Dempsey Amanda F, Lockhart Steven, Campagna Elizabeth J, Pyrzanowski Jennifer, Barnard Juliana, O' Leary Sean T
Adult and Child Consortium for Outcomes Research and Dissemination Science Program, Children's Hospital Colorado and University of Colorado, 13199 East Montview Blvd, Suite 300, Aurora, CO 80045, United States.
Adult and Child Consortium for Outcomes Research and Dissemination Science Program, Children's Hospital Colorado and University of Colorado, 13199 East Montview Blvd, Suite 300, Aurora, CO 80045, United States. Electronic address: Sean.O'
Vaccine. 2016 Dec 7;34(50):6217-6222. doi: 10.1016/j.vaccine.2016.10.083. Epub 2016 Nov 10.
Little is known about HPV vaccine communication tools currently used by primary care providers of adolescents, or how such tools impact the quality of HPV vaccine recommendations, which some have defined as using a "presumptive" communication style, continuing to offer vaccines despite resistance, and strongly recommending vaccines at the appropriate ages. We surveyed primary care providers to assess their current use of HPV vaccine communication tools, and how these related to their HPV vaccine recommendation quality.
Cross sectional survey of 183 pediatrics and family medicine primary care providers in the Denver metro area.
Response rate was 82% (n=150). Most (59%) providers used a presumptive vaccine recommendation >75% of the time, and 76% reported continuing to offer the HPV vaccine even after parent refusal. However, less than two-thirds of providers "strongly" recommended the vaccine to 11-12year olds (60% for females, 55% for males, p=0.02). The HPV vaccine information sheet from the Centers from Disease Control and Prevention was the most frequently used communication tool during clinical visits (64% used at least 75% of the time) and directing parents to preferred websites was the most frequently used between-visit communication tool (21% used >50% of visits). Use of tools was not associated with any measure of HPV vaccine recommendation quality but was associated with longer HPV vaccine discussion times.
Providers use only limited types of adolescent HPV vaccine communication tools, and frequently do not use preferred vaccine communication strategies. Better engagement with existing HPV vaccine communication tools, and/or the creation of new tools may be needed to enhance providers' ability to provide high quality HPV vaccine recommendations.
目前对于青少年初级保健提供者所使用的人乳头瘤病毒(HPV)疫苗沟通工具知之甚少,也不清楚此类工具如何影响HPV疫苗推荐的质量,有人将HPV疫苗推荐质量定义为采用“推定式”沟通方式、在家长有抵触情绪时仍继续提供疫苗以及在适当年龄强烈推荐接种疫苗。我们对初级保健提供者进行了调查,以评估他们目前对HPV疫苗沟通工具的使用情况,以及这些工具与他们的HPV疫苗推荐质量之间的关系。
对丹佛市区183名儿科和家庭医学初级保健提供者进行横断面调查。
回复率为82%(n = 150)。大多数(59%)提供者在超过75%的时间里采用推定式疫苗推荐,76%的提供者报告称即使在家长拒绝后仍继续提供HPV疫苗。然而,不到三分之二的提供者“强烈”向11至12岁儿童推荐该疫苗(女性为60%,男性为55%,p = 0.02)。疾病控制与预防中心的HPV疫苗信息单是临床就诊期间最常用的沟通工具(64%的人至少在75%的时间里使用),引导家长访问推荐网站是就诊期间最常用的沟通工具(21%的人在超过50%的就诊中使用)。工具的使用与HPV疫苗推荐质量的任何指标均无关联,但与更长的HPV疫苗讨论时间相关。
提供者仅使用有限类型的青少年HPV疫苗沟通工具,且经常不采用推荐的疫苗沟通策略。可能需要更好地利用现有的HPV疫苗沟通工具,和/或创建新工具,以提高提供者提供高质量HPV疫苗推荐的能力。