Ramaswamy Megha, Allison Molly, Musser Brynne, Satterwhite Catherine, Armstrong Robert, Kelly Patricia J
Department of Preventive Medicine and Public Health, University of Kansas School of Medicine (Drs Ramaswamy and Satterwhite, Mss Allison and Musser, and Mr Armstrong); and School of Nursing, University of Missouri Kansas City, Kansas City, Missouri (Dr Kelly).
J Public Health Manag Pract. 2020 Mar/Apr;26(2):168-175. doi: 10.1097/PHH.0000000000001021.
Local health departments (LHDs) play a vital role in community vaccination programs for human papillomavirus (HPV) infection, but little research has been done to assess LHD interest in cross-sectoral partnerships to vaccinate high-risk groups, specifically incarcerated persons.
To describe factors associated with interest in a novel implementation strategy linking LHDs with jails in 4 Midwestern states to deliver HPV vaccine.
Survey based on the Consolidated Framework for Implementation Research (CFIR) model given to LHD administrators. A modified Poisson relative risk regression was used to assess the relationship between independent variables and LHD interest in implementation of a jail-based HPV vaccination program.
LHDs in Kansas, Missouri, Iowa, and Nebraska.
From September 2017 to April 2018, two-thirds (237/344) of invited LHD administrators from the 4 states responded to the survey.
LHD interest in implementation of a jail-based HPV vaccination program.
Forty-five percent of LHDs were interested in learning more about implementing a jail-based HPV vaccination program, and 2% already offered or had plans to offer HPV vaccine in their jails. Barriers to implementation were cost (66%), inmates' short incarcerations (47%), and availability of medical staffing (43%). LHD characteristics associated with interest in implementation of a jail-based HPV vaccination program included "inner setting" CFIR variables, which capture the structural and cultural context for program implementation: 7 or more employees (odds ratio [OR] = 2.22; 95% confidence interval [CI], 1.24-3.95), perception of importance to provide HPV vaccine in jails (OR = 3.70; 95% CI, 2.00-6.84), and already providing any vaccines in jails (OR = 2.62; 95% CI, 1.18-5.80).
Nearly half of LHDs in the region expressed interest in partnering with local entities to meet HPV vaccination needs of high-risk groups. Research on cross-sectoral partnerships and what these collaborations look like in practice is needed for public health impact.
地方卫生部门（LHDs）在人类乳头瘤病毒（HPV）感染的社区疫苗接种项目中发挥着至关重要的作用，但针对评估LHDs对跨部门合作以接种高危人群（特别是被监禁人员）疫苗的兴趣所开展的研究甚少。
描述与对一项将中西部4个州的LHDs与监狱相联系以提供HPV疫苗的新型实施策略的兴趣相关的因素。
基于实施研究综合框架（CFIR）模型对LHDs管理人员进行调查。采用修正的泊松相对风险回归来评估自变量与LHDs对实施基于监狱的HPV疫苗接种项目的兴趣之间的关系。
堪萨斯州、密苏里州、爱荷华州和内布拉斯加州的LHDs。
2017年9月至2018年4月，来自这4个州的受邀LHDs管理人员中有三分之二（237/344）回复了调查。
LHDs对实施基于监狱的HPV疫苗接种项目的兴趣。
45%的LHDs有兴趣进一步了解实施基于监狱的HPV疫苗接种项目，2%的LHDs已经在其监狱中提供或计划提供HPV疫苗。实施的障碍包括成本（66%）、囚犯监禁时间短（47%）和医疗人员配备情况（43%）。与对实施基于监狱的HPV疫苗接种项目的兴趣相关的LHDs特征包括“内部环境”CFIR变量，这些变量反映了项目实施的结构和文化背景：7名或更多员工（比值比[OR]=2.22；95%置信区间[CI]，1.24 - 3.95）、认为在监狱中提供HPV疫苗很重要（OR = 3.70；95% CI，2.00 - 6.84）以及已经在监狱中提供任何疫苗（OR = 2.62；95% CI，1.18 - 5.80）。
该地区近一半的LHDs表示有兴趣与当地实体合作，以满足高危人群的HPV疫苗接种需求。为实现公共卫生影响，需要开展关于跨部门合作以及这些合作在实际中情况的研究。
