Kahn Jessica A, Rosenthal Susan L, Tissot Abbigail M, Bernstein David I, Wetzel Caitlin, Zimet Gregory D
Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio 45229, USA.
Ambul Pediatr. 2007 Sep-Oct;7(5):367-73. doi: 10.1016/j.ambp.2007.05.010.
The objectives of this qualitative study were to describe the range of pediatricians' attitudes about human papillomavirus (HPV) vaccines and to explore factors influencing their intention to recommend HPV vaccines, extending the findings of previous quantitative studies.
A diverse sample of pediatricians participated in semistructured individual interviews to assess attitudes and intentions regarding HPV immunization. Framework analysis was used for qualitative analysis.
The mean age of the 31 participants was 47 years, 17 (55%) were female, 9 (29%) were black, and 4 (13%) were Latino. The efficacy, safety, and potential health impact of vaccination were the primary factors driving participants' decisions about recommending HPV vaccines. Perceived benefits of HPV vaccination included prevention of HPV-related disease and the opportunity to educate adolescents. Perceived barriers included anticipated parental beliefs (eg, parental denial that their child would be at risk) and provider beliefs (eg, reluctance to discuss sexuality with preadolescents). Participants reported high intention to recommend HPV vaccines overall, but intention varied according to patient age, patient gender, and HPV vaccine type. The primary reasons underlying this variation included perceptions about the health impact of vaccination and relevance of HPV vaccines to the provider's patients. The main factors driving intention to recommend HPV vaccines included knowledge, personal and professional characteristics, office procedures, vaccine cost and reimbursement, parental factors, and specific attitudes about HPV vaccination.
These findings provide a framework for understanding pediatricians' decisions to recommend HPV vaccines and may be used to guide the design of interventions to maximize vaccine recommendations.
本定性研究的目的是描述儿科医生对人乳头瘤病毒（HPV）疫苗的态度范围，并探讨影响他们推荐HPV疫苗意愿的因素，扩展以往定量研究的结果。
选取不同的儿科医生样本参与半结构化个人访谈，以评估他们对HPV免疫接种的态度和意愿。采用框架分析法进行定性分析。
31名参与者的平均年龄为47岁，其中17名（55%）为女性，9名（29%）为黑人，4名（13%）为拉丁裔。疫苗的有效性、安全性和潜在健康影响是推动参与者决定是否推荐HPV疫苗的主要因素。HPV疫苗接种的预期益处包括预防HPV相关疾病以及有机会对青少年进行教育。预期障碍包括家长的观念（例如，家长否认自己的孩子有风险）和医生的观念（例如，不愿与青春期前儿童讨论性问题）。参与者总体上报告有很高的意愿推荐HPV疫苗，但意愿因患者年龄、患者性别和HPV疫苗类型而异。这种差异的主要原因包括对疫苗健康影响的认知以及HPV疫苗与医生患者的相关性。推动推荐HPV疫苗意愿的主要因素包括知识、个人和专业特征、办公室程序、疫苗成本和报销、家长因素以及对HPV疫苗接种的具体态度。
这些发现为理解儿科医生推荐HPV疫苗的决定提供了一个框架，可用于指导干预措施的设计，以最大限度地提高疫苗推荐率。
