Gross Tyra T, Rahman Mahbubur, M Wright Abigail, M Hirth Jacqueline, Sarpong Kwabena O, Rupp Richard E, D Barrett Alan, Berenson Abbey B
Department of Obstetrics & Gynecology and Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77550-0587, USA.
Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA.
Matern Child Health J. 2016 Nov;20(Suppl 1):154-163. doi: 10.1007/s10995-016-2030-0.
Introduction The objective of this qualitative study was to assess healthcare providers' acceptability of an ongoing postpartum human papillomavirus (HPV) vaccination program in Southeast Texas and its integration into everyday clinical care. Methods In 2012, the Department of Obstetrics & Gynecology at the University of Texas Medical Branch (UTMB) began offering HPV vaccination as part of standard postpartum care to increase vaccination rates among young women in Galveston County. Initial vaccine doses were offered on the postpartum unit while subsequent doses were coordinated with postpartum and well-baby visits. Thirty months after project initiation, semi-structured interviews of physicians (n = 12) and nurses (n = 6) involved in postpartum and pediatric care at UTMB were conducted. Interview transcripts were analyzed using thematic analysis in Nvivo10. Results Overall, providers demonstrated "pro-vaccine" attitudes and stated the program was an effective strategy for vaccinating hard-to-reach women. Cancer prevention was the main perceived benefit while follow-up compliance was the primary perceived patient barrier. The initial challenges with integrating postpartum HPV vaccination included miscommunication between providers regarding vaccine orders and coordination issues with well-baby visits for follow-up doses. One novel finding was providers' beliefs that women's personal HPV vaccine practices may positively impact their decisions about later vaccinating their children against HPV. Providers' suggestions to improve the program included: enhancing postpartum HPV vaccine education for patients, offering more continuing education for providers, and increasing community awareness of HPV vaccination. Discussion These findings can help providers of postpartum care understand how to integrate postpartum HPV vaccination into their current practices and how to overcome perceived vaccination barriers.
引言 这项定性研究的目的是评估医疗服务提供者对德克萨斯州东南部正在进行的产后人乳头瘤病毒（HPV）疫苗接种计划的接受程度，以及该计划融入日常临床护理的情况。方法 2012年，德克萨斯大学医学分部（UTMB）妇产科开始将HPV疫苗接种作为标准产后护理的一部分，以提高加尔维斯顿县年轻女性的疫苗接种率。初始疫苗剂量在产后病房提供，后续剂量则与产后及婴儿健康检查协调安排。项目启动30个月后，对参与UTMB产后和儿科护理的医生（n = 12）和护士（n = 6）进行了半结构化访谈。使用Nvivo10中的主题分析法对访谈记录进行了分析。结果 总体而言，医疗服务提供者表现出“支持疫苗接种”的态度，并表示该计划是为难以接触到的女性接种疫苗的有效策略。预防癌症是主要的预期益处，而后续接种的依从性是主要的预期患者障碍。将产后HPV疫苗接种纳入常规护理的最初挑战包括医疗服务提供者之间关于疫苗订购的沟通不畅，以及与婴儿健康检查后续剂量的协调问题。一个新发现是，医疗服务提供者认为女性个人的HPV疫苗接种行为可能会对她们日后为孩子接种HPV疫苗的决定产生积极影响。医疗服务提供者对改进该计划的建议包括：加强对患者的产后HPV疫苗教育，为医疗服务提供者提供更多继续教育，以及提高社区对HPV疫苗接种的认识。讨论 这些发现可以帮助产后护理提供者了解如何将产后HPV疫苗接种纳入他们目前的实践中，以及如何克服预期的疫苗接种障碍。
