Acceptability of School-Based Health Centers for Human Papillomavirus Vaccination Visits: A Mixed-Methods Study
Acceptability of School-Based Health Centers for Human Papillomavirus Vaccination Visits: A Mixed-Methods Study
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DOI：
10.1111/josh.12540
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发表时间：
2017-09-01
影响因子：
2.2
通讯作者：
Niccolai, Linda M.
中科院分区：
文献类型：
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作者：
Hansen, Caitlin E.;Okoloko, Edirin;Niccolai, Linda M.
人类乳头瘤病毒（HPV）疫苗接种率高的国家主要通过学校接种疫苗取得了这一成功。在美国，使用以学校为基础的健康中心（SBHC），HPV疫苗仍然没有得到充分利用，可以提高接种率。在这个混合方法的研究中，我们研究了接受，促进者，和障碍的HPV疫苗接种访问SBHCs从青少年和parents.METHODSWe的角度进行了定性访谈和结构化调查，从城市，医院为基础的诊所招募的青少年和家长。与父母（N = 20）和青少年（N = 20）的访谈录音和转录分析使用迭代的主题方法。定量措施的调查管理的父母（N = 131）来自定性结果。调查结果采用卡方检验进行分析。在定性访谈中，许多参与者对SBHC的HPV疫苗接种表示赞同。促进因素包括方便，易于安排，不错过工作或学校。然而，注意到的障碍包括对在医疗之家以外获得护理的担忧、医疗记录的碎片化以及对SBHC的负面看法。定量研究结果显示，较高比例的父母使用SBHC的经验，愿意使用中学（59.5%）或高中（80.5%）SBHC的HPV疫苗接种相比，那些谁没有使用SBHC（P <0.05的两个比较）。在SBHC接种HPV疫苗的障碍可以通过更多关于SBHC作用的教育和改善协调护理的系统来解决。
BACKGROUNDCountries with high human papillomavirus (HPV) vaccination rates have achieved this success largely through school-based vaccination. Using school-based health centers (SBHCs) in the United States, where HPV vaccine remains underutilized, could improve uptake. In this mixed-methods study, we examined acceptability, facilitators, and barriers of HPV vaccination visits at SBHCs from the perspectives of adolescents and parents.METHODSWe conducted qualitative interviews and structured surveys with adolescents and parents recruited from an urban, hospital-based clinic. Interviews with parents (N = 20) and adolescents (N = 20) were audio-recorded and transcribed for analysis using an iterative thematic approach. Quantitative measures for a survey administered to parents (N = 131) were derived from the qualitative findings. Survey results were analyzed by chi-square tests.RESULTSMany participants expressed favorable opinions of HPV vaccination at SBHCs in qualitative interviews. Facilitators included convenience, ease of scheduling, and not missing work or school. However, barriers were noted including concerns about obtaining care outside the medical home, fragmentation of medical records, and negative perceptions about SBHCs. Quantitative findings revealed that a higher proportion of parents with experience using SBHCs were willing to use a middle school (59.5%) or high school (80.5%) SBHC for HPV vaccinations compared with those who had not used SBHCs (p < .05 for both comparisons).CONCLUSIONSHPV vaccination visits at SBHCs were acceptable, and SBHC users expressed more favorable attitudes. Barriers to HPV vaccination at SBHCs can be addressed through more education about SBHCs' role, and improvement of systems to coordinate care.