Parent-Provider Communication of HPV Vaccine Hesitancy.
Parent-Provider Communication of HPV Vaccine Hesitancy.
复制标题
HPV疫苗犹豫的父母提供者的交流。
DOI：
10.1542/peds.2017-2312
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发表时间：
2018-06
期刊：
影响因子：
8
通讯作者：
Tiro JA
中科院分区：
文献类型：
--
作者：
Shay LA;Baldwin AS;Betts AC;Marks EG;Higashi RT;Street RL Jr;Persaud D;Tiro JA
为了减少可预防的人乳头瘤病毒（HPV）相关癌症的负担，提供者必须与疫苗犹豫不决的父母进行有效沟通。这项研究开发了一种类型学，其特征是父母与提供者围绕HPV疫苗犹豫的沟通。我们在德克萨斯州达拉斯的六家儿科诊所对43名未接种疫苗的青少年进行了录音，其中父母对HPV疫苗接种犹豫不决。我们定性编码了父母如何口头表达犹豫（自信的反应，提出问题或表达担忧）以及提供者是否以默许（同意推迟接种）和/或坚持（继续讨论）回应。我们描述了父母/提供者通信代码和当天接种疫苗的频率。在43次访问中，有37位家长以多种方式表示犹豫1+次。最常见的是肯定答复（26次访问），其次是问题（15次访问）和关切（12次访问）。当第一次表达犹豫是一个问题或关注时，分别有67%和63%的青少年在当天接种疫苗，而33%的最初肯定反应接种疫苗。提供者只在18次访问中作出了坚持的答复，12次访问中是默许和坚持的混合，6次访问中只有默许。当提供者只使用持久性，18名青少年中有17人接种疫苗;当提供者只默许时，没有青少年接种疫苗。我们的探索性分析表明，提供者让犹豫不决的父母参与讨论，解决他们的担忧，可能会导致当天接种HPV疫苗。数据显示，即使是做出自信声明的父母也会受到供应商的影响。我们的研究结果强调了一个重要的错失机会时，供应商只是默许父母的犹豫。
To reduce burden of preventable human papillomavirus (HPV) related cancers, providers must effectively communicate with vaccine-hesitant parents. This study developed a typology characterizing parent-provider communication around HPV vaccine hesitancy. We audio-recorded 43 visits with unvaccinated adolescents at six pediatric clinics in Dallas, Texas in which parents were undecided about HPV vaccination. We qualitatively coded how parents verbally expressed hesitancy (assertive response, asking a question, or expressing concern) and whether providers responded with acquiescence (agree to defer vaccination) and/or persistence (continue discussion). We described frequency of parent/provider communication codes and same-day vaccination. Among the 43 visits, 37 parents expressed hesitancy 1+ times in many ways. Assertive responses were most common (26 visits), followed by questions (15 visits) and concerns (12 visits). When the first expression of hesitancy was a question or concern, 67% and 63%, respectively, of adolescents received same-day vaccinations, while 33% with an initial assertive response were vaccinated. Providers responded with persistence only in 18 visits, a mix of acquiescence and persistence in 12 visits, only acquiescence in 6 visits. When providers only used persistence, 17 of 18 adolescents were vaccinated; when providers responded with only acquiescence, no adolescents received the vaccine. Our exploratory analysis suggests that providers engaging hesitant parents in a discussion that addresses their concerns can lead to same-day HPV vaccination. Data show that even parents making assertive statements are amenable to influence by providers. Our findings highlight an important missed opportunity when providers simply acquiesce to parental hesitation.
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影响因子：
2.3
作者：
Kester LM;Zimet GD;Fortenberry JD;Kahn JA;Shew ML
通讯作者：
Shew ML
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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作者：
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通讯作者：
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