Intervention effects from a social marketing campaign to promote HPV vaccination in preteen boys.
Intervention effects from a social marketing campaign to promote HPV vaccination in preteen boys.
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DOI：
10.1016/j.vaccine.2014.05.044
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发表时间：
2014-07-16
期刊：
影响因子：
5.5
通讯作者：
Coyne-Beasley, Tamera
中科院分区：
文献类型：
--
作者：
Cates, Joan R.;Diehl, Sandra J.;Crandell, Jamie L.;Coyne-Beasley, Tamera
在美国，人乳头瘤病毒（HPV）疫苗接种的采用一直很缓慢。2011年，CDC建议男孩在11-12岁时常规使用HPV疫苗。我们与父母和供应商一起进行并评估了一项社会营销干预，以刺激青春期前男孩接种HPV疫苗。我们的目标是在北卡罗来纳州13个县的9-13岁男孩的父母和供应商。为期3个月的干预措施包括向所有县卫生部门以及194名注册的提供者分发HPV疫苗接种海报和小册子;两个广播公益广告;以及在线CME培训。使用NC免疫登记数据拟合考克斯比例风险模型，以检查目标县与具有相似人口统计学特征的对照县（n=15）相比，干预期间9-13岁男孩的疫苗接种率是否增加。与其他青少年疫苗相比，相似的模型适用于同一年龄段女孩的HPV疫苗接种以及男孩的脑膜炎球菌和Tdap疫苗接种。年龄、种族和儿童疫苗（VFC）资格对干预的调节作用被考虑。考克斯模型显示了干预效应（β=0.29，HR=1.34，p= 0.0024），表明在干预期间，干预县的疫苗接种概率相对于对照县增加了34%。与女孩的HPV疫苗接种和男孩的Tdap和脑膜炎球菌疫苗接种的比较表明，在干预期间，男孩的HPV疫苗接种有独特的促进作用。年龄、种族和VFC资格的模型协变量都与疫苗接种率显著相关（所有p<0.0001）。HPV疫苗接种率在11-12岁的男孩中最高。总的来说，每四次为青春期前男孩接种Tdap和脑膜炎球菌疫苗的诊所就诊中就有三次错过了同时接种HPV疫苗的机会。社会营销技术可以鼓励父母和卫生保健提供者为青春期前的男孩接种HPV疫苗。
Adoption of human papillomavirus (HPV) vaccination in the US has been slow. In 2011, HPV vaccination of boys was recommended by CDC for routine use at ages 11–12. We conducted and evaluated a social marketing intervention with parents and providers to stimulate HPV vaccination among preteen boys. We targeted parents and providers of 9–13 year old boys in a 13 county NC region. The 3-month intervention included distribution of HPV vaccination posters and brochures to all county health departments plus 194 enrolled providers; two radio PSAs; and an online CME training. A Cox proportional hazards model was fit using NC immunization registry data to examine whether vaccination rates in 9–13 year old boys increased during the intervention period in targeted counties compared to control counties (n=15) with similar demographics. To compare with other adolescent vaccines, similar models were fit for HPV vaccination in girls and meningococcal and Tdap vaccination of boys in the same age range. Moderating effects of age, race, and Vaccines for Children (VFC) eligibility on the intervention were considered. The Cox model showed an intervention effect (β=0.29, HR=1.34, p=.0024), indicating that during the intervention the probability of vaccination increased by 34% in the intervention counties relative to the control counties. Comparisons with HPV vaccination in girls and Tdap and meningococcal vaccination in boys suggest a unique boost for HPV vaccination in boys during the intervention. Model covariates of age, race and VFC eligibility were all significantly associated with vaccination rates (p<.0001 for all). HPV vaccination rates were highest in the 11–12 year old boys. Overall, three of every four clinic visits for Tdap and meningococcal vaccines for preteen boys were missed opportunities to administer HPV vaccination simultaneously. Social marketing techniques can encourage parents and health care providers to vaccinate preteen boys against HPV.
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