Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA.
WF Connell School of Nursing, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA 02467, USA.
Vaccine. 2018 May 3;36(19):2637-2642. doi: 10.1016/j.vaccine.2018.03.060. Epub 2018 Apr 4.
Despite increasing awareness of the importance of a provider recommendation for HPV vaccine, the U.S. has yet to achieve the Healthy people 2020 goal of 80% series completion among adolescents. This failure indicates a need for further examination of the modifiable influences on parents' decision-making. Healthcare providers can influence parents' HPV vaccination decision-making, but little is known about parents' perspectives on the counseling they receive. We sought to assess U.S. parents' satisfaction with provider communication about HPV vaccine and associations with vaccination behaviors.
Parents of 11-to-17-year-old adolescents who discussed HPV vaccination with a healthcare provider at least once (n = 795) completed our online survey in Fall 2016. We assessed their satisfaction with the discussion using the HPV Vaccine Communication Satisfaction Scale (α = 0.94). We examined associations between satisfaction (categorized as low, moderate, or high), and three vaccination behaviors: refusal/delay, series initiation (≥1 dose), and continuation (≥2 doses among initiators) using multivariable logistic regression.
Most parents reported high (36%) or moderate (38%) satisfaction with provider communication about HPV vaccination; fewer reported low (26%) satisfaction. Moderately satisfied parents (vs. low) had lower odds of refusal/delay (aOR = 0.59, 95% CI: 0.38-0.89), and higher odds of initiation (aOR = 1.71, 95% CI:1.15-2.55) and continuation (aOR = 2.05, 95% CI: 1.24-3.40). The associations were stronger for highly satisfied parents (refusal/delay aOR = 0.45, 95% CI: 0.29-0.70, initiation aOR = 3.59, 95% CI: 2.23-5.78, and continuation aOR = 4.08, 95% CI: 2.38-7.01).
Our study suggests that parent satisfaction with provider communication may play an important role in HPV vaccination decision-making. Yet, communication satisfaction has been largely unexamined in the HPV-vaccine literature to date. We introduce a brief, 7-item HPV Vaccine Communication Scale that can be used to assess parents' level of satisfaction with their provider's communication specific to HPV vaccine. We identify communication areas for providers to prioritize when discussing HPV vaccine with parents.
尽管人们越来越意识到提供者推荐 HPV 疫苗的重要性，但美国仍未实现“健康人民 2020”目标，即青少年 HPV 疫苗系列接种率达到 80%。这一失败表明需要进一步研究对父母决策有影响的可改变因素。医疗保健提供者可以影响父母对 HPV 疫苗接种的决策，但对于父母对他们所接受的咨询的看法知之甚少。我们试图评估美国父母对提供者关于 HPV 疫苗沟通的满意度，并评估其与疫苗接种行为的关联。
2016 年秋季，我们对至少与一位医疗保健提供者讨论过 HPV 疫苗接种的 11 至 17 岁青少年的父母进行了在线调查。我们使用 HPV 疫苗沟通满意度量表（HPV Vaccine Communication Satisfaction Scale，α=0.94）评估他们对讨论的满意度。我们使用多变量逻辑回归分析了满意度（分为低、中、高）与三种疫苗接种行为（拒绝/延迟、系列启动（至少 1 剂）和继续（启动者至少 2 剂）之间的关联。
大多数父母报告提供者沟通 HPV 疫苗接种的满意度较高（36%）或中等（38%）；报告满意度较低（26%）的比例较低。与低满意度父母（与低满意度父母相比）相比，中等满意度父母拒绝/延迟的可能性较低（OR=0.59，95%CI：0.38-0.89），开始接种（OR=1.71，95%CI：1.15-2.55）和继续接种（OR=2.05，95%CI：1.24-3.40）的可能性较高。对于高度满意的父母，这些关联更强（拒绝/延迟 OR=0.45，95%CI：0.29-0.70，启动 OR=3.59，95%CI：2.23-5.78，和继续 OR=4.08，95%CI：2.38-7.01）。
我们的研究表明，父母对提供者沟通的满意度可能在 HPV 疫苗接种决策中发挥重要作用。然而，迄今为止，HPV 疫苗文献中对沟通满意度的研究还很少。我们引入了一个简短的 7 项 HPV 疫苗沟通量表，可用于评估父母对提供者 HPV 疫苗沟通的满意度。我们确定了提供者在与父母讨论 HPV 疫苗时需要优先考虑的沟通领域。
