School of Nursing, 5751Rutgers University, Newark, NJ, USA.
Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Am J Health Promot. 2022 Sep;36(7):1152-1161. doi: 10.1177/08901171221091438. Epub 2022 Apr 20.
: This study examined factors associated with healthcare providers' (HCPs') recommendation of HPV vaccination for younger and older adolescents. : This is a cross-sectional study, using web-based survey of HCPs in New Jersey in 2018. The study outcome was a dichotomous measure of HCPs' recommendation of the HPV vaccine. The study predictors included practice characteristics (i.e., proportions of race/ethnicity, age groups, insurance type, and VFC recipients) and HCP's characteristics (i.e., specialty and perceived knowledge, effectiveness, concerns, parent- and system-related barriers, and facilitators). Data analysis included logistic regression models using separate blocks for practice and provider characteristics, followed by a backward stepwise approach to determine the surviving predictors. Respondents (N=390) included physicians (75%) and nurse practitioners (25%), specialized in pediatrics (62%), family medicine (20%), and women's health (18%). The HCPs' recommendation rates for HPV vaccination were 56% for younger adolescents (11-13 years old) and 73% for older adolescents (14-17 years old). For , the recommendation rates were significantly higher in practices with higher proportions of younger adolescent, Black and Hispanic patients; among pediatric providers; and with HCPs' higher levels of knowledge and lower levels of concern about the vaccine. For , the rates were significantly higher in practices with higher proportions patients who are Hispanic, privately insured, and VFC recipients; among pediatric providers; and with HCPs' higher levels of knowledge and lower levels of concern about the vaccine as well as higher levels of facilitators for recommending the HPV vaccine. Interventions targeting HCPs need to focus on improving their knowledge regarding the vaccine, reduce their concerns around its safety, and utilize facilitators strategies, particularly among non-pediatric providers.
本研究调查了医疗保健提供者(HCPs)推荐 HPV 疫苗接种给年轻和年长青少年的相关因素。
这是一项横断面研究,使用 2018 年新泽西州 HCP 的网络调查。研究结果是 HCP 推荐 HPV 疫苗的二分测量。研究预测因素包括实践特征(即种族/民族比例、年龄组、保险类型和 VFC 接受者)和 HCP 的特征(即专业和感知知识、有效性、关注、父母和系统相关障碍以及促进因素)。数据分析包括使用实践和提供者特征的单独块的逻辑回归模型,然后采用逐步向后方法确定存活的预测因素。
受访者(N=390)包括医生(75%)和执业护士(25%),专门从事儿科(62%)、家庭医学(20%)和妇女健康(18%)。HPV 疫苗接种的 HCP 推荐率为年轻青少年(11-13 岁)的 56%和年长青少年(14-17 岁)的 73%。对于前者,在年轻青少年、黑人和西班牙裔患者比例较高的实践中,儿科提供者中,以及 HCP 对疫苗的知识水平较高且对疫苗的担忧程度较低的情况下,推荐率显著较高。对于后者,在西班牙裔患者比例较高、私人保险和 VFC 接受者比例较高的实践中,儿科提供者中,以及 HCP 对疫苗的知识水平较高且对疫苗的担忧程度较低以及推荐 HPV 疫苗的促进因素水平较高的情况下,推荐率显著较高。
针对 HCP 的干预措施需要侧重于提高他们对疫苗的知识,减少他们对疫苗安全性的担忧,并利用促进因素策略,特别是在非儿科提供者中。