Shegog Ross, Savas Lara S, Frost Erica L, Thormaehlen Laura C, Teague Travis, Steffy Jack, Healy Catherine Mary, Shay Laura Aubree, Preston Sharice, Vernon Sally W
Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA.
Department of Anthropology, Washington University in St. Louis, St. Louis, MO 63130, USA.
Vaccines (Basel). 2023 Jul 21;11(7):1270. doi: 10.3390/vaccines11071270.
Human papilloma virus (HPV) vaccination rates remain below national goals in the United States despite the availability of evidence-based strategies to increase rates. The Adolescent Vaccination Program (AVP) is a multi-component intervention demonstrated to increase HPV vaccination rates in pediatric clinics through the implementation of six evidence-based strategies. The purpose of this study, conducted in Houston, Texas, from 2019-2021, was to adapt the AVP into an online decision support implementation tool for standalone use and to evaluate its feasibility for use in community clinics. Phase 1 (Adaptation) comprised clinic interviews ( = 23), literature review, Adolescent Vaccination Program Implementation Tool (AVP-IT) design documentation, and AVP-IT development. Phase 2 (Evaluation) comprised usability testing with healthcare providers (HCPs) ( = 5) and feasibility testing in community-based clinics ( = 2). AVP-IT decision support provides an Action Plan with tailored guidance on implementing six evidence-based strategies (immunization champions, assessment and feedback, continuing education, provider prompts, parent reminders, and parent education). HCPs rated the AVP-IT as acceptable, credible, easy, helpful, impactful, and appealing (≥80% agreement). They rated AVP-IT supported implementation as easier and more effective compared to usual practice ( ≤ 0.05). The clinic-based AVP-IT uses facilitated strategy implementation by 3-month follow-up. The AVP-IT promises accessible, utilitarian, and scalable decision support on strategies to increase HPV vaccination rates in pediatric clinic settings. Further feasibility and efficacy testing is indicated.
尽管有基于证据的策略来提高接种率，但美国的人乳头瘤病毒（HPV）疫苗接种率仍低于国家目标。青少年疫苗接种计划（AVP）是一项多组成部分的干预措施，已证明通过实施六种基于证据的策略可提高儿科诊所的HPV疫苗接种率。本研究于2019年至2021年在得克萨斯州休斯顿进行，目的是将AVP改编为一个独立使用的在线决策支持实施工具，并评估其在社区诊所使用的可行性。第1阶段（改编）包括诊所访谈（n = 23）、文献综述、青少年疫苗接种计划实施工具（AVP-IT）设计文档以及AVP-IT开发。第2阶段（评估）包括与医疗保健提供者（HCPs）进行可用性测试（n = 5）以及在社区诊所进行可行性测试（n = 2）。AVP-IT决策支持提供了一个行动计划，其中包含关于实施六种基于证据的策略（免疫接种倡导者、评估与反馈、继续教育、提供者提示、家长提醒和家长教育）的量身定制的指导。HCPs将AVP-IT评为可接受、可信、简单、有帮助、有影响力且有吸引力（≥80%的人达成一致）。他们认为与常规做法相比，AVP-IT支持的实施更容易且更有效（P≤0.05）。基于诊所的AVP-IT通过3个月的随访促进策略实施。AVP-IT有望在儿科诊所环境中为提高HPV疫苗接种率的策略提供可获取、实用且可扩展的决策支持。表明需要进一步进行可行性和有效性测试。
