Impact of a Virtual Reality Curriculum on Human Papillomavirus Vaccination: A Pilot Trial.
Impact of a Virtual Reality Curriculum on Human Papillomavirus Vaccination: A Pilot Trial.
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DOI：
10.1016/j.amepre.2022.05.003
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发表时间：
2022-11
影响因子：
5.5
通讯作者：
Rosen, Brittany L.
中科院分区：
文献类型：
--
作者：
Real, Francis J.;Ollberding, Nicholas J.;Meisman, Andrea R.;DeBlasio, Dominick J.;Pero, Mary Beth;Davis, David;Cruse, Bradley;Klein, Melissa D.;Kahn, Jessica A.;Rosen, Brittany L.
虽然人乳头瘤病毒（HPV）疫苗接种的最强预测因子是高质量的建议，但医生通常提供弱建议。因此，作者开发了推荐免疫接种的虚拟沉浸式交流培训（VICTORI），这是一种基于虚拟现实（VR）的干预手段，为医生提供了有意识地实践推荐行为的机会。VICTORI包括虚拟现实模拟，在模拟过程中，参与者向不愿接种疫苗的护理人员虚拟化身提供咨询。在参与VICTORI之前，参与者对智能手机应用程序的推荐行为进行了评估。VICTORI的非随机对照试验由执业医师和住院医师进行。干预组完成应用程序和VICTORI模拟，而对照组只完成应用程序。假设干预组患者的HPV疫苗接种率会增加。干预前定义为分配培训前6个月（2020年2月1日- 2020年7月31日），干预后定义为分配培训后6个月（2020年10月1日- 2021年3月31日）。主要结果是在前后就诊的符合条件的患者中，人乳头瘤病毒疫苗接种率的变化。在142名符合条件的医生中，134名（94%）选择参加，其中93 /97（96%）的干预和37名（81%）的对照参与者中的30名完成了研究方案。干预组患者培训后HPV疫苗接种率有统计学意义升高（54.3% ~ 72.4%，差异18.1% [95% CI=11.0, 25.8], p<0.001），对照组无统计学意义升高（59.5% ~ 63.4%，差异3.9% [95% CI= - 11.0, 19.0], p=0.609）。总之，VR训练后HPV疫苗接种增加，值得进一步研究。
Although the strongest predictor of human papillomavirus (HPV) vaccination is a high-quality recommendation, physicians often provide weak recommendations. Thus, the authors developed Virtual Immersive Communication Training on Recommending Immunizations (VICTORI), a virtual reality (VR)–based intervention that provided physicians the opportunity to deliberately practice recommendation behaviors. VICTORI included VR simulations during which participants counseled caregiver avatars hesitant to vaccinate. Before participation in VICTORI, participants reviewed a smartphone application on recommendation behaviors. A nonrandomized control trial of VICTORI was conducted with licensed and resident physicians. The intervention group completed the application and VICTORI simulations, whereas a comparison group completed only the application. The hypothesis was that HPV vaccination rates would increase for patients in the intervention group. The preintervention period was defined as the 6 months before allocated training (February 1, 2020–July 31, 2020), and the postintervention period was the 6 months after (October 1, 2020–March 31, 2021). The primary outcome was a change in the rates of human papillomavirus vaccine initiation among eligible patients presenting to clinic before and after. Of 142 eligible physicians, 134 (94%) chose to participate, with 93 of /97 (96%) intervention and 30 of 37 (81%) comparison participants completing study protocols. There was a statistically significant increase in patients’ HPV vaccine initiation rates after training within the intervention group (54.3%–72.4%; 18.1% difference [95% CI=11.0, 25.8]; p<0.001) but not within the comparison group (59.5%–63.4%; 3.9% difference [95% CI= −11.0, 19.0]; p=0.609). In conclusion, HPV vaccine initiation increased after VR training, and further study is warranted.
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