Promoting and Providing HPV Vaccination in Hawaii: Barriers Faced by Health Providers.
Promoting and Providing HPV Vaccination in Hawaii: Barriers Faced by Health Providers.
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DOI：
10.1007/s10900-016-0191-9
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发表时间：
2016-10
影响因子：
5.9
通讯作者：
Hernandez BY
中科院分区：
文献类型：
--
作者：
Tom A;Robinett H;Buenconsejo-Lum L;Soon R;Hamilton M;Francisco-Natanauan P;Cruz MR;Balajadia R;Hernandez BY
尽管有HPV预防疫苗，但在美国，接种情况并不理想。在夏威夷州，HPV疫苗在女性中的覆盖率有所下降，在13-17岁男性中的覆盖率仍然很低。低吸收率的原因尚不清楚，可能表明存在HPV疫苗接种的关键障碍。本调查的目的是确定夏威夷儿童HPV疫苗接种的政策、制度和环境障碍和促进因素。一项86项关于HPV疫苗接种的知识、态度、信念、实践和障碍的在线调查被分发给夏威夷儿科、家庭医学和妇产科的执业医生。调查共收到120名医生的回复。与大型集体执业的医生相比，私人执业的医生更关注疫苗订购和储存成本（p < 0.0001）、报销水平（p < 0.0001）和保险覆盖率（p < 0.0001）。83%的医疗服务提供者表示，缺乏家长对HPV感染的知识和理解是一个障碍。超过一半的医生（58%）报告说完成3剂量计划是一个障碍。大多数医生没有使用跟踪或提醒系统来确保完成剂量。大多数（58%）提供者认为缺乏基于学校的疫苗接种要求是一个障碍。夏威夷的HPV疫苗接种可能受到医生对父母知识和态度的认知的阻碍。费用制度障碍是私人执业障碍中较为特殊的一种。完成3剂计划仍然是一个挑战。
Despite the availability of HPV prophylactic vaccines, uptake has been suboptimal in the US. In the state of Hawaii, HPV vaccine coverage has decreased among females and remains low among males aged 13–17. The reasons for low uptake are unknown and may indicate the existence of critical barriers to HPV vaccination. The purpose of this investigation was to identify policy, system and environmental barriers and promoters of pediatric HPV vaccination in Hawaii. An online 86-item survey addressing knowledge, attitudes, beliefs, practices, and barriers to HPV vaccination was distributed to practicing physicians in Hawaii specializing in Pediatrics, Family Medicine, and Obstetrics-Gynecology. Survey responses were received from a total of 120 physicians. Private practice physicians reported more concerns with vaccine ordering and stocking costs (p < 0.0001), reimbursement levels (p < 0.0001), and insurance coverage (p < 0.0001) compared to physicians in large group practices. Eighty-three percent of providers cited lack of parent knowledge and understanding of HPV infection as a barrier. Over half of physicians (58 %) reported that completion of the 3-dose schedule was a barrier. Most physicians did not use tracking or reminder systems to ensure dose completion. A majority (58 %) of providers cited the lack of school-based vaccination requirements as a barrier. Uptake of HPV vaccination in Hawaii may be impeded by physician perception of parent knowledge and attitudes. Cost-related system barriers are particular barriers among those in private practice. Completion of the 3-dose schedule also remains a challenge.
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DOI：
10.15585/mmwr.mm6429a3
发表时间：
2015-07-31
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Reagan-Steiner S;Yankey D;Jeyarajah J;Elam-Evans LD;Singleton JA;Curtis CR;MacNeil J;Markowitz LE;Stokley S
通讯作者：
Stokley S
影响因子：
7.6
作者：
Cates, Joan R.;Shafer, Autumn;Smith, Jennifer S.
通讯作者：
Smith, Jennifer S.
影响因子：
3.6
作者：
Humiston, SG;Rosenthal, SL
通讯作者：
Rosenthal, SL
影响因子：
3.7
作者：
Ko, Emily M.;Missmer, Stacey;Johnson, Natasha R.
通讯作者：
Johnson, Natasha R.
影响因子：
1.8
作者：
Leddy, Meaghan A.;Anderson, Britta L.;Schulkin, Jay
通讯作者：
Schulkin, Jay