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妇产科医生对26岁及以下女性和女孩的人乳头瘤病毒(HPV)疫苗接种建议。

Obstetrician/gynecologists' HPV vaccination recommendations among women and girls 26 and younger.

作者信息

Brennan Luke P, Rodriguez Natalia M, Head Katharine J, Zimet Gregory D, Kasting Monica L

机构信息

Weldon School of Biomedical Engineering, Purdue University, 206 S Martin Jischke Dr, West Lafayette, IN 47907, USA.

Indiana University Medical Scientist/Engineer Training Program, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

出版信息

Prev Med Rep. 2022 Mar 15;27:101772. doi: 10.1016/j.pmedr.2022.101772. eCollection 2022 Jun.

Abstract

BACKGROUND

Obstetrician/gynecologists (OB/GYNs) are well poised to vaccinate girls and young women against HPV, however little is known about if and how they recommend the HPV vaccine. This study aims to understand factors associated with strong and frequent HPV vaccine recommendations among OB/GYNs for patients 26 years and younger.

METHODS

224 practicing U.S. OB/GYNs were surveyed for how strongly and frequently they recommend the HPV vaccine to patients 26 and younger. Provider beliefs, knowledge, and preferences surrounding the vaccine, as well as clinic and patient-level variables were examined as covariates. We then examined the relationships using multivariable logistic regression analyses.

RESULTS

Of the 224 respondents, 205 were included in the analysis, with 57% (n = 116) reporting strongly and frequently recommending the HPV vaccination to eligible patients 26 and younger. The regression showed two provider beliefs and two clinic-level attributes to be strongly associated with strong and frequent recommendations. Being a strong and frequent recommender was positively associated with believing other gynecologists frequently recommend the vaccine (aOR 24.33 95%CI[2.56-231.14]) and believing that 50% or more of their patients are interested in receiving the vaccine (aOR 2.77 95%CI[1.25-6.13]). The clinic-level attributes were having the vaccine stocked (aOR 2.66 95%CI[1.02-6.93]) and suburban (aOR 3.31 95%CI[1.07-10.19]) or urban (aOR 3.54 95%CI[1.07-11.76]) location versus rural.

CONCLUSIONS

These findings suggest that OB/GYN peer support and educating OB/GYN about patients' interest in HPV vaccination may improve HPV vaccination. This work can inform clinic-level interventions including stocking the vaccine and focusing improvement efforts on rural clinics.

摘要

背景

妇产科医生处于为女孩和年轻女性接种人乳头瘤病毒(HPV)疫苗的有利位置,然而对于他们是否以及如何推荐HPV疫苗却知之甚少。本研究旨在了解与妇产科医生向26岁及以下患者强烈且频繁推荐HPV疫苗相关的因素。

方法

对224名美国执业妇产科医生进行调查,了解他们向26岁及以下患者推荐HPV疫苗的强烈程度和频率。将医生对疫苗的信念、知识和偏好,以及诊所和患者层面的变量作为协变量进行检查。然后使用多变量逻辑回归分析来研究这些关系。

结果

在224名受访者中,205名被纳入分析,其中57%(n = 116)报告称强烈且频繁地向符合条件的26岁及以下患者推荐HPV疫苗。回归分析显示,两种医生信念和两种诊所层面的属性与强烈且频繁的推荐密切相关。成为强烈且频繁的推荐者与相信其他妇科医生经常推荐该疫苗呈正相关(调整优势比[aOR] 24.33,95%置信区间[CI][2.56 - 231.14]),以及相信50%或更多的患者有兴趣接种该疫苗呈正相关(aOR 2.77,95%CI[1.25 - 6.13])。诊所层面的属性包括有疫苗库存(aOR 2.66,95%CI[1.02 - 6.93])以及位于郊区(aOR 3.31,95%CI[1.07 - 10.19])或城市(aOR 3.54,95%CI[1.07 - 11.76]),而非农村地区。

结论

这些发现表明,妇产科医生之间的同伴支持以及让妇产科医生了解患者对HPV疫苗接种的兴趣可能会提高HPV疫苗接种率。这项工作可为诊所层面的干预措施提供参考,包括储备疫苗以及将改进工作重点放在农村诊所。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2984/8935521/c9c7e480d6aa/gr1.jpg

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