Missed clinical opportunities: Provider recommendations for HPV vaccination for 11-12 year old girls are limited
Missed clinical opportunities: Provider recommendations for HPV vaccination for 11-12 year old girls are limited
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DOI：
10.1016/j.vaccine.2011.09.006
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发表时间：
2011-11-03
期刊：
影响因子：
5.5
通讯作者：
Giuliano, Anna R.
中科院分区：
文献类型：
--
作者：
Vadaparampil, Susan T.;Kahn, Jessica A.;Giuliano, Anna R.
目的：本研究的目的是确定医生对早期（11-12 岁）、中期（13-17 岁）和晚期青春期/青年（18-26 岁）女性患者推荐人乳头瘤病毒（HPV）疫苗接种的流行情况，并确定与青少年早期建议相关的因素。方法：2009 年 4 月至 2009 年 8 月对全国代表性的 1538 名随机样本进行了 38 项调查。家庭医生、儿科医生和妇产科医生从美国医学会医师主档案中获取。使用多变量模型评估过去 12 个月内与医生推荐 HPV 疫苗接种频率相关的因素（“总是”= 76-100% 的时间 vs. 其他 = 0-75%）。结果：收到了 1013 名医生的完整调查，其中包括 500 名家庭医生、287 名儿科医生和 226 名妇产科医生（回复率 = 67.8%）。在各个专业中，34.6% 的医生表示他们“总是”向青少年早期推荐 HPV 疫苗，52.7% 向青少年中期推荐，50.2% 向青少年晚期/年轻人推荐 HPV 疫苗。所有年龄段的儿科医生“始终”推荐 HPV 疫苗的可能性最高 (P < 0.001)。医生专业、年龄、种族、报告的障碍和儿童疫苗提供者状况与“始终”建议青少年早期接种 HPV 疫苗接种显着相关。结论：研究结果表明错过了 HPV 疫苗接种的临床机会，并且感知到的疫苗接种障碍可能会推动有关推荐的决策。结果表明，需要采取针对年龄和专业的实践和政策层面的干预措施，以增加美国女性的 HPV 疫苗接种。 (C) 2011 Elsevier Ltd. 保留所有权利。
Objective: The purpose of this study was to determine the prevalence of physician recommendation of human papillomavirus (HPV) vaccination in early (ages 11-12), middle (13-17), and late adolescent/young adult (18-26) female patients by physician specialty, and to identify factors associated with recommendation in early adolescents.Methods: A 38-item survey was conducted April 2009 through August 2009 among a nationally representative random sample of 1538 Family Physicians, Pediatricians, and Obstetricians and Gynecologists obtained from the American Medical Association Physician Masterfile. A multivariable model was used to assess factors associated with frequency of physician recommendation of HPV vaccination ("always" = 76-100% of the time vs. other = 0-75%) within the past 12 months.Results: Completed surveys were received from 1013 physicians, including 500 Family Physicians, 287 Pediatricians, and 226 Obstetricians and Gynecologists (response rate = 67.8%). Across the specialties, 34.6% of physicians reported they "always" recommend the HPV vaccine to early adolescents, 52.7% to middle adolescents, and 50.2% to late adolescents/young adults. The likelihood of "always" recommending the HPV vaccine was highest among Pediatricians for all age groups (P < 0.001). Physician specialty, age, ethnicity, reported barriers, and Vaccines for Children provider status were significantly associated with "always" recommending HPV vaccination for early adolescents.Conclusions: Findings suggest missed clinical opportunities for HPV vaccination, and perceived barriers to vaccination may drive decisions about recommendation. Results suggest the need for age and specialty targeted practice and policy level interventions to increase HPV vaccination among US females. (C) 2011 Elsevier Ltd. All rights reserved.