Calling the Shots? Adolescents' Influence on Human Papillomavirus Vaccine Decision-Making During Clinical Encounters
Calling the Shots? Adolescents' Influence on Human Papillomavirus Vaccine Decision-Making During Clinical Encounters
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DOI：
10.1016/j.jadohealth.2019.10.020
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发表时间：
2020-04-01
影响因子：
7.6
通讯作者：
Perkins, Rebecca B.
中科院分区：
文献类型：
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作者：
Fenton, Anny T. H. R.;Eun, Terresa J.;Perkins, Rebecca B.
目的：本研究的目的是调查青少年在临床就诊期间对人乳头瘤病毒 (HPV) 疫苗决策和接受的影响。方法：我们招募了讲英语和/或西班牙语的父母及其 9-17 岁的青少年儿童，他们有资格接种第一剂 HPV 疫苗，并在大波士顿地区的儿科和家庭医学诊所寻求常规护理，参加了多层次干预措施，以提高 HPV 疫苗接种覆盖率。家长完成了预访调查，其中包括家长接种疫苗的意愿。我们对青少年的临床经历进行了编码，以定义青少年参与疫苗讨论和免疫合作的情况。通过分析青少年参与讨论和家长预先了解疫苗的意愿，确定青少年对疫苗决策的影响。结果：共有113名青少年及其家长参与。 87% 的青少年在访问期间接种了第一剂 HPV 疫苗。大多数反应为阴性（23% 为轻度反应，23% 为中度反应，10% 为极端反应）；几乎所有反对意见都是与注射疼痛有关，而不是针对 HPV 疫苗接种。少数反应为阳性（12%），33% 为中立，12% 未参与疫苗讨论。所有出现阳性或中性反应的青少年都接受了疫苗接种，91% 的阴性反应青少年也接受了疫苗接种。在考虑了父母预先接种疫苗的意图并分析了临床接触期间的讨论后，只有 5% 的青少年似乎对疫苗接种产生积极 (n = 3) 或消极 (n = 3) 的影响。结论：在这项研究中，青少年很少影响父母的疫苗决策，尽管许多人对注射的疼痛表现出痛苦。这表明增加青少年参与疫苗讨论可能对疫苗接种率的影响有限。 (C) 2019 年青少年健康与医学协会。版权所有。
Purpose: The aim of the study was to examine adolescents' influence on human papillomavirus (HPV) vaccine decision-making and receipt during clinical visits.Methods: We recruited English- and/or Spanish-speaking parents and their adolescent children aged 9-17 years who were eligible for the first HPV vaccine dose and seeking routine care at pediatric and family medicine clinics in the Greater Boston area enrolled in a multilevel intervention to improve HPV vaccination coverage. Parents completed previsit surveys that included parental intention to vaccinate. We coded transcripts of adolescents' clinical encounters to define adolescents' participation in vaccine discussions and cooperation with immunization. Adolescents' influence on vaccine decision-making was determined based on analyses of their participation in discussions and parents' previsit vaccine intentions.Results: A total of 113 adolescents and their parents participated. Eighty-seven percent of adolescents received their first HPV vaccine dose during the visit. Most reactions were negative (23% mild, 23% moderate, and 10% extreme); nearly all objections were concerns related to the pain of injection rather than specific toHPV vaccination. A minority of reactions were positive (12%), 33% were neutral, and 12% did not participate in vaccine discussions. All adolescents with positive or neutral reactions received vaccination, as did 91% of those with negative reactions. After accounting for parents' previsit vaccine intentions and analyzing discussions during clinical encounters, only 5% of adolescents appeared to influence vaccination either positively (n = 3) or negatively (n = 3).Conclusions: In this study, adolescents rarely influenced parents' vaccine decision-making, although many exhibited distress over the pain of injections. This suggests that increasing adolescents' involvement in vaccine discussions may have limited effects on vaccination rates. (C) 2019 Society for Adolescent Health and Medicine. All rights reserved.