Multilevel perspectives on school-based opportunities to improve HPV vaccination among medically underserved adolescents: Beyond school entry mandates.
Multilevel perspectives on school-based opportunities to improve HPV vaccination among medically underserved adolescents: Beyond school entry mandates.
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DOI：
10.1080/21645515.2023.2251815
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发表时间：
2023-08-01
影响因子：
4.8
通讯作者：
Tsui, Jennifer
中科院分区：
文献类型：
--
作者：
Shin, Michelle B.;Sloan, Kylie;Baezconde-Garbanati, Lourdes;Dang, Emily;Garcia, Samantha;Palinkas, Lawrence A.;Unger, Jennifer B.;Willgerodt, Mayumi;Crabtree, Benjamin F.;Tsui, Jennifer
以学校为基础的HPV疫苗接种计划提高了全球青少年的疫苗接种率。然而，在美国，以学校为基础的HPV疫苗接种战略主要集中在学校入学接种疫苗的规定上，只有五个州/司法管辖区通过了这一规定。许多学校和校本保健中心（shbhcs）已经向医疗服务不足的青少年提供保健服务，并且没有充分探索改善HPV疫苗教育和接种方面差距的机会。这项对诊所和社区成员的定性研究评估了学校内外增加HPV疫苗接种的潜在机会。数据来自一项更大的混合方法研究，旨在了解在医疗服务不足的社区采用基于证据的HPV疫苗接种策略的经验。家长研究包括在2020年12月至2022年1月期间在洛杉矶和新泽西与诊所（提供者、诊所领导、工作人员）和社区（种族/少数民族父母、倡导者、付款人、政策代表）成员进行的访谈和焦点小组。我们创建了一个与学校/ shbhcs相关的精简文本数据集（30个深度访谈，7个焦点小组），并进行了定向内容分析。与会者指出，学校和中小企业卫生中心是接触在获得初级保健方面遇到障碍的医疗服务不足的青少年的理想场所。家长/提供者对学校的HPV疫苗管理/教育表达了共同的兴趣，但由于疫苗日益政治化，一些倡导者/政策参与者遇到了挑战。与会者强调了在学校扩大人乳头瘤病毒疫苗教育和管理的政策，包括未成年人同意和增加shbhc对人乳头瘤病毒疫苗的资助。需要更多的研究来探索现有的基础设施，合作伙伴的动机，以及在疫苗授权之外改善学校内医疗服务不足的青少年的HPV疫苗接种的机会。
School-based HPV vaccination programs have improved vaccine uptake among adolescents globally. However, school-based HPV vaccination strategies in the United States (US) have mainly focused on school-entry mandates for vaccination, which have passed in only five states/jurisdictions. Many schools and school-based health centers (SBHCs) already provide health services to medically underserved adolescents and opportunities to improve disparities in HPV vaccine education and uptake are underexplored. This qualitative study of clinic and community members assessed potential opportunities within and outside schools to increase HPV vaccination. Data were generated from a larger mixed-methods study designed to understand experiences with HPV vaccination evidence-based strategies in medically underserved communities. The parent study included interviews and focus groups conducted with clinic (providers, clinic leaders, staff) and community (racial/ethnic minority parents, advocates, payers, policy representatives) members in Los Angeles and New Jersey between December 2020-January 2022. We created a reduced dataset of text related to schools/SBHCs (30 in-depth interviews, 7 focus groups) and conducted a directed content analysis. Participants indicated that schools and SBHCs are ideal venues for reaching medically underserved adolescents experiencing barriers to primary care access. Parents/providers expressed mutual interest in HPV vaccine administration/education in schools, but some advocates/policy participants experienced challenges due to increasing politicization of vaccines. Participants highlighted policies for expanding HPV vaccine education and administration in schools, including minor consent and increasing SBHC funding for HPV vaccines. More research is needed to explore existing infrastructure, partner motivation, and opportunities to improve HPV vaccination among medically underserved adolescents within schools beyond vaccine mandates.
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