Department of Health Behavior & Lineberger Comprehensive Cancer Center, University of North Carolina, CB# 7440, Chapel Hill, NC, 27599, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina, CB# 7440, Chapel Hill, NC, 27599, USA.
Soc Sci Med. 2020 Dec;266:113441. doi: 10.1016/j.socscimed.2020.113441. Epub 2020 Oct 13.
Receiving a healthcare provider's recommendation is a well-documented predictor of human papillomavirus (HPV) vaccination, and yet recommendations remain understudied and undertheorized.
To qualitatively describe strategies providers use to motivate HPV vaccination.
We surveyed a national sample of 771 U.S. primary care physicians. Data came from an open-ended item that assessed physicians' perspectives on the most effective thing they could say to persuade parents to get HPV vaccine for their 11- to 12-year-old children. Using a standardized codebook and two independent coders, we conducted a thematic analysis to identify rhetorical strategies underlying physicians' responses.
We identified two sets of strategies for motivating HPV vaccination. One set drew parents' attention to specific actors or vaccine characteristics. Physicians using these strategies asked parents to consider their children's individual risk in the short-term, named specific diseases that could be prevented, emphasized the novelty of HPV vaccine as a cancer prevention tool, and gave their personal endorsement for HPV vaccination. In contrast, the second set of strategies was more distancing and impersonal. Physicians using these strategies referenced future risk, described cancer prevention in general terms, framed HPV vaccine as similar to other vaccines, and shared organizational endorsements for HPV vaccination. Across these two sets of strategies, a tension emerged between the goals of engaging parents' perceptions of HPV as a threat to their children versus framing HPV vaccination as a normative standard of care.
Our findings suggest that theoretical frameworks, such as Construal Level Theory, may be helpful for positioning provider recommendations in the broader literature on persuasive communication. By identifying competing approaches to motivating HPV vaccination, this study lays the groundwork for future research to test the acceptability and impact of strategies for recommending routine preventive care.
接受医疗保健提供者的推荐是人类乳头瘤病毒（HPV）疫苗接种的一个有充分记录的预测因素，但推荐的研究仍然不足，理论也不足。
定性描述提供者用来激励 HPV 疫苗接种的策略。
我们调查了美国 771 名初级保健医生的全国样本。数据来自一个开放式项目，评估了医生对最有效的说服父母为 11 至 12 岁的孩子接种 HPV 疫苗的看法。使用标准化的代码本和两个独立的编码员，我们进行了主题分析，以确定医生反应背后的修辞策略。
我们确定了两组激励 HPV 疫苗接种的策略。一组策略引起了父母对特定参与者或疫苗特征的注意。使用这些策略的医生要求父母考虑他们孩子的短期个人风险，指出可以预防的具体疾病，强调 HPV 疫苗作为癌症预防工具的新颖性，并对 HPV 疫苗给予个人认可。相比之下，第二组策略更具距离感和非个人化。使用这些策略的医生参考未来风险，用一般术语描述癌症预防，将 HPV 疫苗描述为与其他疫苗相似，并分享对 HPV 疫苗的组织认可。在这两组策略中，父母将 HPV 视为对孩子的威胁的看法与将 HPV 疫苗作为常规护理标准的看法之间出现了紧张关系。
我们的研究结果表明，理论框架，如构建水平理论，可能有助于将提供者的建议置于更广泛的有说服力的沟通文献中。通过确定激励 HPV 疫苗接种的竞争方法，本研究为未来测试推荐常规预防保健策略的可接受性和影响的研究奠定了基础。
