Relative contributions of parental intention and provider recommendation style to HPV and meningococcal vaccine receipt
Relative contributions of parental intention and provider recommendation style to HPV and meningococcal vaccine receipt
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DOI：
10.1080/21645515.2019.1591138
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发表时间：
2019-04-18
影响因子：
4.8
通讯作者：
Perkins, Rebecca B.
中科院分区：
文献类型：
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作者：
Eun, Terresa J.;Hanchate, Amresh;Perkins, Rebecca B.
我们描述了父母的意愿和供应商的推荐方式对HPV和脑膜炎球菌疫苗接种的相对贡献。符合脑膜炎球菌和HPV疫苗接种条件的父母-子女二人组参加了访视前调查，并同意录音记录他们与疫苗接种相关的医疗保健提供者的临床互动。调查分析了父母和儿童的人口统计数据以及父母为儿童接种HPV和/或脑膜炎球菌疫苗的意愿。分析录音，以确定提供者的推荐风格，定义为指示（提供者表示疫苗在该次访视时到期）或不，以及儿童接受疫苗。线性和逻辑回归模型被用来确定父母的意图和供应商的推荐风格的疫苗接收的相对贡献。56名父母/儿童参与。79%的儿童接种了HPV疫苗，93%的儿童接种了脑膜炎球菌疫苗。在控制了人口统计学变量后，父母的意图并没有因疫苗类型而异。然而，提供者不太可能使用HPV的指示建议，而不是脑膜炎球菌疫苗。在控制了人口统计学因素、父母意图和提供者推荐方式后，疫苗类型（HPV或脑膜炎球菌）不再与疫苗接种相关。以前归因于疫苗特异性因素的差异可能由父母和提供者在疫苗接种中的作用来解释。这些研究结果表明，有关青少年疫苗接种的干预措施和政策建议应侧重于增加父母对疫苗的需求，并确保提供者将所有疫苗作为医疗护理标准。
We described the relative contributions of parental intention and provider recommendation style to HPV and meningococcal vaccine receipt. Parent-child dyads that were eligible for both meningococcal and HPV vaccines participated in pre-visit surveys and consented to audio recording of their clinical interactions with healthcare providers related to vaccination. Surveys were analyzed for parent and child demographics and parental intention to vaccinate children with HPV and/or meningococcal vaccines. Audio recordings were analyzed for provider recommendation style, defined as indicated (provider stated vaccine was due at that visit) or not, and for child receipt of vaccines. Linear and logistic regression models were used to determine the relative contributions of parental intention and provider recommendation style to vaccine receipt. 56 parents/child dyads participated. 79% of children received HPV vaccines, and 93% received meningococcal vaccines. After controlling for demographic variables, parental intention did not differ by vaccine type. However, providers were less likely to use an indicated recommendation for HPV than for meningococcal vaccine. After controlling for demographic factors, parental intention, and provider recommendation style, vaccine type (HPV or meningococcal) was no longer associated with vaccine receipt Differences that were previously attributed to vaccine-specific factors may be explained by parents' and providers' roles in vaccine receipt. These findings suggest that interventions and policy recommendations regarding adolescent vaccination should focus on increasing parental demand for vaccines and ensuring that providers present all vaccines as the medical standard of care.