Web enhanced adoption of HPV vaccine in minority communities

第一种减少人类死亡的疫苗(Gardasil-Merck)的最新开发和监管批准 乳头瘤病毒(HPV)感染是一项重要的医学创新，可能会减少 宫颈癌的发病率。女性青春期早期(9-12岁)首次性行为前接种疫苗 年)将导致两种特定的HPV类型16和18型的相应减少，已知这两种类型导致大多数 (-70%)。与许多其他以科学为基础的医学创新一样，疫苗 采用并不总是迅速的，往往取决于各种社会和文化因素，以及 创新本身的性质在这种特殊情况下，HPV疫苗的传播和采用可能是 尤其复杂，因为HPV与性行为和传播有关。这些 在少数族裔社区中，问题可能会很明显，在那里，可以获得关于医疗的有效信息 往往缺乏创新，在提供医疗服务时忽视了文化和社区的作用 服务。这里提出了一项调查，将运用创新扩散理论以及 减少不确定性，以指导基于网络的工具的迭代开发，以促进知情采用 人乳头瘤病毒疫苗。将开发三套Web工具：1)为盟军医疗保健设计的Web工具 帮助他们就HPV疫苗进行沟通的团队成员；2)为家长设计的网络工具 女性早期青少年，将提供信息并减少围绕决定的不确定性 让她们的女儿接种疫苗，以及3)为少女自己设计的网络工具，这些工具将 还提供有关HPV疫苗接种的信息并减少不确定性。这是一项随机疗效试验 网络干预计划在新墨西哥州的学校卫生诊所(SBHC)进行。参与的社区卫生服务中心 将随机接受一套疫苗接种网络工具或在通常情况下提供HPV疫苗 和惯常礼仪。网络工具将在文化上量身定做并适当。结果衡量标准将 包括评估父母和青少年对疫苗的了解，减少接种疫苗的采用 不确定性，以及疫苗采用和接种依从性措施。

The recent development and regulatory approval of the first vaccine (Gardasil-Merck) to reduce human papillomavirus (HPV) infections represents an important medical innovation that can potentially reduce the incidence of cervical cancer. Vaccination of female eariy adolescents prior to sexual debut (age range 9-12 years) will have a consequent reduction in two specific HPV types 16 and 18, known to cause a majority (-70%) of cervical cancer woridwide. As with many other science-based medical innovations, vaccine adoption is not always rapid and often depends on a variety of social and cultural factors, as well as the nature of the innovation itself In this particular case, the diffusion and adoption of HPV vaccination may be especially complicated because of the association of HPV with sexual behavior and transmission. These issues are likely to be pronounced in minority communities where access to valid information about medical innovations is often lacking, and the role of culture and community is neglected in the provision of medical services. Proposed here is an investigation that will employ Diffusion of Innovations theory as well as uncertainty reduction to guide the iterative development of web-based tools to prompt the informed adoption of the HPV vaccines. Three sets of web tools will be developed: 1) web tools designed for allied health care team members that will aid in their communication about HPV vaccine; 2) web tools designed for parents of female early adolescents that will provide information and reduce uncertainty surrounding the decision to have their daughters vaccinated, and 3) web tools designed for female eariy adolescents themselves that wil also provide information and reduce uncertainty about HPV vaccination. A randomized efficacy trial of this web intervention is planned for school-based health clinics (SBHCs) in New Mexico. Participating SBHCs would be randomized to either receive the set of vaccination web tools or offer HPV vaccine under the usual and customary protocol. The web tools will be culturally tailored and appropriate. Outcome measures will include assessments of parent and adolescent vaccine understanding, reduction of vaccination adoption uncertainty, and vaccine adoption and inoculation adherence measures.