Testing an HPV Vaccine Decision Aid for 27- to 45-Year-Old Adults in the United States: A Randomized Trial.

IF 3.1 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Medical Decision Making Pub Date : 2025-02-01 Epub Date: 2024-12-24 DOI:10.1177/0272989X241305142

Erika L Thompson, Justin Luningham, Sarah A Alkhatib, Jessica Grace, Idara N Akpan, Ellen M Daley, Gregory D Zimet, Christopher W Wheldon

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Abstract

Background: In the United States, human papillomavirus (HPV) vaccination among 27- to 45-y-olds (mid-adults) is recommended based on shared clinical decision making with a health care provider. We developed a patient decision aid tool to support the implementation of this mid-adult HPV vaccination guideline. The purpose of this study was to evaluate the effect of a patient decision aid tool for HPV vaccination, HPV DECIDE, compared with an information fact sheet among mid-adults who have not received the HPV vaccine.

Method: Participants were recruited between December 2023 and January 2024. We used a randomized Solomon, 4-group, pretest/posttest design with mid-adults aged 27 to 45 y who were unvaccinated for HPV and balanced based on sex (n = 612). The primary outcome was decisional conflict. Intermediate outcomes included knowledge, behavioral expectancies, self-efficacy, and perceived risk. Variables were measured using validated scales. Pretest sensitization was not present; intervention and control groups were compared. Fixed-effects inverse-variance weighting was used to pool effect estimates and determine meta-analytic statistical significance across tests with and without pretest controls.

Results: Participants in the intervention group had significantly lower total decisional conflict scores (B = -3.58, P = 0.007) compared with the control group. Compared with the control group, participants in the intervention group showed higher knowledge (B = 0.48, P = 0.020), greater intention to receive (B = 0.196, P = 0.049) and discuss the HPV vaccine (B = 0.324, P ≤ 0.001), and greater self-efficacy about HPV vaccine decision making (B = 3.28, P = 0.043). There were no statistically significant results for perceived risks of HPV infection.

Conclusions: The HPV DECIDE tool for mid-adult HPV vaccination shows promise for immediate reductions in decisional conflict and improvement in knowledge, intentions, and self-efficacy about the HPV vaccine. Future studies are warranted to evaluate the effectiveness of this patient decision aid tool in real-world settings.

Highlights: Shared clinical decision making is recommended for HPV vaccination with mid-adults.A patient decision aid for HPV vaccination reduced decisional conflict for mid-adults.The HPV vaccine patient decision aid was acceptable to mid-adults.

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美国27- 45岁成人HPV疫苗决策辅助测试：一项随机试验

背景：在美国，根据与卫生保健提供者共同的临床决策，建议27至45岁（中年）的人乳头瘤病毒（HPV）疫苗接种。我们开发了一种患者决策辅助工具，以支持该成人中期HPV疫苗接种指南的实施。本研究的目的是评估HPV疫苗接种患者决策辅助工具HPV DECIDE的效果，并与未接种HPV疫苗的中年成年人的信息情况表进行比较。方法：在2023年12月至2024年1月期间招募参与者。我们采用随机所罗门，4组，测试前/测试后设计，年龄在27至45岁之间的未接种HPV疫苗的中年人，并根据性别进行平衡（n = 612）。主要的结果是决策冲突。中间结果包括知识、行为预期、自我效能和感知风险。采用有效的量表测量变量。不存在测试前致敏；干预组与对照组比较。固定效应反方差加权用于汇总效应估计，并确定有无前测控制的meta分析统计显著性。结果：干预组决策冲突总分显著低于对照组（B = -3.58, P = 0.007）。与对照组相比，干预组对HPV疫苗的知晓程度（B = 0.48, P = 0.020）、接种意向（B = 0.196, P = 0.049）和讨论意向（B = 0.324, P≤0.001）较高，对HPV疫苗决策的自我效能感（B = 3.28, P = 0.043）较高。对于HPV感染的感知风险没有统计学上的显著结果。结论：用于中期成人HPV疫苗接种的HPV决策工具有望立即减少决策冲突，并改善HPV疫苗的知识，意图和自我效能。未来的研究有必要评估这种患者决策辅助工具在现实世界中的有效性。重点：建议中年人接种HPV疫苗时共享临床决策。一项针对HPV疫苗接种的患者决策援助减少了中年人的决策冲突。人乳头瘤病毒疫苗患者决策辅助对中年人是可接受的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Decision Making 医学-卫生保健

CiteScore

6.50

自引率

5.60%

发文量

146

审稿时长

6-12 weeks

期刊介绍： Medical Decision Making offers rigorous and systematic approaches to decision making that are designed to improve the health and clinical care of individuals and to assist with health care policy development. Using the fundamentals of decision analysis and theory, economic evaluation, and evidence based quality assessment, Medical Decision Making presents both theoretical and practical statistical and modeling techniques and methods from a variety of disciplines.