Enhancing Adolescent Immunization through Parent and Teacher Interventions

摘要 迫切需要提高青少年的疫苗接种率。疾控中心健康人的目标之一 2010年的倡议是在该建议实施后的5年内将青少年疫苗覆盖率提高到90%。 尽管如此，全国覆盖率仍然低于这一水平。乔治亚州还没有达到这一目标的任何一个 推荐给青少年的四种疫苗：TDAP、MCV4、HPV和流感疫苗。这项建议 评估了两种可用于提高全国青少年疫苗覆盖率的潜在干预措施。 具体地说，我们将确定是仅限父项的策略还是多组件父项和 以青少年为重点的(教师授课)干预导致更高的免疫覆盖率。这一设计将 使我们能够确定接触青少年接种疫苗的最佳方式。这一点具有特别的相关性 因为青少年疫苗的数量近年来有所增加，而且可能会继续上升。我们 将进行一项三臂对照试验，使用系统的平衡重复设计来比较 佐治亚州东部一个种族多元化的大县里士满的疫苗接种率。我们会随机 选择2所高中和3所中学作为三个分支中的一个。在第一个ARM中，我们将实现 两个周期的仅针对父母的干预旨在激励父母为他们的青少年接种疫苗。 在第二个ARM中，我们将实施针对父母双方的多成分干预的两个周期 和青少年，通过老师进行干预。在第三个武器中，我们将不实施任何干预。 主要结果将是估计青少年疫苗接种覆盖率的变化。其他结果将 包括这两种干预措施对疫苗接受度介体的影响。这项研究的发现可能 具有重要的政策影响，为可移植和相关的教育干预奠定了基础 已被证明能有效增加青少年的免疫接种。

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.