Adult and Child Consortium for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Denver, United States.
Adult and Child Consortium for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Denver, United States.
Vaccine. 2019 Feb 28;37(10):1307-1312. doi: 10.1016/j.vaccine.2019.01.051. Epub 2019 Feb 4.
To assess secondary, parent-reported outcomes from a randomized controlled trial (RCT) of a provider communication intervention aimed at improving adolescent HPV vaccination.
A paper survey was provided to a random sample of 777 parents of adolescents from 8 control and 8 intervention clinics participating in the larger trial. Chi-square or Fisher's exact tests assessed associations between study arm and providers' HPV vaccine communication strategies, parents' vaccination attitudes and parent's HPV vaccine acceptance. Exploratory analyses assessed the association between receipt of 'very strong' or presumptive HPV vaccine recommendation (regardless of study arm) and parent's perceptions about their providers' vaccine communication, and parents' attitudes and acceptance of the HPV vaccine.
The response rate was 47%. There were no differences between study arms in parents' report of how their provider communicated about the HPV vaccine, parent vaccination attitudes, or uptake of the HPV vaccine. Receipt of a 'very strong' recommendation was associated with greater perceived urgency for getting vaccinated, greater trust in the information received from the provider, decreased vaccine hesitancy, and increased vaccine receipt. Receipt of a presumptive recommendation was associated with a lower likelihood of having concerns about the vaccine's safety, lower vaccine hesitancy, and an increased likelihood of vaccination. Neither recommendation strategy appeared to negatively impact parents' visit experience or trust in the information being provided. Similar results were found in sub-analyses of vaccine hesitant parents.
Providing very strong, presumptive HPV vaccine recommendations is associated with improved parent vaccination attitudes and acceptance, and does not seem to have significant negative impacts, even among parents who are vaccine hesitant. Response bias in our sample could explain why there were no reported differences between study arms in parents' reports of how their adolescent's providers communicated about the HPV vaccine.
评估一项针对改善青少年 HPV 疫苗接种的提供者沟通干预的随机对照试验（RCT）的次要、家长报告的结果。
向参与更大规模试验的 8 个对照组和 8 个干预组诊所的 777 名青少年家长的随机样本提供纸质调查。使用卡方或 Fisher 精确检验评估研究臂与提供者 HPV 疫苗沟通策略、父母疫苗接种态度和父母 HPV 疫苗接受度之间的关联。探索性分析评估了是否收到“强烈”或假定的 HPV 疫苗推荐（无论研究臂如何）与父母对其提供者疫苗沟通的看法、父母对 HPV 疫苗的态度和接受程度之间的关联。
回复率为 47%。在父母对 HPV 疫苗沟通的看法、父母的疫苗接种态度或 HPV 疫苗接种率方面，研究臂之间没有差异。收到“强烈”推荐与更大的疫苗接种紧迫性、对提供者提供的信息的更大信任、减少疫苗犹豫和增加 HPV 疫苗接种有关。收到假定推荐与对疫苗安全性的担忧降低、疫苗犹豫降低和增加接种的可能性有关。这两种推荐策略似乎都没有对父母的就诊体验或对所提供信息的信任产生负面影响。在对疫苗犹豫不决的父母的亚分析中也发现了类似的结果。
提供强烈的、假定的 HPV 疫苗推荐与改善父母的疫苗接种态度和接受度有关，即使在疫苗犹豫不决的父母中，似乎也没有显著的负面影响。我们样本中的回应偏差可能解释了为什么在父母报告他们青少年的提供者如何沟通 HPV 疫苗方面，研究臂之间没有报告差异。
