Division of General Pediatrics and Adolescent Health, University of Minnesota; 717 Delaware St. SE, Minneapolis, MN 55414, USA.
Department of Health Behavior, University of North Carolina, CB 7440, Chapel Hill, NC 27599, USA.
Vaccine. 2018 Jan 25;36(4):461-466. doi: 10.1016/j.vaccine.2017.12.020. Epub 2017 Dec 24.
Offering HPV vaccine in settings beyond the traditional medical home holds promise for increasing the currently low levels of coverage. As adolescents frequently visit dentists, dental practices may be one such alternative vaccination setting. This study assessed parent attitudes about the roles dental providers could play in HPV prevention, including vaccine provision.
In September 2016, we conducted an online survey using a national sample (n = 1209) of U.S. parents of adolescent children aged 11-17. Adolescents' mean age was 14; 53% were male and 62% were non-Hispanic white. We identified correlates of parents' comfort with dentists as HPV vaccinators using multivariable logistic regression.
Overall, 23% of parents reported that they would feel comfortable with their child receiving HPV vaccine from a dentist. In multivariable analyses, parents had greater odds of being comfortable if they had higher trust in their child's primary care provider (OR = 1.27, 95% CI: 0.96-1.68) and lower odds if their child was female (OR = 0.65, 95% CI: 0.50-0.86). Convenience (20%) and oral health expertise (20%) were the most commonly cited benefits of dentists administering the vaccine. Wanting their child's regular provider to administer and track vaccinations (61% and 58%, respectively), and lack of insurance coverage (30%) were the most commonly cited concerns. Parents expressed somewhat greater comfort with roles dentists might play in promoting HPV vaccination other than vaccine delivery, such as providing education.
Parents in this sample had low comfort with dentists as HPV vaccinators. Findings from this study highlight potential concerns to be addressed before dental practices consider offering HPV vaccination in the future. Further research should assess dentists' perspectives and explore alternative roles for dental providers in HPV prevention efforts.
在传统医疗模式之外提供 HPV 疫苗接种服务有望提高目前较低的疫苗接种率。由于青少年经常看牙医，因此牙科诊所可能是一个替代疫苗接种场所。本研究评估了家长对牙科医生在 HPV 预防中的作用的态度，包括疫苗接种。
2016 年 9 月，我们使用全国性样本（n=1209）对美国 11-17 岁青少年的父母进行了一项在线调查。青少年的平均年龄为 14 岁；53%为男性，62%为非西班牙裔白人。我们使用多变量逻辑回归确定了父母对牙医作为 HPV 疫苗接种者的舒适度的相关因素。
总体而言，23%的家长表示他们愿意让孩子从牙医那里接种 HPV 疫苗。在多变量分析中，如果家长对孩子的初级保健提供者信任度较高（OR=1.27，95%CI：0.96-1.68），则更有可能感到舒适；如果孩子是女性（OR=0.65，95%CI：0.50-0.86），则不太可能感到舒适。便利性（20%）和口腔健康专业知识（20%）是家长认为牙医接种疫苗的最常见好处。希望孩子的常规提供者接种和跟踪疫苗接种（分别为 61%和 58%）以及缺乏保险覆盖（30%）是家长最常提到的担忧。家长对牙医在推广 HPV 疫苗接种方面的作用（除了疫苗接种外）的态度略为更舒适，例如提供教育。
在本研究中，家长对牙医作为 HPV 疫苗接种者的接受程度较低。本研究结果强调了在牙科诊所考虑未来提供 HPV 疫苗接种之前需要解决的潜在问题。进一步的研究应评估牙医的观点，并探索牙科医生在 HPV 预防工作中的替代角色。
