Effect of provider recommendation style on the length of adolescent vaccine discussions.
Effect of provider recommendation style on the length of adolescent vaccine discussions.
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DOI：
10.1016/j.vaccine.2020.11.015
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发表时间：
2021-02-05
期刊：
影响因子：
5.5
通讯作者：
Perkins RB
中科院分区：
文献类型：
--
作者：
Fenton ATHR;Orefice C;Eun TJ;Biancarelli D;Hanchate A;Drainoni ML;Perkins RB
确定提供者的疫苗推荐方式是否影响青少年疫苗讨论的时间长度。我们使用青少年有资格接种HPV疫苗±脑膜炎球菌疫苗的临床遭遇的录音来分析疫苗讨论。我们测量了疫苗讨论的时间长度，提供者使用“指定”（接种疫苗应在访问）或“选择性”（接种疫苗是可选的）推荐风格，以及疫苗接收。从访视前和访视后的调查中收集父母和儿童的人口统计学资料、父母的疫苗接种意向和父母对疫苗讨论的满意度。我们使用线性和logit回归随机效应估计推荐风格的关联与讨论长度和疫苗接收，分别。我们分析了82个临床接触和43个提供者的106个疫苗讨论（82个HPV; 24个脑膜炎球菌）。当提供者将疫苗接种作为选择性接种与指示性接种时，疫苗讨论时间更长（140对74 s; p值< 0.001）。控制疫苗类型、父母接种意图和患者特征，选择性方式与41秒的疫苗讨论相关（p值< 0.05）。提供者使用脑膜炎球菌疫苗的指定方式比HPV疫苗更频繁（96% vs. 72%; p值< 0.05）。父母接种疫苗的几率是9.3倍高后，指示与选择性介绍（p值< 0.05）。疫苗讨论长度和演讲风格与父母满意度无关。我们的研究结果表明，使用指定的建议可以提高疫苗讨论的效率和有效性，但这种方式更常用于脑膜炎球菌疫苗而不是HPV疫苗。越来越多的供应商使用HPV疫苗的指示样式有可能提高疫苗接种率并节省就医时间。
To determine whether providers’ vaccine recommendation style affects length of the adolescent vaccine discussions. We analyzed vaccine discussions using audio-recordings of clinical encounters where adolescents were eligible for HPV vaccines ± meningococcal vaccines. We measured length of vaccine discussions, the provider’s use of an “indicated” (vaccination due at visit) or “elective” (vaccination is optional) recommendation style, and vaccine receipt. Parent and child demographics, parental vaccination intentions, and parental satisfaction with vaccine discussion were collected from pre- and post-visit surveys. We used linear and logit regressions with random effects to estimate recommendation style’s association with discussion length and with vaccine receipt, respectively. We analyzed 106 vaccine discussions (82 HPV; 24 meningococcal) across 82 clinical encounters and 43 providers. Vaccine discussions were longer when providers presented vaccination as elective versus indicated (140 vs. 74 s; p-value < 0.001). Controlling for vaccine type, parental vaccination intent, and patient characteristics, an elective style was associated with 41 seconds longer vaccine discussion (p-value < 0.05). Providers used the indicated style more frequently with the meningococcal vaccine than with the HPV vaccine (96% vs. 72%; p-value < 0.05). Parents’ odds of vaccinating were 9.3 times higher following an indicated versus an elective presentation (p-value < 0.05). Vaccine discussion length and presentation style were not associated with parental satisfaction. Our results suggest that using an indicated recommendation improves vaccine discussions’ efficiency and effectiveness, but this style is used more often with meningococcal than HPV vaccines. Increasing providers’ use of indicated styles for HPV vaccines has the potential to increase vaccination rates and save time during medical visits.
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