Beavis Anna L, Krishnamoorthi Mahima S, Adler Sarah, Fleszar Laura G, Moran Meghan B, Rositch Anne F
Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Vaccine X. 2024 Jul 24;20:100533. doi: 10.1016/j.jvacx.2024.100533. eCollection 2024 Oct.
Despite over 15 years of real-world data that supports the safety and efficacy of the human papillomavirus (HPV) vaccine, in the United States vaccine hesitancy persists. Many studies have focused on vaccine-hesitant parents, but fewer have examined provider perspectives on how to address HPV vaccine hesitancy.
Between July 2021-April 2022, we recruited providers in Maryland and the broader Mid-Atlantic region who practiced pediatrics, primary care, family medicine, or adolescent medicine and who provided outpatient care for children ages 10-17. Semi-structured virtual interviews focused on provider-reported strategies to address HPV vaccine-hesitant parents, as well as perceived barriers to successful vaccination and provider perspectives on specific interventions to address parental hesitancy. Audio recordings were transcribed and analyzed via a combination of deductive and inductive coding. Higher-level themes within the domains of strategies, barriers, and perspectives on specific proposed interventions were identified.
A total of sixteen providers completed an interview. Within the domain of provider-reported strategies, the following themes emerged: 1) leveraging continuity of care and established parental trust, 2) supporting parental autonomy, 3) tailoring the approach to specific concerns of vaccine-hesitant parents, 4) normalizing the HPV vaccine, and 5) focusing on health prevention and cancer prevention. Barriers providers identified were: 1) limited time, 2) lack of common ground with parents, 3) parent-child decision discordance, 4) availability of misinformation, and 5) parental concerns such as safety and necessity. In the domain for proposed interventions, providers favored interventions that saved time or were not resource-intense, that did not single out the HPV vaccine as different, were patient friendly, and leveraged efficiency through the electronic medical record. The insights from this study can help inform the development of provider-acceptable and feasible tools and interventions to address parental HPV vaccine hesitancy.
尽管有超过15年的真实世界数据支持人乳头瘤病毒（HPV）疫苗的安全性和有效性，但在美国，对疫苗的犹豫态度依然存在。许多研究都聚焦于对疫苗持犹豫态度的父母，但较少有研究探讨医疗服务提供者对于如何解决HPV疫苗犹豫问题的看法。
在2021年7月至2022年4月期间，我们在马里兰州及更广泛的中大西洋地区招募了从事儿科、初级保健、家庭医学或青少年医学工作，并为10至17岁儿童提供门诊护理的医疗服务提供者。半结构化虚拟访谈聚焦于医疗服务提供者报告的应对HPV疫苗犹豫父母的策略，以及成功接种疫苗的感知障碍和医疗服务提供者对解决父母犹豫的具体干预措施的看法。录音通过演绎编码和归纳编码相结合的方式进行转录和分析。确定了策略、障碍以及对具体提议干预措施的看法等领域内的更高层次主题。
共有16名医疗服务提供者完成了访谈。在医疗服务提供者报告的策略领域，出现了以下主题：1）利用连续护理和已建立的父母信任；2）支持父母自主权；3）根据HPV疫苗犹豫父母的具体担忧调整方法；4）使HPV疫苗常态化；5）关注健康预防和癌症预防。医疗服务提供者确定的障碍有：1）时间有限；2）与父母缺乏共同立场；3）亲子决策不一致；4）错误信息的存在；5）父母对安全性和必要性等方面的担忧。在提议干预措施领域，医疗服务提供者倾向于节省时间或资源消耗少、不将HPV疫苗单独区分开来、对患者友好且通过电子病历提高效率的干预措施。本研究的见解有助于为开发医疗服务提供者可接受且可行的工具和干预措施提供参考，以解决父母对HPV疫苗的犹豫问题。
