Department of Sociology, Stanford University , Palo Alto, CA , California , USA.
Department of General Internal Medicine, Boston University School of Medicine , Boston, MA , USA.
Hum Vaccin Immunother. 2019;15(10):2460-2465. doi: 10.1080/21645515.2019.1591138. Epub 2019 Apr 16.
We described the relative contributions of parental intention and provider recommendation style to HPV and meningococcal vaccine receipt. Parent-child dyads that were eligible for both meningococcal and HPV vaccines participated in pre-visit surveys and consented to audio recording of their clinical interactions with healthcare providers related to vaccination. Surveys were analyzed for parent and child demographics and parental intention to vaccinate children with HPV and/or meningococcal vaccines. Audio recordings were analyzed for provider recommendation style, defined as indicated (provider stated vaccine was due at that visit) or not, and for child receipt of vaccines. Linear and logistic regression models were used to determine the relative contributions of parental intention and provider recommendation style to vaccine receipt. 56 parents/child dyads participated. 79% of children received HPV vaccines, and 93% received meningococcal vaccines. After controlling for demographic variables, parental intention did not differ by vaccine type. However, providers were less likely to use an indicated recommendation for HPV than for meningococcal vaccine. After controlling for demographic factors, parental intention, and provider recommendation style, vaccine type (HPV or meningococcal) was no longer associated with vaccine receipt Differences that were previously attributed to vaccine-specific factors may be explained by parents' and providers' roles in vaccine receipt. These findings suggest that interventions and policy recommendations regarding adolescent vaccination should focus on increasing parental demand for vaccines and ensuring that providers present all vaccines as the medical standard of care.
我们描述了父母意愿和提供者推荐风格对 HPV 和脑膜炎球菌疫苗接种的相对贡献。符合脑膜炎球菌和 HPV 疫苗接种条件的亲子对参加了就诊前调查，并同意对其与医疗保健提供者就疫苗接种进行的临床互动进行音频记录。调查分析了父母和孩子的人口统计学特征以及父母接种 HPV 和/或脑膜炎球菌疫苗的意愿。对音频记录进行了分析，以确定提供者的推荐风格，定义为（提供者表示疫苗在本次就诊时应接种）或未表示，以及儿童接种疫苗的情况。线性和逻辑回归模型用于确定父母意愿和提供者推荐风格对疫苗接种的相对贡献。共有 56 对父母/孩子参与。79%的儿童接种了 HPV 疫苗，93%的儿童接种了脑膜炎球菌疫苗。在控制人口统计学变量后，疫苗类型与父母意愿无差异。然而，提供者不太可能对 HPV 疫苗使用指示性推荐，而对脑膜炎球菌疫苗则更倾向于使用。在控制人口统计学因素、父母意愿和提供者推荐风格后，疫苗类型（HPV 或脑膜炎球菌）不再与疫苗接种相关。先前归因于疫苗特定因素的差异可能可以通过父母和提供者在疫苗接种中的作用来解释。这些发现表明，青少年疫苗接种的干预措施和政策建议应侧重于增加父母对疫苗的需求，并确保提供者将所有疫苗作为医疗标准护理来提供。
