Differences in stakeholder-reported barriers and implementation strategies between counties with high, middle, and low HPV vaccine initiation rates: a mixed methods study.
Differences in stakeholder-reported barriers and implementation strategies between counties with high, middle, and low HPV vaccine initiation rates: a mixed methods study.
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DOI：
10.1186/s43058-022-00341-y
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发表时间：
2022-09-06
影响因子：
--
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更好地了解人乳头瘤病毒（HPV）疫苗接种率的县级差异，可以帮助针对性干预措施，以减少HPV相关癌症的差异。我们进行了一项混合方法研究，比较了北方佛罗里达22个县中最高、中等和最低HPV疫苗启动率（接受第一剂）县之间的持照者报告的障碍和提高HPV疫苗接种率的努力。在2018年8月至2019年4月期间，我们通过有目的和滚雪球抽样招募了利益相关者（n = 68），以确定潜在的参与者，他们对所在县的HPV疫苗接种活动最了解，并代表各种观点，以创建每个县的多样化图片，并完成半结构化访谈。2018年县级HPV疫苗启动率是根据佛罗里达卫生部的免疫登记和人口计数估计的。采用实施变革专家建议（ERIC）分类法，按重要性和可行性对实施战略进行了分类。我们根据HPV疫苗启动率比较了三分之一县组之间HPV疫苗接种的障碍和实施策略：最高（18个利益相关者）、中等（27个利益相关者）和最低（23个利益相关者）。68名利益相关者中的大多数是女性（89.7%）、非西班牙裔白色（73.5%），代表了各种临床和非临床职业。所提到的障碍代表了五个主题：医疗保健的获取，临床医生的做法，社区伙伴关系，目标人群和文化障碍。在主题，县之间的差异出现Terciles。在医疗保健服务方面，最高比率的县利益相关者关注交通，最低比率的县利益相关者关注缺乏临床医生，中等县利益相关者两者都提到。ERIC象限I策略的数量、更高的可行性和重要性随着HPV疫苗接种的三分位数而减少：最高= 6，中间= 5，最低= 3策略。最高、中等和最低疫苗接种率县之间的不同障碍和战略表明，在最低和中等疫苗接种率县内采取有针对性的努力，采用最高疫苗接种率县的战略，可能会减少差距。
A greater understanding of the county-level differences in human papillomavirus (HPV) vaccination rates could aid targeting of interventions to reduce HPV-related cancer disparities. We conducted a mixed-methods study to compare the stakeholder-reported barriers and efforts to increase HPV vaccination rates between counties within the highest, middle, and lowest HPV vaccine initiation (receipt of the first dose) rates among 22 northern Florida counties. Between August 2018 and April 2019, we recruited stakeholders (n = 68) through purposeful and snowball sampling to identify potential participants who were most knowledgeable about the HPV vaccination activities within their county and would represent a variety of viewpoints to create a diverse picture of each county, and completed semi-structured interviews. County-level HPV vaccine initiation rates for 2018 were estimated from the Florida Department of Health’s immunization registry and population counts. Implementation strategies were categorized by level of importance and feasibility using the Expert Recommendations for Implementing Change (ERIC) taxonomy. We compared the barriers and implementation strategies for HPV vaccination between tercile groups of counties by HPV vaccine initiation rates: highest (18 stakeholders), middle (27 stakeholders), and lowest (23 stakeholders). The majority of the 68 stakeholders were female (89.7%), non-Hispanic white (73.5%), and represented a variety of clinical and non-clinical occupations. The mentioned barriers represented five themes: healthcare access, clinician practices, community partnerships, targeted populations, and cultural barriers. Within themes, differences emerged between county terciles. Within healthcare access, the highest rate county stakeholders focused on transportation, lowest rate county stakeholders focused on lack of clinicians, and middle county stakeholders mentioned both. The number of ERIC quadrant I strategies, higher feasibility, and importance described decreased with the tercile for HPV vaccination: highest = 6, middle = 5, and lowest =3 strategies. The differing barriers and strategies between the highest, middle, and lowest vaccination rate counties suggest that a tailored and targeted effort within the lowest and middle counties to adopt strategies of the highest rate counties may reduce disparities.
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影响因子：
5.5
作者：
Enujioke SC;Shedd-Steele R;Daggy J;Burney H;Robertson L;Head K;Zimet G
通讯作者：
Zimet G
影响因子：
26.1
作者：
Dempsey, Amanda F.;Pyrznawoski, Jennifer;O'Leary, Sean T.
通讯作者：
O'Leary, Sean T.
DOI：
10.1016/j.pedn.2018.05.008
发表时间：
2018-09
期刊：
Journal of pediatric nursing
影响因子：
--
作者：
Carhart MY;Schminkey DL;Mitchell EM;Keim-Malpass J
通讯作者：
Keim-Malpass J
DOI：
10.1016/j.socscimed.2020.113375
发表时间：
2021-01
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Lahijani AY;King AR;Gullatte MM;Hennink M;Bednarczyk RA
通讯作者：
Bednarczyk RA
影响因子：
4.5
作者：
Daniel CL;Lawson F;Vickers M;Green C;Wright A;Coyne-Beasley T;Lee HY;Turberville S
通讯作者：
Turberville S