J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):e153-e157. doi: 10.1016/j.japh.2020.05.005. Epub 2020 Jun 21.
Human papillomavirus (HPV)-associated cancer rates are higher in rural areas. Despite the preventive benefits of HPV vaccination, uptake is lower among rural populations. Community-based pharmacies with a strong presence in rural communities may be ideal for improving HPV vaccination access. Our objective was to determine whether spatial access to pharmacies among adolescents and young adults in South Carolina varied by rurality and geographic access to primary care providers.
Geographic information systems methods were used to evaluate spatial access to community-based pharmacies among persons aged 10-24 years in South Carolina census tracts (CTs). CTs were categorized as metropolitan, micropolitan, or small-town and isolated rural CTs using rural-urban commuting area codes and as health provider shortage areas (HPSAs) or not. Descriptive and spatial statistics were calculated to compare access across CT groupings and to evaluate geospatial clustering.
Areas of highest access clustered among the metropolitan CTs. Whereas spatial access was higher in metropolitan than micropolitan CTs, there was no difference in spatial access between metropolitan and small-town and rural CTs. In general, HPSA-designated areas had lower spatial access to pharmacies than non-HPSA-designated areas. However, in micropolitan areas, there was no difference in spatial access to pharmacies based on HPSA designation.
Spatial access to pharmacies among small town and rural areas was comparable to urban areas as was HPSA-designated micropolitan areas and non-HPSA micropolitan areas. This suggests that pharmacies are equally accessible to both urban and rural populations in South Carolina, but additional research is needed to identify effective strategies to promote the uptake of and the availability of HPV vaccination in pharmacies (e.g., insurance coverage) and to ensure patients are educated on the benefits of HPV vaccinations and its availability in nonprimary care settings.
人乳头瘤病毒（HPV）相关癌症在农村地区的发病率较高。尽管 HPV 疫苗接种具有预防作用，但农村人口的接种率较低。在农村社区拥有强大服务的社区药房可能是改善 HPV 疫苗接种可及性的理想选择。我们的目的是确定南卡罗来纳州青少年和年轻人获得药房的空间机会是否因农村地区和获得初级保健提供者的地理位置不同而有所不同。
使用地理信息系统方法评估南卡罗来纳州普查区（CT）中 10-24 岁人群获得社区药房的空间机会。使用城乡通勤区代码将 CT 分为大都市、微都市和小镇及偏远农村 CT，并根据卫生提供者短缺区（HPSA）或非 HPSA 进行分类。计算描述性和空间统计数据，以比较 CT 分组之间的可及性，并评估地理空间聚类。
高可达性区域集中在大都市 CT 中。大都市 CT 的空间可达性高于微都市 CT，但大都市 CT 与小镇和农村 CT 之间的空间可达性没有差异。一般来说，指定 HPSA 的区域获得药房的空间可达性较低，但在微都市地区，根据 HPSA 指定，获得药房的空间可达性没有差异。
与城市地区相比，农村和小镇地区获得药房的空间可达性相当，指定 HPSA 的微都市地区和非 HPSA 微都市地区也是如此。这表明，在南卡罗来纳州，药房对城市和农村人口同样具有可及性，但需要进一步研究，以确定有效策略来促进在药房接种 HPV 疫苗的普及（例如，保险覆盖范围），并确保患者了解 HPV 疫苗接种的益处及其在非初级保健环境中的可及性。
