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评估人乳头瘤病毒疫苗接种培训在不同临床角色的临床和社区环境中的实施情况。

Evaluation of a human papillomavirus vaccination training implementation in clinical and community settings across different clinical roles.

机构信息

Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.

Center for Epidemiology & Healthcare Delivery Research, JPS Health Network, Fort Worth, TX, USA.

出版信息

Transl Behav Med. 2024 Mar 21;14(4):249-256. doi: 10.1093/tbm/ibae010.

Abstract

Improving human papillomavirus (HPV) vaccination is a national priority but uptake declined following the coronavirus pandemic. A strong predictor of HPV vaccination in the USA is a strong provider recommendation. Therefore, we developed a brief, asynchronous training on HPV vaccine recommendations in clinical and community settings as part of a multisite quality improvement initiative. This paper aims to describe the implementation and initial outcomes of the training provided. A 20-minute training on HPV vaccine bundled recommendations, motivational interviewing, and brief responses to patient concerns (Communicating about HPV vaccination to Adults and Teens; HPV CHAT) was implemented at seven safety-net clinics, two practice-based research network clinics, and nine county immunization clinics. We integrated training with clinical care teams; thus, we assessed immediate training outcomes across their different clinical roles compared to pre-training. In April-May 2022, HPV CHAT training was launched. One hundred eighty-seven people participated in the training and completed the pre-/postevaluation surveys. Knowledge about the HPV vaccine guidelines improved with notable changes in correctly reporting vaccine eligibility (P < .05). A significant change in participants' confidence when addressing safety concerns and answering questions about the HPV vaccine (clinicians, 26.8% and 17.1%; nurses, 29.0% and 23.2%, and clinical staff, 18.2% and 37.7%) was observed. At post-test, more than 85% of clinicians and nurses reported their plan to routinely recommend the HPV vaccine. This quality improvement initiative demonstrated implementation feasibility of a brief HPV vaccine training that improved provider and clinical staff knowledge, confidence, and intention to routinely recommend HPV vaccination.

摘要

提高人乳头瘤病毒(HPV)疫苗接种率是国家的优先事项,但在冠状病毒大流行之后,接种率有所下降。在美国,强有力的HPV 疫苗接种预测因素是强有力的提供者推荐。因此,我们在一个多地点质量改进倡议中,开发了一个关于在临床和社区环境中推荐 HPV 疫苗的简短、异步培训。本文旨在描述培训的实施和初步结果。在七个安全网诊所、两个基于实践的研究网络诊所和九个县免疫诊所实施了关于 HPV 疫苗联合推荐、动机访谈和对患者关注的简短回应(向成人和青少年传播 HPV 疫苗;HPV CHAT)的 20 分钟培训。我们将培训与临床护理团队相结合;因此,我们评估了他们不同临床角色的即时培训结果,与培训前进行了比较。2022 年 4 月至 5 月,推出了 HPV CHAT 培训。187 人参加了培训,并完成了培训前后的评估调查。关于 HPV 疫苗指南的知识有所提高,正确报告疫苗资格的情况有显著变化(P<0.05)。参与者在处理安全问题和回答 HPV 疫苗相关问题时的信心有了显著变化(临床医生为 26.8%和 17.1%,护士为 29.0%和 23.2%,以及临床工作人员为 18.2%和 37.7%)。在测试后,超过 85%的临床医生和护士表示他们计划常规推荐 HPV 疫苗。这项质量改进倡议表明,实施简短 HPV 疫苗培训是可行的,该培训提高了提供者和临床工作人员的知识、信心,并计划常规推荐 HPV 疫苗接种。

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