫苗提供者建议的多层次因素：混合方法研究

• 批准号: 10758516
• 负责人: Mallory Ellingson
• 金额: $ 4.77万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10758516
• 关键词: Address; Adolescence; Adolescent; Attitude; Belief; Characteristics; Child; Communities; County; Data; Decision Making; Development; Education; Educational Status; Ethnic Origin; Foundations; Frequencies; Goals; Health Personnel; Hispanic; Human Papilloma Virus Vaccine; Individual; Insurance Coverage; Intervention; Intervention Studies; Interview; Knowledge; Literature; Maps; Methods; Neighborhoods; Observational Study; Parents; Patients; Pattern; Perception; Persons; Population Heterogeneity; Poverty; Process; Provider; Race; Recommendation; Research; Services; Teenagers; Urbanicity; Vaccinated; Vaccination; Vaccines; Variant; adolescent health; community-level factor; falls; improved; multilevel analysis; novel; parental influence; public health intervention; response; sociodemographics; uptake; vaccine acceptance; vaccine platform

PROJECT SUMMARY Healthcare provider (HCP) recommendations are one of the most important factors influencing parents’ acceptance of adolescent vaccines. A large body of literature across qualitative, observational and intervention studies has demonstrated that parents who receive a vaccine recommendation from a healthcare provider are much more likely to vaccinate their child. However, provider recommendations are not universal and high- quality recommendations are even more uncommon. Provider recommendations for adolescent vaccines can vary in strength, consistency, and timeliness, but the factors that influence the frequency and quality of these recommendations have not been well explored. The vaccine decision making process is influenced by factors at multiple levels including the individual, interpersonal, and community levels. Provider vaccine recommendations can be conceptualized in the same way–HCPs are influenced not only by their own attitudes and knowledge about the vaccine, but also their perceptions and knowledge of the patient and community in which they practice. Additionally, these factors do not work in isolation and can interact across levels to influence recommendations. In the proposed project, we will conduct a sequential mixed-methods study to explore how provider recommendations vary by individual, interpersonal and community level factors. First, we will conduct a multi- level analysis of nationally-representative zip code level data from NIS-Teen to examine how provider recommendations vary by interpersonal factors (i.e. patient characteristics - race/ethnicity, education level, insurance coverage) and community-level factors (i.e. urbanicity, poverty level) as well as how these factors interact (Specific Aim 1). To better understand our findings from Aim 1, we will conduct in-depth interviews with adolescent HCPs to explore how individual-level factors (i.e. provider attitudes) inform interpersonal and community level variation (Specific Aim 2). These interviews will be conducted in New Haven County among HCPs who both represent and provide service to a socio-demographically diverse population. Through this sequential mixed-methods approach, we will identify both how provider recommendations vary as well as explore the underlying beliefs and biases that guide provider recommendation practices. So far, research has primarily focused on the impact of provider recommendations for the HPV vaccine; examining the entire adolescent vaccine platform in this proposal will allow us to expand this limited body of literature. Our results will provide a foundation for the development and targeting of interventions to improve the quality of provider recommendations for greater coverage for all adolescent vaccines.

项目摘要 医疗保健提供商（HCP）建议是影响父母的最重要因素之一 接受青少年疫苗。跨定性，观察和干预的大量文献 研究表明，从医疗保健提供者那里收到疫苗建议的父母是 为孩子接种疫苗的可能性更大。但是，提供商的建议不是普遍的，也不是高的 高质量的建议更加罕见。提供者建议青少年疫苗可以 强度，一致性和及时性各不相同，但是影响这些频率和质量的因素 建议尚未得到很好的探索。 疫苗决策过程受到包括个人在内的多个层次的因素的影响， 人际关系和社区层面。提供者疫苗建议可以在同一概念上概念化 方法 - HCP不仅受到自己的出席和了解疫苗的知识的影响，而且还受到他们的知识 对他们实践的患者和社区的看法和知识。另外，这些因素确实 不孤立地工作，可以跨级别互动以影响建议。 在拟议的项目中，我们将进行一项连续的混合方法研究，以探索提供商 建议因个人，人际关系和社区层面因素而异。首先，我们将进行多个 NIS-Teen的国家代表性邮政编码级别数据的级别分析以检查提供商的方式 建议因人际交往因素而异（即患者特征 - 种族/种族，教育水平， 保险范围）和社区级别的因素（即城市化，贫困水平）以及这些因素如何 互动（特定目标1）。为了更好地了解AIM 1的发现，我们将对 青少年HCP探讨个人级别因素（即提供者参加）如何告知人际关系和 社区级别的变化（特定目标2）。这些访谈将在纽黑文县进行 HCP代表并为社会人口统计学上多样化的人群提供服务。 通过这种连续的混合方法方法，我们将确定提供者建议如何变化为 以及探索指导提供者建议实践的潜在信念和偏见。迄今为止， 研究主要集中于提供者建议对HPV疫苗的影响。检查 该提案中的整个青少年疫苗平台将使我们能够扩大这种有限的文献。我们的 结果将为开发和靶向干预措施的基础，以提高质量 提供者建议所有青少年疫苗的覆盖范围更大。