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描述具有较高人乳头瘤病毒疫苗接种意愿但尚未接种疫苗的美国青少年的母亲。

Characterizing U.S. mothers with high human papillomavirus vaccine intent yet unvaccinated adolescents.

机构信息

Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA; Leonard David Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA.

Department of Communication Studies, Indiana University-Purdue University Indianapolis, Cavanaugh Hall 307C, 425 University Boulevard, Indianapolis, IN 46202, USA.

出版信息

Prev Med. 2023 Apr;169:107472. doi: 10.1016/j.ypmed.2023.107472. Epub 2023 Feb 26.

Abstract

HPV vaccination rates remain suboptimal in the United States. While the current literature focuses on expressly hesitant parents, few studies have examined parents with "high intent", or those indicating they definitely will vaccinate and have had the opportunity but not yet vaccinated their adolescents. Our objective was to differentiate characteristics of mothers with high intent from those who already vaccinated their adolescents using various socioeconomic, previous vaccine decision-making, and healthcare provider relationship-related variables. English-speaking mothers or female guardians of adolescents ages 11-14 years living in low HPV vaccine uptake states within the U.S. in September 2018 were recruited from a national survey panel as part of a larger study. We assessed HPV vaccine status of their adolescents and categorized respondents into two categories: Already Vaccinated and High Intent. We assessed differences using a multivariable logistic regression model. Among 2406 mothers, 18% reported high intent vs. 82% already having vaccinated. Mothers with high intent were more likely to identify as non-Hispanic White (p = 0.01), to have a younger adolescent (p < 0.001), and to report not receiving a provider HPV vaccination recommendation (p < 0.001). Mothers who estimated that half/more (vs. less) of their child's friends have received/will receive the vaccine had higher odds of already vaccinating (p < 0.001). Our findings suggest that clinicians may be able to improve HPV vaccination uptake within their practices by giving repeated, high-quality recommendations to parents of children who are not yet vaccinated. Additionally, these findings indicate perceived social norms may play a large role in on-time vaccine uptake. Reassuring hesitant parents that most parents accept the vaccine may also improve uptake in clinical practice.

摘要

HPV 疫苗接种率在美国仍然不理想。虽然目前的文献主要集中在明确表示犹豫不决的父母,但很少有研究调查那些“意向很高”的父母,即那些表示肯定会为孩子接种疫苗且有机会但尚未为青少年接种疫苗的父母。我们的目的是通过各种社会经济、以前的疫苗决策和医疗保健提供者关系相关变量,区分有高意向的母亲和已经为青少年接种疫苗的母亲的特征。2018 年 9 月,在美国 HPV 疫苗接种率较低的州,从一个全国性调查小组中招募了英语为母语的母亲或 11-14 岁青少年的女性监护人,作为一项更大研究的一部分。我们评估了他们青少年的 HPV 疫苗接种状况,并将受访者分为两类:已接种和高意向。我们使用多变量逻辑回归模型评估差异。在 2406 名母亲中,18%报告有高意向,82%已经为孩子接种了疫苗。有高意向的母亲更有可能是非西班牙裔白人(p=0.01),青少年年龄较小(p<0.001),并报告未收到提供者 HPV 疫苗接种建议(p<0.001)。估计一半/更多(而非更少)孩子的朋友已经接种/将接种疫苗的母亲更有可能已经为孩子接种(p<0.001)。我们的研究结果表明,临床医生可以通过向尚未接种疫苗的儿童的父母反复提供高质量的建议,来提高 HPV 疫苗接种率。此外,这些发现表明,感知到的社会规范可能在按时接种疫苗方面发挥重要作用。向犹豫不决的父母保证大多数父母都接受疫苗,也可能会提高临床实践中的接种率。

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