University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave, Houston, TX, USA.
Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, USA.
BMC Public Health. 2021 Mar 24;21(1):585. doi: 10.1186/s12889-021-10534-0.
Parents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement.
Using a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11-14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level.
Baseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period.
A brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates.
ClinicalTrials.gov Identifier: NCT02600884 . Prospectively registered September 1, 2015.
父母在青少年性健康和人乳头瘤病毒（HPV）疫苗接种方面发挥着关键作用。护士处于医疗保健的前沿，在促进 HPV 疫苗接种和亲子性健康沟通方面发挥着至关重要的作用。我们增强了基于父母的性健康课程“家庭共同讨论”（FTT），将青少年疫苗接种纳入其中，即 FTT+HPV，并培训了学生护士，以提供强有力的 HPV 疫苗接种和亲子性健康沟通支持。
使用随机对照试验设计，我们对 2015 年至 2018 年间从医疗服务不足的社区招募的 519 名父母及其 11-14 岁的青少年进行了 FTT+HPV 的疗效研究。参与者从 22 个课后项目（如男孩女孩俱乐部）和 19 所特许学校招募。对于父母，我们研究了保护因素，包括亲子性健康沟通和父母参与。对于青少年，我们研究了性健康知识、亲子性健康沟通和亲子关系。为了评估 HPV 疫苗接种的启动和完成情况，我们在 IMMTRAC 免疫登记处搜索了 85%的青少年记录，并对没有登记记录的青少年使用父母报告。使用干预后一个月和六个月的估计平均差异计算组间差异，显著性水平设定为 p<0.05。
HPV 疫苗接种的基线率较低，为 55.7%。干预后一个月，两组在疫苗接种启动或完成率方面没有显著差异。然而，在干预后六个月时，两组之间存在显著差异，干预组有 70.3%的人开始 HPV 疫苗系列接种，而对照组为 60.6%（p=0.02）。六个月时，两组 HPV 系列完成率无差异。干预组在 condom 知识（p=0.04）、亲子关系（p=0.04）和沟通频率（p=0.001）方面有显著改善，而对照组则没有。两组在六个月的随访期间，性活动率仍然较低。
由学生护士提供的简短的基于父母的青少年性健康和 HPV 疫苗接种干预措施可以改善性健康结果，包括保护父母的因素、青少年性健康知识和 HPV 疫苗接种启动率。
ClinicalTrials.gov 标识符：NCT02600884。2015 年 9 月 1 日前瞻性注册。
