美国当代医疗服务提供者对如何解决 HPV 疫苗接种犹豫不决问题的看法:定性研究

IF 2.7 Q3 IMMUNOLOGY Vaccine: X Pub Date : 2024-07-24 DOI:10.1016/j.jvacx.2024.100533
Anna L. Beavis , Mahima S. Krishnamoorthi , Sarah Adler , Laura G. Fleszar , Meghan B. Moran , Anne F. Rositch
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引用次数: 0

摘要

导言尽管超过 15 年的真实世界数据证明了人类乳头瘤病毒 (HPV) 疫苗的安全性和有效性,但在美国,疫苗接种犹豫仍然存在。方法在 2021 年 7 月至 2022 年 4 月期间,我们在马里兰州和更广泛的大西洋中部地区招募了从事儿科、初级保健、家庭医学或青少年医学并为 10-17 岁儿童提供门诊服务的医疗服务提供者。半结构式虚拟访谈的重点是医疗服务提供者报告的应对HPV疫苗犹豫不决的家长的策略,以及成功接种疫苗的已知障碍和医疗服务提供者对解决家长犹豫不决的具体干预措施的看法。通过演绎和归纳编码相结合的方法对录音进行了转录和分析。在策略、障碍和对具体建议干预措施的看法等领域中,确定了更高层次的主题。在医疗服务提供者报告的策略领域中,出现了以下主题:1)利用医疗服务的连续性和已建立的家长信任;2)支持家长的自主权;3)根据对疫苗有疑虑的家长的具体关注点调整方法;4)使 HPV 疫苗正常化;5)关注健康预防和癌症预防。提供者指出的障碍有1) 时间有限;2) 与家长缺乏共识;3) 家长与子女的决定不一致;4) 存在错误信息;5) 家长关注的问题,如安全性和必要性。在建议的干预措施方面,医疗服务提供者倾向于节省时间或不耗费资源的干预措施,这些措施不会将 HPV 疫苗单独作为一种不同的疫苗,对患者友好,并能通过电子病历提高效率。本研究的启示有助于开发医疗服务提供者可接受且可行的工具和干预措施,以解决家长对 HPV 疫苗犹豫不决的问题。
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Contemporary provider perspectives on how to address HPV vaccine hesitancy in the US: A qualitative study

Introduction

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.

Methods

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.

Results and discussion

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.

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来源期刊
Vaccine: X
Vaccine: X Multiple-
CiteScore
2.80
自引率
2.60%
发文量
102
审稿时长
13 weeks
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