Impact and acceptability of self-consent procedures for the school-based human papillomavirus vaccine: a mixed-methods study protocol
Impact and acceptability of self-consent procedures for the school-based human papillomavirus vaccine: a mixed-methods study protocol
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DOI：
10.1136/bmjopen-2017-021321
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发表时间：
2018-03-01
期刊：
影响因子：
2.9
通讯作者：
Hickman, Matthew
中科院分区：
文献类型：
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作者：
Audrey, Suzanne;Ferrer, Harriet Batista;Hickman, Matthew
前言人乳头瘤病毒(HPV)疫苗在青春期早期接种，可以显著降低宫颈癌的发病率和死亡率。然而，缺乏父母的书面同意是一些年轻女性没有接种疫苗的一个关键原因。国家法律框架允许女孩在没有父母同意的情况下接种疫苗，只要她们被认为是吉利克合格的，但在没有父母书面同意的情况下接种疫苗有一些沉默。布里斯托尔和南格洛斯特郡正在实施自我同意程序。这项研究将检查这些新程序的实施、可接受性和影响。方法和分析英国公共卫生和儿童健康信息系统的常规数据的统计分析将从两个方面测试HPV疫苗接种的增加：(A)在我们的干预地点改变前后进行比较时，是否有增加？和(B)我们干预地点的百分比变化与英格兰没有进行此类干预的比较地点(就初始HPV感染、种族和剥夺水平而言与我们的干预地点相似)是否不同，以及如何变化？对于过程评估，我们将开发一个逻辑模型，并使用调查问卷、观察和对年轻女性、学校护士、学校教职员工和家长的录音采访来检查背景、自我同意的实施情况以及对新程序的反应。伦理和传播布里斯托尔大学健康科学学院研究伦理委员会和国家卫生服务健康研究机构为这项研究提供了批准。我们将与主要利益攸关方一起编写一份报告，提出有关自我同意程序的建议。将至少撰写两篇论文，在同行评议的期刊上发表，并在会议上发表演讲。结果摘要将应要求与参与免疫接种的护士、学校教职员工、年轻人和家长分享。
Introduction The human papillomavirus (HPV) vaccine, administered in early adolescence, can substantially reduce cervical cancer incidence and mortality. However, lack of written parental consent is a key reason why some young women do not receive the vaccine. The national legal framework allows girls to be vaccinated without parental consent provided they are deemed Gillick competent, but there is some reticence about vaccinating without written parental consent. Self-consent procedures are being implemented in Bristol and South Gloucestershire. This study will examine the implementation, acceptability and impact of these new procedures.Methods and analysis Statistical analyses of routine data from Public Health England and the Child Health Information System will test if there has been an increase in HPV vaccination uptake in two ways: (a) Is there an increase when comparing before and after the change in our intervention sites? and (b) Does the percentage change in our intervention sites differ from comparison sites (similar to our intervention sites in terms of initial HPV uptake, ethnicity and deprivation levels) in England where no such intervention took place and how? For the process evaluation, we will develop a logic model and use questionnaires, observations and audio-recorded interviews with young women, school nurses, school staff and parents to examine the context, implementation of self-consent and response to the new procedures.Ethics and dissemination The University of Bristol Faculty of Health Sciences Research Ethics Committee and the National Health Service Health Research Authority provided approvals for the study. We will produce a report with recommendations about self-consent procedures in conjunction with key stakeholders. At least two papers will be written for publication in peer-reviewed journals and for conference presentations. A summary of results will be shared with participating immunisation nurses, school staff, young people and parents as requested.