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评估多组分干预措施在改善医疗保健提供者关于人乳头瘤病毒疫苗接种沟通方面的实施情况。

Evaluation of the Implementation of a Multicomponent Intervention to Improve Health Care Provider Communication About Human Papillomavirus Vaccination.

机构信息

Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), School of Medicine, University of Colorado Denver, Aurora.

Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), School of Medicine, University of Colorado Denver, Aurora.

出版信息

Acad Pediatr. 2018 Nov-Dec;18(8):882-888. doi: 10.1016/j.acap.2018.08.004. Epub 2018 Aug 11.

DOI:10.1016/j.acap.2018.08.004
PMID:30107236
Abstract

OBJECTIVE

To evaluate the relative use, usefulness, and facilitators and barriers to use as perceived by providers of 5 different components in a human papillomavirus vaccine communication intervention-which was found to be effective at improving human papillomavirus vaccination rates.

METHODS

Four serial surveys of 108 providers (doctor of medicine, nurse practitioner, or doctor of osteopathic medicine) from intervention clinics involved in the study assessed the use and usefulness of the 5 communication intervention components during a 12-month period.

RESULTS

Survey response rates were 79% to 86%. The fact sheet (64%-77%) and motivational interviewing techniques (MI; 86%) were the most used components-use was sustained during the 12-month period. These components also were perceived as somewhat or very useful by most providers, and this perceived usefulness increased over time (very or somewhat useful at end of study, 97% fact sheet, 98% MI, respectively). Although fewer providers reported using the Web site (15%-42%), or disease images (6%-17%), when these were used, most providers (67%-87%) felt they were somewhat or very useful. The decision aid was not used frequently (17%-41% of providers), and 43% of providers felt it was not very or not at all useful. Facilitators and barriers were identified for each component. The fact sheet and MI were perceived as the easiest to integrate into the clinic workflow.

CONCLUSIONS

The fact sheet and MI were the most used and most useful intervention components. Both were easy to integrate into clinic workflow, and their use was sustained over time. Dissemination of similar interventions in the future should focus on these 2 specific components.

摘要

目的

评估 5 种不同人乳头瘤病毒(HPV)疫苗沟通干预组件的相对使用情况、有效性以及提供者认为的使用障碍和促进因素,这些组件在提高 HPV 疫苗接种率方面被证明是有效的。

方法

对参与研究的干预诊所的 108 名提供者(医学博士、执业护士或骨科医生)进行了 4 次连续调查,在 12 个月的时间内评估了 5 种沟通干预组件的使用情况和有效性。

结果

调查的回复率为 79%至 86%。在 12 个月的时间里,使用情况持续存在,其中使用最多的组件是情况说明书(64%-77%)和动机访谈技术(MI;86%)。大多数提供者认为这些组件有些或非常有用,而且这种有用性随着时间的推移而增加(在研究结束时非常或有些有用,情况说明书分别为 97%,MI 为 98%)。尽管较少的提供者报告使用网站(15%-42%)或疾病图像(6%-17%),但当使用这些组件时,大多数提供者(67%-87%)认为它们有些或非常有用。决策辅助工具的使用频率不高(17%-41%的提供者),43%的提供者认为它不是非常有用或根本没有用。为每个组件确定了促进因素和障碍。情况说明书和 MI 被认为是最容易整合到临床工作流程中的组件。

结论

情况说明书和 MI 是使用最频繁、最有用的干预组件。两者都很容易整合到临床工作流程中,而且随着时间的推移,它们的使用情况得以持续。未来在传播类似的干预措施时,应重点关注这两个特定组件。

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