Physicians' Intentions to Administer HPV Vaccine

医生接种 HPV 疫苗的意图

• 批准号: 8073054
• 负责人: ANDRZEJ KULCZYCKI
• 金额: $ 7.25万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-15 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8073054
• 关键词: 12 year old; Acute; Adherence; Adopted; Adoption; Advisory Committees; Age; Alabama; Anogenital cancer; Anogenital venereal warts; Attitude; Awareness; Behavior; Behavior Control; Cervical; Characteristics; Data; Developed Countries; Disease; Faculty; Family; Family Practice; Female; Happiness; Health; Health Care Costs; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Immunization; Intention; Intervention; Knowledge; Lead; Licensure; Malignant neoplasm of cervix uteri; Measures; Mississippi; Morbidity - disease rate; Patient ambiguity; Patients; Pattern; Perception; Physicians; Planning Theory; Population; Prevention strategy; Primary Care Physician; Provider; Public Health; Questionnaires; Recommendation; Research; Role; Schedule; Series; Sexually Transmitted Diseases; Specific qualifier value; Suggestion; Surveys; Techniques; Testing; United States; United States Food and Drug Administration; Vaccination; Vaccines; Virus; Work; base; burden of illness; design; early experience; experience; girls; health disparity; improved; meetings; minority health; mortality; public health relevance; response; socioeconomics

DESCRIPTION (provided by applicant): Cervical cancer, genital warts, and other health conditions associated with human papillomavirus (HPV) exact substantial morbidity, mortality, and expenses. In 2006, the Food and Drug Administration (FDA) approved a quadrivalent HPV vaccine for females ages 9-26, and the Advisory Committee on Immunization Practices (ACIP) recommended routine vaccination for girls ages 11-12. Modest vaccination rates to date, however, indicate problems with increasing coverage and adherence to the recommended vaccine schedule, and may presage difficulties in realizing the vaccine's public health promise. Provider-oriented issues and challenges related to vaccine implementation may have been underestimated and remain insufficiently studied, especially with regard to primary care physicians (PCPs), who are well suited to provide vaccine to most young females. The broad objective of this study is to identify the appropriate constellation of factors that differentially relate to clinicians' stated intentions to administer HPV vaccine as recommended. Our central hypothesis is that clinicians' attitudes, subjective norms, and perceptions of issues as barriers significantly influence their intentions to administer the vaccine and, ultimately, their behavior, as predicted by the theory of planned behavior (TPB). We propose four specific aims: 1) to develop a theoretically-informed survey questionnaire for the assessment of TPB-based and other measures of PCPs' intentions to administer the HPV vaccine; 2) to implement the survey questionnaire among PCPs in Alabama and Mississippi; 3) to examine PCP characteristics and TPB-based measures regarding intention to administer HPV vaccine under different conditions; and 4) to identify groups of PCPs who can be differentiated with respect to the patterns of functional relations between the TPB-factors and intentionality. Using nominal group technique meetings and other steps, the survey instrument will be developed, pre-tested and piloted with PCPs and family practice residents and faculty. At least 300 complete survey responses will be collected from PCPs to allow examination of our hypotheses and relationships between relevant variables and intentionality under different patient conditions. Intentionality will be operationalized through a series of behaviorally anchored case vignettes. PCPs' awareness and attitudes regarding ACIP recommendations will also be evaluated. The study will be administered in two states with high HPV-associated disease burdens, acute PCP shortages, and low HPV immunization rates. The proposed research will yield important information to improve understanding of theoretical predictors and provider-based barriers to HPV vaccination in actual practice. This should also suggest useful direction for developing provider-based strategies to increase the likelihood of vaccine administration that could be studied in future research. PUBLIC HEALTH RELEVANCE: HPV vaccination offers an effective prevention strategy for reducing the substantial morbidity and healthcare costs caused by persistent HPV infection, so long as problems besetting current modest vaccination rates are better understood and overcome. The proposed study will examine factors that differentially relate to clinicians' stated intentions to administer HPV vaccine, using new measures of intentionality and clinicians' evaluative perceptions of professional recommendations. Our work will help inform future research and the design of strategies to improve the likelihood that physicians would adopt recommendations for administering HPV vaccine.

描述（由申请人提供）：宫颈癌、生殖器疣和其他与人乳头瘤病毒（HPV）相关的健康状况导致大量的发病率、死亡率和费用。2006年，美国食品和药物管理局（FDA）批准了9-26岁女性的四价HPV疫苗，免疫实践咨询委员会（ACIP）建议为11-12岁的女孩接种常规疫苗。然而，迄今为止的适度疫苗接种率表明，在扩大覆盖面和遵守推荐的疫苗接种时间表方面存在问题，并可能预示着在实现疫苗的公共卫生承诺方面存在困难。与疫苗实施有关的面向提供者的问题和挑战可能被低估，并且仍然没有得到充分的研究，特别是在初级保健医生方面，他们非常适合为大多数年轻女性提供疫苗。本研究的主要目的是确定与临床医生按照建议接种HPV疫苗的既定意图差异相关的适当因素。我们的中心假设是，临床医生的态度，主观规范，并作为障碍的问题的看法显着影响他们的意图管理疫苗，并最终，他们的行为，如计划行为理论（TPB）预测。我们提出四个具体目标：1）制定一份理论上知情的调查问卷，用于评估PCP接种HPV疫苗的意向的TPB和其他措施; 2）在亚拉巴马和密西西比的PCP中实施调查问卷; 3）检查PCP的特征和不同条件下HPV疫苗接种意向的TPB措施;（4）根据TPB因素与意向性之间的功能关系模式，确定可以区分的PCP群体。使用名义组技术会议和其他步骤，调查工具将开发，预测试和试点与PCP和家庭实践居民和教师。将从PCP中收集至少300份完整的调查问卷，以检查我们的假设以及不同患者条件下相关变量和意向之间的关系。意向性将通过一系列以行为为基础的案例小插曲来实现。还将评估初级专业人员对ACIP建议的认识和态度。该研究将在两个HPV相关疾病负担高、PCP严重短缺和HPV免疫率低的州进行。拟议的研究将产生重要的信息，以提高对理论预测因素和实际实践中HPV疫苗接种的提供者障碍的理解。这也应该为开发基于提供者的策略提供有用的方向，以增加疫苗接种的可能性，这可以在未来的研究中进行研究。 公共卫生相关性：HPV疫苗接种提供了一种有效的预防策略，可以降低持续性HPV感染引起的大量发病率和医疗费用，只要更好地理解和克服当前适度疫苗接种率所面临的问题。这项拟议的研究将使用新的意向性措施和临床医生对专业建议的评价性看法，研究与临床医生表示的接种HPV疫苗的意图有差异的因素。我们的工作将有助于为未来的研究和策略设计提供信息，以提高医生采用HPV疫苗接种建议的可能性。

项目成果

Primary Care Physicians' Adherence to Guidelines and Their Likelihood to Prescribe the Human Papillomavirus Vaccine for 11- and 12-Year-Old Girls.

• DOI: 10.1016/j.whi.2015.07.012
• 发表时间: 2016-01
• 期刊: Women's health issues : official publication of the Jacobs Institute of Women's Health
• 作者: Kulczycki A;Qu H;Shewchuk R
• 通讯作者: Shewchuk R