Carhart Miev Y, Schminkey Donna L, Mitchell Emma M, Keim-Malpass Jessica
University of Virginia School of Nursing, Charlottesville, VA, USA.
University of Virginia School of Nursing, Charlottesville, VA, USA; University of Virginia School of Medicine, Department of Pediatrics, Charlottesville, VA, USA.
J Pediatr Nurs. 2018 Sep-Oct;42:1-8. doi: 10.1016/j.pedn.2018.05.008. Epub 2018 May 24.
Despite the evidence, the availability since 2006, and strong recommendations from many professional organizations, the human papillomavirus (HPV) vaccine has had a low uptake rate nationally and these trends have been even lower in the state of Virginia.
We explored key stakeholders' perspectives on factors influencing HPV vaccination in central and southern Virginia organized within the socio-ecological model (SEM) framework. We conducted semi-structured key informant interviews with 31 stakeholders involved in HPV vaccination or cancer prevention.
Stakeholders identified barriers at all SEM levels: Knowledge gaps and sexuality concerns (parent-child dyad level), time constraint and inconsistent recommendation (interpersonal level), lack of leadership and informational support (organizational and community level), and an ineffective mandate (policy level). Facilitators identified were realistic/receptive attitude (parent-child dyad level), provider's strong recommendation and educational support (interpersonal level), team approach and useful data (organizational level), educational outreach and community resources (community level), and support from federal and professional organizations (policy level).
The stakeholder analysis provided an environmental scan of the barriers and facilitators so that an effective HPV vaccination strategy can be planned and implemented in the Commonwealth of Virginia by public health nurses.
尽管有相关证据，自2006年起就可获得该疫苗，且许多专业组织也大力推荐，但人乳头瘤病毒（HPV）疫苗在全国的接种率较低，在弗吉尼亚州这种趋势更为明显。
我们在社会生态模型（SEM）框架内，探讨了弗吉尼亚州中部和南部关键利益相关者对影响HPV疫苗接种因素的看法。我们对31名参与HPV疫苗接种或癌症预防的利益相关者进行了半结构化关键信息人访谈。
利益相关者在SEM的各个层面都识别出了障碍：知识差距和对性方面的担忧（亲子二元组层面）、时间限制和建议不一致（人际层面）、缺乏领导力和信息支持（组织和社区层面）以及指令无效（政策层面）。识别出的促进因素包括现实/接受态度（亲子二元组层面）、提供者的强烈推荐和教育支持（人际层面）、团队协作方法和有用数据（组织层面）、教育推广和社区资源（社区层面）以及来自联邦和专业组织的支持（政策层面）。
利益相关者分析对障碍和促进因素进行了环境审视，以便公共卫生护士能够在弗吉尼亚州规划并实施有效的HPV疫苗接种策略。
