Columbia Mailman School of Public Health, USA.
J Health Polit Policy Law. 2013 Aug;38(4):645-81. doi: 10.1215/03616878-2208567. Epub 2013 May 3.
This article explores the political dimensions of policy formation for the human papillomavirus (HPV) vaccine through case studies of six states: California, Indiana, New Hampshire, New York, Texas, and Virginia. Using thematic content analysis of semistructured key informant interviews with policy stakeholders, newspaper articles, and archival materials, we describe the trajectory of public health policy developments for HPV immunization and analyze key influences on policy outcomes through the theoretical lens of the Multiple Streams framework. Specifically, we examine factors influencing the extent to which HPV was perceived as a problem meriting policy action; political forces that facilitated and impeded policy adoption, including interest-group opposition and structural and ideological features of the states' political environments; and factors affecting which policy alternatives received consideration. We find that effective policy entrepreneurship played a critical role in determining policy outcomes. We conclude by discussing lessons from the case of HPV vaccination for future efforts to craft vaccination policies.
本文通过对加利福尼亚州、印第安纳州、新罕布什尔州、纽约州、德克萨斯州和弗吉尼亚州这六个州的案例研究，探讨了人乳头瘤病毒（HPV）疫苗政策制定的政治层面。我们对政策利益相关者的半结构化关键知情者访谈、报纸文章和档案材料进行了主题内容分析，描述了 HPV 免疫接种公共卫生政策发展的轨迹，并通过多源流框架的理论视角分析了政策结果的关键影响因素。具体而言，我们考察了影响 HPV 被视为值得采取政策行动的问题的程度的因素；促进和阻碍政策采用的政治力量，包括利益集团的反对以及各州政治环境的结构性和意识形态特征；以及影响哪些政策选择受到考虑的因素。我们发现，有效的政策创业在决定政策结果方面发挥了关键作用。最后，我们讨论了 HPV 疫苗接种案例对未来制定疫苗接种政策的经验教训。
