Associations of trust and healthcare provider advice with HPV vaccine acceptance among African American parents.
Associations of trust and healthcare provider advice with HPV vaccine acceptance among African American parents.
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DOI：
10.1016/j.vaccine.2016.12.045
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发表时间：
2017-02-01
期刊：
影响因子：
5.5
通讯作者：
Joseph JG
中科院分区：
文献类型：
--
作者：
Fu LY;Zimet GD;Latkin CA;Joseph JG
建议医疗保健提供者（HCP）向所有父母强烈推荐HPV疫苗接种。然而，强烈的建议可能在促进非洲裔美国人接种疫苗方面效果较差，这些人平均对医疗保健系统有更大的不信任。本研究探讨了非裔美国人父母对HCP的信任和HCP疫苗接种建议对HPV疫苗接受度的影响。参与者于2012年7月至2014年7月期间从城市学术医疗中心招募。我们调查了400名10至12岁儿童的非裔美国父母，他们的HCP为他们提供HPV疫苗，以评估社会人口因素，疫苗信念，对HCP的信任以及收到的HPV疫苗建议。审查病历以确定疫苗接种情况。在多变量分析中，父母“非常强烈”推荐HPV疫苗的儿童接受疫苗的几率是父母“不是非常强烈”推荐疫苗的儿童的四倍多。父母对HCP的信任“很多”与“没有”或只有“一些”与接受HPV疫苗的几率增加一倍以上有关。在所有亚组中，非常强烈的HCP建议与更高的疫苗接种几率相关，包括那些对HPV疫苗持更消极的基线态度和那些信任水平较低的人。将HCP推荐的变量强度和父母对HCP的信任添加到已经针对社会人口因素和父母疫苗信念进行调整的多变量模型中，将伪R2从0.52提高到0.55。在参与者中，接受强烈的疫苗推荐和对HCP的信任程度较高与HPV疫苗接种的可能性较高相关，但并没有增加已经根据基线个人信念和社会人口因素调整的模型的预测价值。
Healthcare providers (HCPs) are advised to give all parents a strong recommendation for HPV vaccination. However, it is possible that strong recommendations could be less effective at promoting vaccination among African Americans who on average have greater mistrust in the healthcare system. This study examines the associations of parental trust in HCPs and strength of HCP vaccination recommendation on HPV vaccine acceptance among African American parents. Participants were recruited from an urban, academic medical center between July 2012 and July 2014. We surveyed 400 African American parents of children ages 10 to 12 years who were offered HPV vaccine by their HCPs to assess sociodemographic factors, vaccine beliefs, trust in HCPs, and the HPV vaccine recommendation received. Medical records were reviewed to determine vaccination receipt. In multivariable analysis, children whose parents were “very strongly” recommended the HPV vaccine had over four times higher odds of vaccine receipt compared with those whose parents were “not very strongly” recommended the vaccine. Having a parent with “a lot of” versus “none” or only “some” trust in HCPs was associated with over twice the odds of receiving HPV vaccine. Very strong HCP recommendations were associated with higher odds of vaccination among all subgroups, including those with more negative baseline attitudes toward HPV vaccine and those with lower levels of trust. Adding the variables strength of HCP recommendation and parental trust in HCPs to a multivariable model already adjusted for sociodemographic factors and parental vaccine beliefs improved the pseudo R2 from 0.52 to 0.55. Among participants, receiving a strong vaccine recommendation and having a higher level of trust in HCPs were associated with higher odds of HPV vaccination, but did not add much to the predictive value of a model that already adjusted for baseline personal beliefs and sociodemographic factors.