Division of Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, Missouri, USA.
Department of Health Policy and Management, Sol Price School of Public Policy, University of Southern California, Los Angeles, California, USA.
Hum Vaccin Immunother. 2022 Dec 31;18(1):1885968. doi: 10.1080/21645515.2021.1885968. Epub 2021 Jun 4.
Human papillomavirus (HPV) causes >40,000 cancer diagnoses each year, yet vaccination rates remain low because widespread implementation of strategies to increase vaccinations has not occurred. Behavioral nudges have demonstrated efficacy in improving uptake of desired behaviors in health care settings but have not been tested for increasing HPV vaccinations. We assessed the impact of an intervention combining behavioral nudges with other proven strategies (i.e., assessment and feedback, provider communication training) on HPV vaccination rates and parental satisfaction in four Midwestern pediatric, outpatient practices. Practices were randomly assigned to receive either assessment and feedback or assessment and feedback combined with vaccine communication training and behavioral nudges in the form of vaccine commitment posters. Providers (n = 16) completed surveys regarding vaccine policies and parents (n = 215) reported on their child's vaccine history and satisfaction with the consultation. Three practices increased HPV vaccination rates (1-10%); however, there was no statistically significant difference by study arm. Most parents ( age 41.3; 8.1; 85% female, 68% White) indicated their child had previously initiated the HPV vaccine series (61%) and 72% indicated receipt of an HPV vaccine during the study visit. Concerns among HPV vaccine-hesitant parents (28%) included vaccine safety and believing the vaccine is unnecessary (40%). Most parents were satisfied with their consultation. Practices in both intervention groups increased vaccination rates. While some parents continue to harbor concerns about vaccine safety and necessity, parents welcomed discussions about HPV and were satisfied with their provider's communication regardless of their vaccine decisions.
人乳头瘤病毒（HPV）每年导致>40000 例癌症诊断，但由于尚未广泛实施增加疫苗接种的策略，疫苗接种率仍然很低。行为提示在改善医疗保健环境中所需行为的接种率方面已被证明有效，但尚未针对增加 HPV 疫苗接种进行测试。我们评估了将行为提示与其他经过验证的策略（即评估和反馈、提供者沟通培训）相结合的干预措施对四个中西部儿科门诊实践中 HPV 疫苗接种率和家长满意度的影响。这些实践被随机分配接受评估和反馈或评估和反馈以及疫苗沟通培训和行为提示（疫苗承诺海报）。提供者（n=16）完成了关于疫苗政策的调查，家长（n=215）报告了他们孩子的疫苗接种史和对咨询的满意度。有三个实践提高了 HPV 疫苗接种率（1-10％）；但是，研究组之间没有统计学上的显著差异。大多数家长（年龄 41.3；8.1；85％女性，68％白人）表示他们的孩子之前已经开始接种 HPV 疫苗系列（61％），并且 72％表示在研究访问期间接种了 HPV 疫苗。对 HPV 疫苗犹豫不决的家长（28％）的担忧包括疫苗安全性和认为疫苗不必要（40％）。大多数家长对他们的咨询感到满意。干预组中的实践都提高了疫苗接种率。尽管一些家长仍然对疫苗安全性和必要性存在担忧，但家长们欢迎讨论 HPV，并对他们的提供者的沟通感到满意，无论他们的疫苗接种决定如何。
