Factors that Influence Healthcare Provider Recommendation of HPV Vaccination.
Factors that Influence Healthcare Provider Recommendation of HPV Vaccination.
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DOI：
10.1177/08901171221091438
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发表时间：
2022-09
影响因子：
2.7
通讯作者：
Tsui, Jennifer
中科院分区：
文献类型：
--
作者：
Btoush, Rula;Kohler, Racquel Kelly;Carmody, Dennis P.;Hudson, Shawna, V;Tsui, Jennifer
关键词：
这项研究检查了与医疗保健提供者（HCP）建议年轻和年长青少年接种HPV疫苗相关的因素。这是一项横断面研究，使用2018年对新泽西HCP进行的基于网络的调查。研究结果是HCP推荐HPV疫苗的二分指标。研究预测因素包括实践特征（即，人种/种族、年龄组、保险类型和VFC接受者的比例）和HCP的特征（即，专业和感知知识、有效性、关注点、与母公司和系统相关的障碍以及促进者）。数据分析包括逻辑回归模型，使用单独的块的做法和供应商的特点，其次是一个向后逐步的方法来确定生存的预测。受访者（N=390）包括医生（75%）和执业护士（25%），专门从事儿科（62%），家庭医学（20%）和妇女健康（18%）。HCP对HPV疫苗接种的推荐率为年轻青少年（11-13岁）的56%和老年青少年（14-17岁）的73%。对于年龄较小的青少年，建议率在以下实践中显著较高：年龄较小的青少年、黑人和西班牙裔患者比例较高;儿科提供者; HCP对疫苗的知识水平较高，关注程度较低。对于年龄较大的青少年，在实践中，西班牙裔，私人保险和VFC接受者的比例较高;儿科提供者中; HCP对疫苗的知识水平较高，关注程度较低，以及推荐HPV疫苗的促进者水平较高。针对HCP的干预措施需要侧重于提高他们对疫苗的了解，减少他们对疫苗安全性的担忧，并利用促进者策略，特别是在非儿科提供者中。
This study examined factors associated with healthcare providers’ (HCPs’) recommendation of HPV vaccination for younger and older adolescents. This is a cross-sectional study, using web-based survey of HCPs in New Jersey in 2018. The study outcome was a dichotomous measure of HCPs’ recommendation of the HPV vaccine . The study predictors included practice characteristics (i.e., proportions of race/ethnicity, age groups, insurance type, and VFC recipients) and HCP’s characteristics (i.e., specialty and perceived knowledge, effectiveness, concerns, parent- and system-related barriers, and facilitators). Data analysis included logistic regression models using separate blocks for practice and provider characteristics, followed by a backward stepwise approach to determine the surviving predictors. Respondents (N=390) included physicians (75%) and nurse practitioners (25%), specialized in pediatrics (62%), family medicine (20%), and women’s health (18%). The HCPs’ recommendation rates for HPV vaccination were 56% for younger adolescents (11-13 years old) and 73% for older adolescents (14-17 years old). For younger adolescents, the recommendation rates were significantly higher in practices with higher proportions of younger adolescent, Black and Hispanic patients; among pediatric providers; and with HCPs’ higher levels of knowledge and lower levels of concern about the vaccine. For older adolescents, the rates were significantly higher in practices with higher proportions patients who are Hispanic, privately insured, and VFC recipients; among pediatric providers; and with HCPs’ higher levels of knowledge and lower levels of concern about the vaccine as well as higher levels of facilitators for recommending the HPV vaccine. Interventions targeting HCPs need to focus on improving their knowledge regarding the vaccine, reduce their concerns around its safety, and utilize facilitators strategies, particularly among non-pediatric providers.
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