Missed opportunities for HPV immunization among young adult women.
Missed opportunities for HPV immunization among young adult women.
复制标题
DOI：
10.1016/j.ajog.2017.11.602
复制
发表时间：
2018-03
影响因子：
9.8
通讯作者：
Sheth SS
中科院分区：
文献类型：
--
作者：
Oliveira CR;Rock RM;Shapiro ED;Xu X;Lundsberg L;Zhang LB;Gariepy A;Illuzzi JL;Sheth SS
尽管有一种安全有效的人乳头瘤病毒疫苗，但美国的疫苗接种率很低。错过推荐和接种人乳头瘤病毒疫苗的临床机会被认为是青少年接受率低的最重要原因之一;然而，对年轻成人（18-26岁）人群中错过机会的频率或特征知之甚少。该研究的目的是评估在城市妇产科诊所就诊的年轻成年妇女中错过人乳头瘤病毒免疫接种机会的比率和相关因素。在这项横断面研究中，审查了所有18-26岁的女性的医疗记录，这些女性免疫接种不足（<3剂），并在2013年2月1日至2014年1月31日期间在城市医院妇产科诊所寻求护理。错过人乳头瘤病毒免疫接种的机会被定义为患者有资格接受疫苗的诊所就诊，并且剂量到期但未施用。多变量逻辑回归被用来测试社会人口变量和错过的机会之间的关联。有1 670个疫苗接种合格的访问由1 241免疫不足的妇女，平均1.3错过机会/人。在研究期间，833名符合疫苗接种条件的妇女（67.1%）至少错过了一次机会。总体而言，最常见的错过机会的访视类型是产后访视（17%）或性传播疾病筛查（21%）或避孕（33%）。在错过机会的患者中，26.5%的患者接受了注射药物或不同疫苗的访视。与白色女性相比，认为自己种族为黑人的女性有更高的调整后机会错失几率（调整后优势比，1.61 [95%置信区间，1.08-2.41]，P <0.02）。报告非英语或非西班牙语首选语言的女性错失机会的调整后比值较低（调整后比值比，0.25 [95%置信区间，0.07-0.87]，P = .03）。本研究中评估的其他患者特征与错失机会无显著相关性。在这项研究中，大多数成年女性错过了人类乳头瘤病毒免疫接种的机会，并观察到显着的种族差异。错过机会的最大频率发生在避孕或性传播疾病筛查的访视中。
Despite the availability of a safe and efficacious vaccine against human papillomavirus, uptake of the vaccine in the United States is low. Missed clinical opportunities to recommend and to administer human papillomavirus vaccine are considered one of the most important reasons for its low uptake in adolescents; however, little is known about the frequency or characteristics of missed opportunities in the young adult (18–26 years of age) population. The objective of the study was to assess both the rates of and the factors associated with missed opportunities for human papillomavirus immunization among young adult women who attended an urban obstetrics and gynecology clinic. In this cross-sectional study, medical records were reviewed for all women 18–26 years of age who were underimmunized (<3 doses) and who sought care from Feb. 1, 2013, to January 31, 2014, at an urban, hospital-based obstetrics and gynecology clinic. A missed opportunity for human papillomavirus immunization was defined as a clinic visit at which the patient was eligible to receive the vaccine and a dose was due but not administered. Multivariable logistic regression was used to test associations between sociodemographic variables and missed opportunities. There were 1670 vaccine-eligible visits by 1241 underimmunized women, with a mean of 1.3 missed opportunities/person. During the study period, 833 of the vaccine eligible women (67.1%) had at least 1 missed opportunity. Overall, the most common types of visits during which a missed opportunity occurred were postpartum visits (17%) or visits for either sexually transmitted disease screening (21%) or contraception (33%). Of the patients with a missed opportunity, 26.5% had a visit at which an injectable medication or a different vaccine was administered. Women who identified their race as black had higher adjusted odds of having a missed opportunity compared with white women (adjusted odds ratio, 1.61 [95% confidence interval, 1.08–2.41], P < .02). Women who reported a non-English- or non-Spanish-preferred language had lower adjusted odds of having a missed opportunity (adjusted odds ratio, 0.25 [95% confidence interval, 0.07–0.87], P = .03). No other patient characteristics assessed in this study were significantly associated with having a missed opportunity. A majority of young-adult women in this study had missed opportunities for human papillomavirus immunization, and significant racial disparity was observed. The greatest frequency of missed opportunities occurred with visits for either contraception or for sexually transmitted disease screening.
登录
查看更多内容
影响因子：
7.6
作者：
Dunne, Eileen F.;Stokley, Shannon;Zhou, Fangjun
通讯作者：
Zhou, Fangjun
影响因子：
33.9
作者：
Reagan-Steiner, Sarah;Yankey, David;Singleton, James A.
通讯作者：
Singleton, James A.
影响因子：
4.7
作者：
Lim, Jung-won;Ashing-Giwa, Kimlin T.
通讯作者：
Ashing-Giwa, Kimlin T.
影响因子：
6.4
作者：
Laprise, Jean-Francois;Markowitz, Lauri E.;Brisson, Marc
通讯作者：
Brisson, Marc
影响因子：
8
作者：
Bernstein, Henry H.;Bocchini, Joseph A., Jr.
通讯作者：
Bocchini, Joseph A., Jr.