Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
Prev Med. 2021 May;146:106484. doi: 10.1016/j.ypmed.2021.106484. Epub 2021 Feb 26.
Since licensure of human papillomavirus (HPV) vaccine in mainland China, little research has been conducted about healthcare providers' (HCPs) understanding and recommendation of HPV vaccine. A multi-stage convenience sample of Chinese HCPs (N = 5270) were surveyed, involving obstetrician-gynecologists, HCPs from Division of Expanded Program on Immunization (DEPI), Community Health Center (CHC) and other non-HPV closely related professions. Binary logistic regression was conducted to explore factors associated with knowledge and recommendation behaviors. Overall, HCPs showed basic HPV/HPV vaccine knowledge with median (interquartile range) score at 9.5 (7.5-11.6) out of 16 and relatively high recommendation behavior (74.8%). Identified knowledge gaps among HCPs included risk factors of HPV infection, best time to vaccinate, prophylactic functions of HPV vaccine and especially classification of low-risk and high-risk types. Profession-specific analysis in individual knowledge item showed HCPs from CHC were suboptimal on HPV while obstetrician-gynecologists were less competent on HPV vaccine knowledge. Obstetrician-gynecologists also recommended vaccination less frequently than HCPs from DEPI and CHC. Besides being key predictors of recommendation practice (2.74, 95% CI: 2.34-3.21), knowledge shared independent determinants with recommendation behavior on age and ethnicity and additionally associated with education and title by itself. Findings highlight overall and profession-specific gaps on HPV and HPV vaccine knowledge and recommendation practice. Future education and training efforts should be profession-niche-targeting and focus much on HCPs with lower title or education background and from minorities.
自中国大陆 HPV 疫苗获得许可以来，针对医疗保健提供者（HCPs）对 HPV 疫苗的理解和推荐的研究甚少。采用多阶段便利抽样方法对 5270 名中国 HCPs 进行了调查，包括妇产科医生、扩大免疫规划（DEPI）部门的 HCPs、社区卫生中心（CHC）和其他与 HPV 相关性不大的专业人员。采用二项逻辑回归分析来探讨与知识和推荐行为相关的因素。总体而言，HCPs 对 HPV/HPV 疫苗的基本知识了解程度尚可，16 分制的中位数（四分位距）得分为 9.5（7.5-11.6），推荐行为率相对较高（74.8%）。HCPs 存在的知识差距包括 HPV 感染的危险因素、最佳接种时间、HPV 疫苗的预防功能，特别是低危型和高危型的分类。针对个别知识项目的专业分析表明，CHC 的 HCPs 在 HPV 方面表现欠佳，而妇产科医生在 HPV 疫苗知识方面则较差。妇产科医生的疫苗接种推荐率也低于 DEPI 和 CHC 的 HCPs。除了是推荐实践的主要预测因素（2.74，95%CI：2.34-3.21）外，知识还与年龄、种族、教育和职称有关，而推荐行为则与年龄、种族和职称有关。研究结果突出了 HPV 和 HPV 疫苗知识以及推荐实践方面的总体和专业差距。未来的教育和培训工作应针对专业领域，并重点关注职称或教育背景较低以及少数民族的 HCPs。
