Previsit Screening for Parental Vaccine Hesitancy: A Cluster Randomized Trial
Previsit Screening for Parental Vaccine Hesitancy: A Cluster Randomized Trial
复制标题
DOI：
10.1542/peds.2019-0802
复制
发表时间：
2019-11-01
期刊：
影响因子：
8
通讯作者：
Taylor, James A.
中科院分区：
文献类型：
--
作者：
Opel, Douglas J.;Henrikson, Nora;Taylor, James A.
目的：评价疫苗犹豫筛查对儿童疫苗接种的影响。方法：我们在华盛顿州的儿科初级保健诊所进行了一项随机分组对照试验。在参与诊所接受健康监督的健康新生儿的疫苗犹豫不决的父母（VHP）有资格。VHP通过使用经验证的关于儿童疫苗的父母态度调查（PACV）的4项版本来识别。在他们的孩子的2个月和6个月的健康监督访问之前，VHP在干预诊所完成了15项PACV嵌入在一项调查中，其中包含安慰剂项目。干预提供者收到了父母的15项PACV反应的摘要和他们的PACV评分的解释;提供者可以自行决定他们如何根据这些信息采取行动。对照诊所的VHP只完成安慰剂调查项目，他们孩子的提供者收到了他们的回答摘要;对照提供者对父母VHP状态保持盲态。我们的研究结果是8个月大的儿童免疫状况，以免疫不足天数的百分比表示。我们使用t检验和线性混合效应回归比较了对照组和干预组的结果。结果：我们招募了24家诊所（每组12家）和156名父母（干预组65名）。父母的特征相似，除了更多的干预（与对照组相比）父母有第一个孩子（60.9%比44%; P = 0.04）。两组之间的结果无显著差异（干预组和对照组的平均免疫不足天数分别为25.2% [95%置信区间：16.0%至34.5%] vs 19.1% [95%置信区间：12.0%至26.3%]）。结论：疫苗犹豫筛查与免疫不足天数无显著相关性。本研究采用cRCT设计，探讨父母疫苗犹豫筛查与儿童免疫状况的相关性。
OBJECTIVE: To evaluate the effect of vaccine hesitancy screening on childhood vaccine uptake. METHODS: We conducted a cluster randomized controlled trial in pediatric primary care clinics in Washington state. Vaccine-hesitant parents (VHPs) with a healthy newborn receiving health supervision at participating clinics were eligible. VHPs were identified by using a 4-item version of the validated Parent Attitudes About Childhood Vaccines Survey (PACV). Before their child's 2- and 6-month health supervision visits, VHPs at intervention clinics completed the 15-item PACV embedded in a survey containing placebo items. Intervention providers received a summary of parents' 15-item PACV responses and interpretation of their PACV score; discretion was given to providers regarding how they acted on this information. VHPs at control clinics completed only the placebo survey items, and their child's provider received a summary of their responses; control providers remained blinded to parent VHP status. Our outcome was child immunization status at 8 months of age expressed as percent of days underimmunized. We compared outcomes in control and intervention participants using t test and linear mixed-effects regression. RESULTS: We enrolled 24 clinics (12 in each arm) and 156 parents (65 in the intervention arm). Parent characteristics were similar across arms except more intervention (versus control) parents had a first-born child (60.9% vs 44%; P = .04). No significant difference in outcome was detected between arms (25.2% [95% confidence interval: 16.0% to 34.5%] vs 19.1% [95% confidence interval: 12.0% to 26.3%] mean days underimmunized in the intervention and control arms, respectively). CONCLUSION: Vaccine hesitancy screening was not significantly associated with days underimmunized.Using a cRCT design, investigators in this study explore the association of screening for parental vaccine hesitancy with child immunization status.