Providers' Perceptions of Parental Human Papillomavirus Vaccine Hesitancy: Cross-Sectional Study
Providers' Perceptions of Parental Human Papillomavirus Vaccine Hesitancy: Cross-Sectional Study
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DOI：
10.2196/13832
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发表时间：
2019-07-02
期刊：
影响因子：
2.8
通讯作者：
Hull, Pamela C.
中科院分区：
文献类型：
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作者：
Cunningham-Erves, Jennifer;Koyama, Tatsuki;Hull, Pamela C.
背景：父母对人乳头瘤病毒（HPV）疫苗的犹豫导致青少年疫苗接种覆盖率低。为了改善医疗保健提供者与犹豫不决的父母的沟通和疫苗推荐实践，了解提供者如何看待父母 HPV 疫苗犹豫是很重要的。目的：本研究旨在描述父母对 HPV 疫苗犹豫的感知原因，并确定社区儿科诊所提供者中与父母犹豫相关的因素。方法：2018 年，田纳西州 23 个社区儿科诊所的提供者受邀完成一项基于网络的基线调查，作为更大规模的质量改进研究重点关注 HPV 疫苗的接种情况。这些调查数据用于横截面二次数据分析。计算提供者自我效能（对推荐 HPV 疫苗能力的信心）、提供者结果预期（对推荐将影响父母决定的预期）以及感知到的父母对 HPV 疫苗犹豫的评分，范围为 0 到 100。提供者对 HPV 疫苗安全性和有效性的信心分为高和低两类。所检查的诊所水平暴露是诊所规模和城乡位置。使用描述性分析来描述按提供者类型划分的感知到的父母障碍。混合效应线性回归模型适合一次采用一个暴露变量，同时控制提供者类型、年龄、性别和种族，以确定提供者和诊所层面与父母对 HPV 疫苗接种障碍相关的因素。 结果：在 23 家诊所的 187 名提供者中，有 137 人完成了调查。大多数医生是白人和女性，其中女性执业护士 (NP) 和医师助理 (PA) 的比例较高。提供者认为，家长对 HPV 疫苗接种最常见的障碍是担心 HPV 疫苗安全性 (88%)、孩子太小 (78%)、儿童通过性活动感染 HPV 的风险较低 (70%) 以及对疫苗的不信任 (59%)。在调整后的混合模型中，父母对 HPV 疫苗的犹豫与几个提供者层面的因素显着相关：自我效能 (P=.001)、结果预期 (P
Background: Human papillomavirus (HPV) vaccine hesitancy among parents contributes to low vaccination coverage in adolescents. To improve health care provider communication and vaccine recommendation practices with hesitant parents, it is important to understand how providers perceive parental HPV vaccine hesitancy.Objective: This study aimed to characterize perceived reasons for parental HPV vaccine hesitancy and identify factors associated with perceived parental hesitancy among providers at community-based pediatric clinics.Methods: In 2018, providers in 23 community-based pediatric clinics in Tennessee were invited to complete a Web-based baseline survey as part of a larger quality improvement study focused on HPV vaccine uptake. These survey data were used for a cross-sectional, secondary data analysis. Scale scores ranging from 0 to 100 were calculated for provider self-efficacy (confidence in ability to recommend HPV vaccine), provider outcome expectations (expectations that recommendation will influence parents' decisions), and perceived parental HPV vaccine hesitancy. Provider confidence in HPV vaccine safety and effectiveness were categorized as high versus low. Clinic-level exposures examined were clinic size and rural-urban location. Descriptive analyses were used to characterize perceived parental barriers by provider type. Mixed-effects linear regression models were fit taking one exposure variable at a time, whereas controlling for provider type, age, gender, and race to identify provider- and clinic-level factors associated with perceived parental barriers to HPV vaccination.Results: Of the 187 providers located in the 23 clinics, 137 completed the survey. The majority of physician providers were white and female, with a higher percentage of females among nurse practitioners (NPs) and physician assistants (PAs). The most common parental barriers to HPV vaccination perceived by providers were concerns about HPV vaccine safety (88%), child being too young (78%), low risk of HPV infection for child through sexual activity (70%), and mistrust in vaccines (59%). In adjusted mixed models, perceived parental HPV vaccine hesitancy was significantly associated with several provider-level factors: self-efficacy (P=.001), outcome expectations (P