Delivery of Adolescent Preventive Services in the Era of New Adolescent Vaccines

新青少年疫苗时代提供青少年预防服务

• 批准号: 7498053
• 负责人: Cynthia M Rand
• 金额: $ 20万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2010-11-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7498053
• 关键词: Delivery; Adolescent; Preventive; Services; Era

DESCRIPTION (provided by applicant): Immunizations for adolescents have become much more complex in recent years, with the licensure of a conjugate vaccine to prevent meningococcal disease, another vaccine to prevent human papillomavirus, and new tetanus toxoid-diphtheria-pertussis vaccine. Additional vaccine recommendations affecting adolescents are likely in the near future, including a recommendation for universal influenza vaccination and future development and licensure of vaccines to prevent cytomegalovirus, herpes simplex virus, and potentially Chlamydia trachomatis. In part due to the success of vaccination, the primary causes of morbidity and mortality during adolescence relate to preventable health behaviors, including tobacco, alcohol and drug use, risky sexual activity, mental health, and injury. Adolescent preventive services guidelines have been developed and endorsed by multiple professional organizations, including the American Medical Association (AMA), American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and the US Maternal and Child Health Bureau (MCHB) to guide physicians in providing preventive counseling and screening for these health issues. Yet it is unclear how physicians prioritize adolescent vaccine delivery along with clinical preventive services (CPS) delivery, and whether vaccine delivery enhances or impedes delivery of other preventive services. This project will assess family physicians' and pediatricians' knowledge, attitude towards and practice of adolescent preventive services delivery through key informant interviews and focus groups. We will also qualitatively evaluate how physicians in a variety of settings (urban, suburban, rural, underserved) and practice types (health maintenance organizations, private, clinic/community health center) prioritize CPS for adolescents, and we will assess potential methods to improve CPS delivery. To quantify the delivery of CPS and immunizations, we will perform chart reviews of 400 adolescents, and interview those adolescents (aged 11-14 and 15-18) and their parents (200 parents of those aged 11-14) in practices in upstate New York. These interviews will also improve our understanding of the attitudes of parents and adolescents toward CPS. The results of this project will guide future educational and practice-based strategies to increase rates of CPS and immunization delivery for adolescents. to Public Health Our project will explore how physicians are balancing the delivery of immunizations concurrently with other preventive services for adolescents. Finding successful methods for delivery of immunizations along with effective counseling and screening will decrease the rate of vaccine preventable diseases in this population, and will reduce the more common morbidities related to risky behaviors in adolescence.

描述（由申请人提供）：近年来，随着预防脑膜炎球菌病的结合疫苗、预防人乳头瘤病毒的另一种疫苗和新的破伤风类毒素-白喉-百日咳疫苗的许可，青少年的免疫接种变得更加复杂。在不久的将来，可能会有其他影响青少年的疫苗建议，包括普遍接种流感疫苗的建议，以及预防巨细胞病毒、单纯疱疹病毒和可能的沙眼衣原体的疫苗的未来开发和许可。部分由于疫苗接种的成功，青春期发病率和死亡率的主要原因与可预防的健康行为有关，包括烟草，酒精和药物的使用，危险的性活动，心理健康和伤害。青少年预防服务指南已被多个专业组织制定和认可，包括美国医学协会（AMA），美国儿科学会（AAP），美国家庭医生学会（AAFP）和美国妇幼保健局（MCHB），以指导医生提供预防咨询和筛查这些健康问题。然而，目前尚不清楚医生如何优先考虑青少年疫苗接种沿着临床预防服务（CPS）的提供，以及疫苗接种是否会增强或阻碍其他预防服务的提供。该项目将通过主要知情人访谈和重点小组评估家庭医生和儿科医生对提供青少年预防服务的知识、态度和做法。我们还将定性评估各种环境（城市，郊区，农村，服务不足）和实践类型（健康维护组织，私人，诊所/社区卫生中心）的医生如何优先考虑青少年CPS，我们将评估潜在的方法来改善CPS交付。为了量化CPS和免疫接种的提供，我们将对400名青少年进行图表审查，并在纽约北部的实践中采访这些青少年（11-14岁和15-18岁）及其父母（11-14岁的200名父母）。这些访谈也将提高我们对家长和青少年对CPS的态度的理解。该项目的成果将指导今后的教育和实践战略，以提高儿童保护方案和青少年免疫接种率。我们的项目将探讨医生如何在为青少年提供免疫接种和其他预防性服务的同时平衡提供免疫接种。找到成功的免疫接种方法，沿着有效的咨询和筛查，将降低这一人群中疫苗可预防疾病的发病率，并将减少与青春期危险行为相关的更常见的发病率。