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一个基于框架的指南,用于将以初级保健为基础的儿科干预措施调整并应用于儿科肿瘤环境:以HPV PROTECT为例。

A framework-based guide for adapting and implementing primary care-based pediatric interventions to the pediatric oncology setting: HPV PROTECT as an exemplar.

作者信息

Klosky James L, Cherven Brooke, Gilkey Melissa B, Aye Jamie, Castellino Sharon M, Gramatges Maria M, Lindemulder Susan, Russell Thomas B, Turcotte Lucie M, Campos González Paula D, Skipper K Elizabeth, Chollette Veronica, Mitchell Sandra A, Colditz Graham A, Bhatia Smita, Landier Wendy

机构信息

Department of Pediatrics, Emory University School of Medicine & The Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.

出版信息

Cancer. 2025 May 1;131(9):e35857. doi: 10.1002/cncr.35857.

Abstract

Pediatric oncology providers can help childhood cancer survivors protect their health by ensuring they receive routine preventive services. Management of these services by survivorship providers is necessary due to patients' suboptimal rates of re-engaging with pediatric primary care after treatment completion. This is especially the case with cancer prevention interventions, like human papillomavirus (HPV) vaccination, as survivors have greater confidence in the recommendations offered by their oncology versus primary care providers when counseling of this nature occurs. As these preventive pediatric interventions have traditionally been tested and delivered in primary care, they may lack appropriate tailoring or adaptation to the pediatric oncology setting. This article serves as a guide for using a best practice (ADAPT) framework for adapting and implementing a provider-focused intervention to increase the uptake of HPV vaccination in the pediatric oncology setting. Once the rationale and guiding principles for engaging in this process are presented, the intervention adaptation processes are illustrated via descriptions of assessment, planning, piloting, evaluation, implementation, and maintenance. Additional considerations specific to the pediatric oncology setting are also provided. By applying ADAPT or other appropriate frameworks when adapting and implementing pediatric interventions in the cancer survivorship setting, progress will be made toward establishing a gold standard in approaching these tasks. Ultimately, these collective efforts will maximize the likelihood of effective intervention delivery and reduce health risk in this vulnerable population.

摘要

儿科肿瘤学医疗服务提供者可以通过确保儿童癌症幸存者接受常规预防服务来帮助他们保护自身健康。由于患者在治疗结束后重新参与儿科初级保健的比例不理想,因此由幸存者医疗服务提供者管理这些服务是必要的。在癌症预防干预措施方面,如人乳头瘤病毒(HPV)疫苗接种,情况尤其如此,因为在进行此类咨询时,幸存者对肿瘤学医疗服务提供者提供的建议比对初级保健提供者提供的建议更有信心。由于这些预防性儿科干预措施传统上是在初级保健中进行测试和实施的,它们可能缺乏针对儿科肿瘤学环境的适当调整或适配。本文作为一个指南,介绍如何使用最佳实践(ADAPT)框架来调整和实施以医疗服务提供者为重点的干预措施,以提高儿科肿瘤学环境中HPV疫苗接种的接受率。在阐述了参与这一过程的基本原理和指导原则后,通过对评估、规划、试点、评估、实施和维护的描述来说明干预措施的调整过程。还提供了针对儿科肿瘤学环境的其他注意事项。在癌症幸存者环境中调整和实施儿科干预措施时,通过应用ADAPT或其他适当的框架,将朝着在处理这些任务方面建立黄金标准取得进展。最终,这些共同努力将最大限度地提高有效干预措施实施的可能性,并降低这一弱势群体的健康风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a60/12038771/6261b60a3aba/CNCR-131-e35857-g002.jpg

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