McRee Annie-Laurie, Gilkey Melissa B, Dempsey Amanda F
J Pediatr Health Care. 2014 Nov-Dec;28(6):541-9. doi: 10.1016/j.pedhc.2014.05.003. Epub 2014 Jul 10.
Health care provider recommendations are critical for human papillomavirus (HPV) vaccine uptake. We sought to describe providers' HPV vaccine recommendation practices and explore their perceptions of parental hesitancy.
A statewide sample (n = 575) of Minnesota health care providers (20% pediatricians, 47% family medicine physicians, and 33% nurse practitioners) completed our online survey in April 2013.
Only 76% of health care providers reported routinely recommending HPV vaccine for girls ages 11 to 12 years, and far fewer (46%) did so for boys (p < .001). A majority of providers reported asking questions about parents' concerns (74%), but many lacked time to probe reasons (47%) or believed that they could not change parents' minds (55%). Higher levels of self-efficacy and outcome expectations were associated with routine recommendations (p < .05).
Findings suggest that providers' perceptions of hesitancy may discourage them from routinely recommending the HPV vaccine. Improving providers' self-efficacy to address hesitancy may be important for improving vaccination rates.
医疗保健提供者的建议对于人乳头瘤病毒（HPV）疫苗的接种至关重要。我们试图描述提供者的HPV疫苗推荐做法，并探讨他们对家长犹豫态度的看法。
2013年4月，明尼苏达州医疗保健提供者的全州范围样本（n = 575）（20%为儿科医生，47%为家庭医学医生，33%为执业护士）完成了我们的在线调查。
只有76%的医疗保健提供者报告称经常为11至12岁的女孩推荐HPV疫苗，而为男孩推荐的比例要少得多（46%）（p <.001）。大多数提供者报告称会询问家长的担忧（74%），但许多人没有时间深入探究原因（47%），或者认为他们无法改变家长的想法（55%）。自我效能感和结果期望水平较高与常规推荐相关（p <.05）。
研究结果表明，提供者对家长犹豫态度的看法可能会阻碍他们常规推荐HPV疫苗。提高提供者应对家长犹豫态度的自我效能感对于提高疫苗接种率可能很重要。
