Expanding access to HPV vaccination in South Carolina through community pharmacies: A geospatial analysis
Expanding access to HPV vaccination in South Carolina through community pharmacies: A geospatial analysis
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DOI：
10.1016/j.japh.2020.05.005
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发表时间：
2020-11-01
影响因子：
2.1
通讯作者：
Eberth, Jan M.
中科院分区：
文献类型：
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作者：
Zahnd, Whitney E.;Harrison, Sayward E.;Eberth, Jan M.
目的：农村地区人乳头瘤病毒(HPV)相关癌症发病率较高。尽管接种HPV疫苗有预防的好处，但农村人口的接种率较低。在农村社区有强大存在的社区药店可能是改善HPV疫苗接种机会的理想选择。我们的目标是确定南卡罗来纳州青少年和年轻人对药店的空间访问是否因乡村和初级保健提供者的地理访问而有所不同。方法：使用地理信息系统方法评估南卡罗来纳州人口普查区域(CT)10-24岁人群对社区药店的空间访问。根据城乡通勤区号，将社区卫生服务分为大都市、小城市或小城镇和孤立的农村社区，并分为卫生服务提供者短缺地区(HPSA)或非卫生服务提供者短缺地区(HPSA)。描述性统计和空间统计用于比较不同CT分组的访问情况，并评估地理空间聚集性。结果：访问最高的区域聚集在大都市CT中。大都市儿童的空间通达高于小城市儿童，而大城市儿童与小城镇儿童和农村儿童的空间通达没有差异。总体而言，HPSA指定的区域与非HPSA指定的区域相比，进入药店的空间通道较少。结论：小城镇和农村地区的小城镇和农村地区的药店空间准入与城市地区相当，HPSA指定的微都市区和非HPSA微都区也是如此。这表明，南卡罗来纳州的城市和农村人口都可以平等地进入药店，但还需要进行更多的研究，以确定有效的战略，以促进药店接受和获得HPV疫苗(例如，保险覆盖范围)，并确保对患者进行关于HPV疫苗的好处及其在非初级保健环境中的可获得性的教育。(C)2020美国药剂师协会(R)。爱思唯尔公司出版，版权所有。
Objective: Human papillomavirus (HPV)-associated cancer rates are higher in rural areas. Despite the preventive benefits of HPV vaccination, uptake is lower among rural populations. Community-based pharmacies with a strong presence in rural communities may be ideal for improving HPV vaccination access. Our objective was to determine whether spatial access to pharmacies among adolescents and young adults in South Carolina varied by rurality and geographic access to primary care providers.Methods: Geographic information systems methods were used to evaluate spatial access to community-based pharmacies among persons aged 10-24 years in South Carolina census tracts (CTs). CTs were categorized as metropolitan, micropolitan, or small-town and isolated rural CTs using rural-urban commuting area codes and as health provider shortage areas (HPSAs) or not. Descriptive and spatial statistics were calculated to compare access across CT groupings and to evaluate geospatial clustering.Results: Areas of highest access clustered among the metropolitan CTs. Whereas spatial access was higher in metropolitan than micropolitan CTs, there was no difference in spatial access between metropolitan and small-town and rural CTs. In general, HPSA-designated areas had lower spatial access to pharmacies than non-HPSA-designated areas. However, in micro-politan areas, there was no difference in spatial access to pharmacies based on HPSA designation.Conclusion: Spatial access to pharmacies among small town and rural areas was comparable to urban areas as was HPSA-designated micropolitan areas and non-HPSA micropolitan areas. This suggests that pharmacies are equally accessible to both urban and rural populations in South Carolina, but additional research is needed to identify effective strategies to promote the uptake of and the availability of HPV vaccination in pharmacies (e.g., insurance coverage) and to ensure patients are educated on the benefits of HPV vaccinations and its availability in nonprimary care settings. (C) 2020 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.