Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas; Sealy Institute for Vaccine Sciences, University of Texas Medical Branch at Galveston, Galveston, Texas.
Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, Texas.
Am J Prev Med. 2019 Apr;56(4):591-602. doi: 10.1016/j.amepre.2018.10.033. Epub 2019 Feb 15.
Despite current recommendations, human papillomavirus vaccine uptake remains low. A systematic review and meta-analysis assessed the effectiveness of interventions targeting human papillomavirus vaccine initiation and completion among children, adolescents, and young adults aged 9-26 years.
Three electronic databases (CINAHL, OVID, and Web of Science) were searched for articles published in English peer-reviewed journals between January 2006 and January 2017 of U.S. studies that evaluated intervention strategies and reported post-intervention human papillomavirus vaccine initiation or completion rates among individuals aged 9-26 years. Study characteristics and outcomes were extracted. Data were collected in 2016 and analyzed in 2017.
Reviewers screened 983 unique titles and abstracts, read 241 full-text articles, and extracted data from 30 articles meeting the inclusion criteria (12 behavioral, ten environmental, four informational, and four combination strategies). Published EQUATOR (Enhancing the Quality and Transparency of Health Research) guidelines were used to assess study quality. Random effects meta-analyses were conducted. The meta-analyses included 17 RCTs and quasi-experiments involving 68,623 children, adolescents, and young adults. The pooled relative incidence estimates were 1.84 (95% CI=1.36, 2.48) for human papillomavirus vaccine initiation and 1.50 (95% CI=1.23, 1.83) for completion. Behavioral and informational interventions doubled human papillomavirus vaccine initiation (relative incidence estimate=2.04, 95% CI=1.36, 3.06 and relative incidence estimate=1.92, 95% CI=1.27, 2.91, respectively). Behavioral interventions increased completion by 68% (relative incidence estimate=1.68, 95% CI=1.25, 2.27).
Evidence supports behavioral interventions for increasing human papillomavirus vaccine initiation and completion. Future studies are needed to assess the effectiveness of interventions in reaching diverse populations and reducing missed opportunities for human papillomavirus vaccination.
尽管目前有相关建议，但人乳头瘤病毒疫苗的接种率仍然较低。本系统评价和荟萃分析评估了针对 9-26 岁儿童、青少年和年轻人的人乳头瘤病毒疫苗接种启动和完成的干预措施的有效性。
在 2006 年 1 月至 2017 年 1 月期间，我们在 CINAHL、OVID 和 Web of Science 三个电子数据库中搜索了评估干预策略并报告了 9-26 岁人群接种人乳头瘤病毒疫苗后启动或完成率的美国研究的英文同行评议期刊文章。提取了研究特征和结果。数据于 2016 年收集，并于 2017 年进行分析。
审查员筛选了 983 篇独特的标题和摘要，阅读了 241 篇全文文章，并从符合纳入标准的 30 篇文章中提取了数据（12 项行为干预、10 项环境干预、4 项信息干预和 4 项联合干预策略）。使用发布的 EQUATOR（增强卫生研究质量和透明度）指南评估了研究质量。进行了随机效应荟萃分析。荟萃分析纳入了 17 项 RCT 和准实验，涉及 68623 名儿童、青少年和年轻人。汇总的相对发病率估计值分别为人乳头瘤病毒疫苗接种启动率为 1.84（95%CI=1.36，2.48）和完成率为 1.50（95%CI=1.23，1.83）。行为和信息干预将人乳头瘤病毒疫苗接种启动率提高了一倍（相对发病率估计值=2.04，95%CI=1.36，3.06 和相对发病率估计值=1.92，95%CI=1.27，2.91）。行为干预使完成率提高了 68%（相对发病率估计值=1.68，95%CI=1.25，2.27）。
证据支持行为干预措施以提高人乳头瘤病毒疫苗的接种启动率和完成率。未来的研究需要评估干预措施在覆盖不同人群和减少人乳头瘤病毒疫苗接种机会错失方面的有效性。
