HPV vaccine recommendation profiles among a national network of pediatric practitioners: understanding contributors to parental vaccine hesitancy and acceptance
HPV vaccine recommendation profiles among a national network of pediatric practitioners: understanding contributors to parental vaccine hesitancy and acceptance
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DOI：
10.1080/21645515.2018.1560771
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发表时间：
2019-08-03
影响因子：
4.8
通讯作者：
Fiks, Alexander G.
中科院分区：
文献类型：
--
作者：
Hopfer, Suellen;Wright, Margaret E.;Fiks, Alexander G.
背景：从业者沟通是HPV疫苗接种率最重要的影响因素和预测因素之一。本研究的目的是进行一个潜在的类分析表征儿科医生HPV recommendationpatterns.Methods：儿科医生的美国儿科学会（AAP）儿科研究在办公室设置（PROS）的国家网络完成了一项在线调查，他们提出了5个假设的小插曲以及儿童访问和回答问题。询问他们使用沟通策略的问题，对青少年患者在未来20年内性活跃的评估，以决定是否推荐HPV疫苗，以及同伴规范。潜在类别分析的特点从业者亚组的基础上，他们的反应模式，以10个调查问题。结果：在470名受访者中，我们确定了三种不同的从业者HPV疫苗推荐特征：（1）从事者（52%）遵循国家基于年龄的指南，强烈推荐HPV疫苗接种，并认为同行强烈推荐;（2）方案遵循者（20%）也强烈建议接种HPV疫苗，但不太可能让家庭参与关于益处的讨论;（3）矛盾型HPV疫苗推荐者（28%）推迟或不推荐HPV疫苗接种，并且更有可能判断青少年在未来两年内是否会发生性行为。在郊区的设置与两倍的几率是一个矛盾的推荐相对于从事者（OR=2.2; 95%CI：1.1-4.1）。结论：研究结果强调了继续努力，以支持从业者采用循证方法HPV疫苗的建议，特别是在矛盾的推荐。
Background: Practitioner communication is one of the most important influences and predictors of HPV vaccination uptake. The objective of this study was to conduct a latent class analysis characterizing pediatric practitioner HPV recommendation patterns.Methods: Pediatric practitioners of the American Academy of Pediatrics' (AAP) Pediatric Research in Office Settings (PROS) national network completed an online survey where they were presented with 5 hypothetical vignettes of well child visits and responded to questions. Questions asked about their use of communication strategies, assessments about the adolescent patient becoming sexually active in the next 2years for decision-making about HPV vaccine recommendation, and peer norms. Latent class analysis characterized practitioner subgroups based on their response patterns to 10 survey questions. Multinomial logistic regression examined practitioner characteristics associated with each profile.Results: Among 470 respondents, we identified three distinct practitioner HPV vaccine recommendation profiles: (1) Engagers (52%) followed national age-based guidelines, strongly recommended HPV vaccination, and perceived peers as strongly recommending; (2) Protocol Followers (20%) also strongly recommended HPV vaccination, but were less likely to engage families in a discussion about benefits; and (3) Ambivalent HPV Vaccine Recommenders (28%) delayed or did not recommend HPV vaccination and were more likely to use judgment about whether adolescents will become sexually active in the next two years. Practicing in a suburban setting was associated with twice the odds of being an Ambivalent Recommender relative to being an Engager (OR=2.2; 95% CI:1.1-4.1).Conclusions: Findings underscore the importance of continued efforts to bolster practitioner adoption of evidence-based approaches to HPV vaccine recommendation especially among Ambivalent Recommenders.