在高风险社区中，服务提供者对 HPV 疫苗接种的障碍和促进因素的看法。

Provider perceptions of barriers and facilitators of HPV vaccination in a high-risk community.

机构信息

Department of Epidemiology, University of California, Los Angeles, Box 951772, Los Angeles, CA 90095-1772, USA.

出版信息

Vaccine. 2012 Jun 22;30(30):4511-6. doi: 10.1016/j.vaccine.2012.04.062. Epub 2012 May 3.

DOI:10.1016/j.vaccine.2012.04.062

PMID:22561142

Abstract

BACKGROUND

Maximizing HPV vaccine uptake among those at highest risk for cervical cancer is critical. We explored healthcare provider perspectives on factors influencing HPV vaccination among adolescent girls in a community with high cervical cancer rates.

METHODS

From March to May 2009, we conducted in-depth interviews with 21 medical staff providing care to adolescent girls at two clinics in Los Angeles, CA, serving a predominantly Hispanic population with high cervical cancer rates. Interviews were recorded and transcribed data were reviewed for coding and thematic content related to potential barriers and facilitators of HPV vaccination.

RESULTS

Providers and medical staff overwhelmingly focused on parental beliefs as barriers to HPV vaccination. Perceived parental misconceptions acting as barriers included the belief that adolescents do not need vaccinations and that no-cost vaccine programs like Vaccines for Children are only available for younger children. Perceived parental concerns that the vaccine will promote sexual activity were prevalent, which prompted providers to frame HPV vaccine as a "routine" vaccine. However, the medical staff felt mothers with a friend or relative supportive of HPV vaccination were more likely to request the vaccine. The staff also noted that for Hispanic parents the "preferred" source of information is peers; if the "right people" in the community were supportive of HPV vaccine, parents were more willing to vaccinate. Other barriers included lack of immunization records among immigrant parents and a difficult-to-reach, mobile clientele.

CONCLUSIONS

Providers noted a number of barriers to HPV vaccination, including some perceived parental misconceptions that could be addressed with education about the need for adolescent vaccines and available free vaccine programs. Because community support appears particularly important to Hispanic parents, the use of promotoras - peer liaisons between health organizations and the community - may increase HPV vaccine uptake in this population.

摘要

背景

最大限度地提高宫颈癌高危人群的 HPV 疫苗接种率至关重要。我们探讨了医疗服务提供者对影响社区内青少年女孩 HPV 疫苗接种的因素的看法，该社区宫颈癌发病率高。

方法

2009 年 3 月至 5 月，我们对加利福尼亚州洛杉矶的两家诊所为青少年女孩提供护理的 21 名医疗保健提供者进行了深入访谈，这些诊所的服务对象主要是西班牙语裔人群，宫颈癌发病率高。采访进行了录音，并对转录数据进行了审查，以确定与 HPV 疫苗接种的潜在障碍和促进因素有关的编码和主题内容。

结果

提供者和医务人员将父母的信念视为 HPV 疫苗接种的主要障碍。父母的误解被认为是障碍，包括青少年不需要接种疫苗以及 Vaccines for Children 等免费疫苗接种计划仅适用于年龄较小的儿童。普遍存在父母担心疫苗会促进性行为的问题，这促使提供者将 HPV 疫苗作为“常规”疫苗。然而，医务人员认为，有朋友或亲戚支持 HPV 疫苗接种的母亲更有可能要求接种疫苗。工作人员还指出，对于西班牙裔父母来说，“首选”的信息来源是同龄人；如果社区中有“合适的人”支持 HPV 疫苗，那么父母更愿意接种疫苗。其他障碍包括移民父母缺乏免疫记录以及难以接触到的流动人口。