Enhancing Adolescent Immunization through Parent and Teacher Interventions

摘要 迫切需要提高青少年疫苗接种率。疾病预防控制中心健康人的目标之一 2010年的倡议是在建议的5年内将青少年疫苗覆盖率提高到90%以上。 尽管如此，全国覆盖率仍低于这一水平。格鲁吉亚州没有达到这一目标的任何一个， 四种推荐的青少年疫苗：Tdap、MCV4、HPV和流感疫苗。这项建议 评估了两种可能的干预措施，可用于提高全国青少年疫苗接种率。 具体地说，我们将确定是只使用父节点的策略，还是使用多组件父节点和 以青少年为重点的（教师提供的）干预措施提高了免疫覆盖率。这种设计将 使我们能够确定接触青少年进行疫苗接种的最佳途径。这一点特别重要， 因为近年来青少年接种疫苗的数量有所增加，而且可能继续增加。我们 将使用系统平衡复制设计进行一项三臂对照试验， 里士满县是格鲁吉亚东部一个种族多元化的大县。我们将随机 选择2所高中和3所中学作为三个分支之一。在第一个方面，我们将实施 两个周期的仅限父母的干预措施，旨在鼓励父母为其青少年接种疫苗。 在第二组中，我们将针对父母双方实施两个周期的多成分干预 和青少年，通过教师提供的干预。在第三个方面，我们将不进行干预。 主要结果将是估计青少年疫苗接种覆盖率的变化。其他成果将 包括两种干预措施对疫苗接受介导物的影响。这项研究的结果可以 具有重要的政策意义，为可移植的相关教育干预奠定了基础 这已经被证明可以有效地提高青少年的免疫接种率。

Abstract There is a critical need to improve adolescent vaccination rates. One of the goals of CDC's Healthy People 2010 initiative is to increase adolescent vaccine coverage to >90% within 5 years of the recommendation. Despite this, national coverage remains below this level. The state of Georgia has not met this goal for any of the four recommended vaccines for adolescents: Tdap, MCV4, HPV and influenza vaccine. This proposal assesses two potential interventions that could be used to increase adolescent vaccine coverage nationally. Specifically, we will determine whether a strategy of parent-only or a strategy of multicomponent parent and adolescent focused (teacher-delivered) intervention leads to higher immunization coverage. This design will allow us to determine the best means of reaching adolescents for vaccination. This has particular relevance since the number of adolescent vaccines has increased in recent years and is likely to continue to rise. We will conduct a three-armed controlled trial using a systematic balanced replication design to compare vaccination rates in Richmond County, a large, racially diverse county of eastern Georgia. We will randomly select 2 high schools and 3 middle schools to be in one of the three arms. In the first arm, we will implement two cycles of the parent-only intervention designed to motivate parents to have their adolescent vaccinated. In the second arm, we will implement two cycles of the multicomponent intervention targeting both parents and adolescents, through a teacher delivered intervention. In the third arm, we will implement no intervention. The primary outcome will be to estimate changes in adolescent vaccination coverage. Other outcomes will include the effect of the two interventions on mediators of vaccine acceptance. Findings from this study could have important policy implications, laying the foundation for portable and relevant educational interventions that have been shown to effectively increase adolescent immunizations.