Adult and Child Consortium for Outcomes Research and Dissemination Science, Aurora, Colo; Division of General Pediatrics, University of Colorado Denver.
Adult and Child Consortium for Outcomes Research and Dissemination Science, Aurora, Colo; Division of Pediatric Infectious Diseases, University of Colorado Denver.
Acad Pediatr. 2018 Mar;18(2S):S23-S27. doi: 10.1016/j.acap.2017.09.001.
The burden of human papillomavirus (HPV) infections is substantial, causing thousands of cancers and deaths in the United States yearly. Safe and effective vaccines exist, yet remains underutilized, particularly among younger adolescents for whom the vaccine is targeted. Provider communication techniques are known to affect parents' and adolescents' acceptance of this vaccine. In this review, we examine the influence that provider communication techniques have on parental attitudes regarding HPV vaccine, as well as how those techniques affect vaccination uptake. We explore the limited literature that has directly measured the influence of provider communication techniques on parental attitudes, which suggests that the strength of a provider recommendation strongly influences parents' perceptions regarding the safety of HPV vaccine, and that brief recommendations might be best for parents without significant concerns. We also review the literature regarding the use of so-called 'presumptive' recommendations, and how these types of recommendations are associated with increased HPV vaccine uptake. Finally, we present new information regarding the use of motivational interviewing as a provider communication technique to improve vaccination uptake, particularly among vaccine-hesitant parents. We close with suggestions for 'best practices' that include using brief, strong, unambiguous language to introduce the HPV vaccine, followed by more nuanced communication techniques, such as motivational interviewing, when encountering resistance.
人乳头瘤病毒（HPV）感染的负担很大，每年在美国导致数千例癌症和死亡。虽然存在安全有效的疫苗，但使用率仍然较低，尤其是针对年轻青少年的疫苗。众所周知，提供者的沟通技巧会影响父母和青少年对这种疫苗的接受程度。在这篇综述中，我们研究了提供者沟通技巧对父母对 HPV 疫苗态度的影响，以及这些技巧如何影响疫苗接种率。我们探讨了直接衡量提供者沟通技巧对父母态度影响的有限文献，这表明提供者建议的力度强烈影响父母对 HPV 疫苗安全性的看法，并且对于没有重大担忧的父母来说，简短的建议可能是最好的。我们还回顾了关于使用所谓的“假定”建议的文献，以及这些类型的建议如何与 HPV 疫苗接种率的增加相关。最后，我们提供了有关使用动机性访谈作为提供者沟通技巧来提高疫苗接种率的新信息，特别是在面对疫苗犹豫不决的父母时。最后，我们提出了“最佳实践”的建议，包括使用简短、有力、明确的语言介绍 HPV 疫苗，然后在遇到阻力时使用更细致的沟通技巧，如动机性访谈。
