Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents.
Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents.
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提供者对与HPV疫苗犹豫不决的父母有关沟通和解雇政策的看法。
DOI：
10.1016/j.pmedr.2021.101562
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发表时间：
2021-12
影响因子：
2.8
通讯作者：
Tiro JA
中科院分区：
文献类型：
--
作者：
Francis JKR;Rodriguez SA;Dorsey O;Blackwell JM;Balasubramanian BA;Kale N;Day P;Preston SM;Thompson EL;Pruitt SL;Tiro JA
提供者（29%）经历了来自家长的hpv特异性疫苗犹豫。提供者在回应家庭的宗教信仰方面缺乏信心。一些提供者（25%）同意对拒绝接种疫苗的家庭采取解雇政策。父母对疫苗的犹豫越来越令人担忧。对于遇到对HPV特异性疫苗犹豫不决的父母的提供者或实践特征，提供者对HPV疫苗问题作出反应的信心，以及疫苗解雇政策（即将患者从实践中移除）的态度和使用，了解较少。北德克萨斯州的供应商完成了一项在线调查。评估的因变量：(1)在实践中遇到的HPV疫苗犹豫父母的百分比定义为实质性的，或高（≥11%，或超过十分之一的青少年患者遇到）与低（≤10%）的水平；(2)应对11个HPV疫苗问题的信心；(3)疫苗解雇政策的态度和使用。进行了卡方检验和费雪精确检验。在156名提供者中，29%的人报告HPV疫苗高度犹豫（≥11%的患者群体）。总体而言，供应商报告对解决疫苗问题“非常有信心”（平均值：3.37 / 4，标准差：0.57）。白人（相对于非白人）提供者和儿科医生（相对于家庭医生）的平均信心得分明显更高。提供者在回应父母的宗教/个人信仰方面最不自信（69%）。一些提供者（25%）同意在反复咨询后拒绝接种疫苗犹豫的父母的政策。更多的医疗服务提供者对儿童（19%）的免疫接种采取不接受政策，而对青少年（10%）的免疫接种采取不接受政策。提供者沟通培训应包括父母的宗教/个人信仰，以有效解决HPV疫苗犹豫。其他地区应检查其hpv特异性疫苗犹豫水平，以了解在青少年和儿童免疫接种中，拒绝接种政策的使用可能会有何不同。
Providers (29%) experience HPV-specific vaccine hesitancy from parents. Providers feel least confident in responding to families’ religious beliefs. Some providers (25%) agree with dismissal policies for families refusing vaccines. Parental vaccine hesitancy is a growing concern. Less is known about provider or practice characteristics that encounter HPV-specific vaccine-hesitant parents, the providers’ confidence in responding to HPV vaccine concerns, and the attitudes and use of vaccine dismissal policies (i.e., removing patients from the practice). North Texas providers completed an online survey. Dependent variables assessed: (1) percentage of HPV vaccine-hesitant parents encountered in practice defined as substantive, or high (≥11%, or among more than one out of ten adolescent patient encounters) versus low (≤10%) levels; (2) confidence in responding to 11 HPV vaccine concerns; (3) attitudes and use of vaccine dismissal policies. Chi-square and Fisher’s exact tests were conducted. Among 156 providers, 29% reported high HPV vaccine hesitancy (≥11% of patient population). Overall, providers reported being “very confident” in addressing vaccine concerns (mean: 3.37 out of 4, SD: 0.57). Mean confidence scores were significantly higher for white (vs. non-white) providers and for pediatricians (vs. family practitioners). Providers were least confident in responding to parents’ religious/personal beliefs (69%). Some providers (25%) agreed with policies that dismissed vaccine-hesitant parents after repeated counseling attempts. More providers used dismissal policies for childhood (19%) than adolescent (10%) immunizations. Provider communication training should include parental religious/personal beliefs to effectively address HPV vaccine hesitancy. Other regions should examine their HPV-specific vaccine hesitancy levels to understand how the use of dismissal policies might vary between adolescent and childhood immunizations.
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