Implementation of Inpatient Postpartum Human Papillomavirus Immunization

住院病人产后人乳头瘤病毒免疫的实施

• 批准号: 10187528
• 负责人: Sangini S. Sheth
• 金额: $ 16.5万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-11 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10187528
• 关键词: 12 year old; 17 year old; Address; Adolescent; Age; Age-Years; Anogenital cancer; Anxiety; Award; Breastfed infant; Caring; Cervical; Cervical dysplasia; Clinical Informatics; Computerized Medical Record; Conduct Clinical Trials; Data; Development; Disease; Dissemination and Implementation; Dose; Excision; FDA approved; Female; Female Adolescents; Focus Groups; Future; Goals; Gynecologist; Health; Health Sciences; Hospitalization; Hospitals; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Hybrids; Immunization; Immunize; Incidence; Influenza; Inpatients; Intervention; Interview; Learning; Lesion; Link; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical Care Costs; Medical Informatics; Mentors; Methods; Minority Groups; Modeling; Modification; Oregon; Oropharyngeal; Outpatients; Pain; Patients; Postpartum Period; Postpartum Women; Pregnant Women; Prevention; Procedures; Process; Qualitative Methods; Research; Research Methodology; Rubella virus vaccine; Scientist; Series; Testing; Training; Translating; Universities; Vaccinated; Vaccination; Vaccines; Visit; Woman; Work; acceptability and feasibility; arm; base; burden of illness; cancer prevention; certificate program; cost estimate; design; dissemination research; dissemination strategy; effectiveness trial; efficacy trial; ethnic minority population; evidence based guidelines; experience; follow-up; implementation fidelity; implementation framework; implementation outcomes; implementation research; implementation science; implementation strategy; implementation tool; implementation trial; improved; influenza virus vaccine; innovation; malignant oropharynx neoplasm; multidisciplinary; obstetric outcomes; postpartum care; preference; premalignant; prevent; programs; racial minority; research to practice; routine care; sexually active; standard of care; success; tool; uptake; usability; vaccine acceptance; vaccine delivery

Project Summary / Abstract Dr. Sheth is an obstetrician and gynecologist whose long-term goal is to optimize the implementation of evidence-based recommendations for prevention of gynecologic cancers. The proposed training and mentored research experience will enable her to achieve her short-term goals of developing expertise in conducting dissemination and implementation (D&I) research on human papillomavirus (HPV) vaccine and of using qualitative methods and medical informatics as research tools. Dr. Sheth has assembled an expert and committed team of mentors and advisors to help her. Dr. Linda Niccolai (primary mentor) is a recognized leader in HPV vaccine research and qualitative methods and Dr. Steven Bernstein (co-mentor) is an expert in D&I research for cancer prevention. Dr. Sheth will complete a certificate program in D&I science through UCSF, take advanced courses at Yale on qualitative methods, clinical informatics and the design and conduct of clinical trials, and complete a course on the design of health IT tools through Oregon Health and Science University. Each year in the U.S., HPV causes approximately 330,000 cases of precancerous cervical dysplasia, and 12,000 cases of cervical cancer. Since 2006, FDA-approved HPV vaccines have been available. Immunization is recommended routinely for all 11-12 year olds, and as catch-up immunization through age 26 years. However, uptake of HPV vaccine in the U.S. is poor: overall, only 43% of adolescents are fully immunized. Sustained efforts for catch-up immunization are critical to address missed opportunities to protect women against HPV-associated diseases. Even among women who have been sexually active before immunization, a substantial burden of disease can be prevented, especially since the current vaccine protects against 9 different HPV types responsible for >80% of cervical cancers. One strategy to improve HPV immunization rates is to vaccinate postpartum women during their hospitalization when there is easy access to patients. This would also reduce the number of visits needed to complete the multi-dose series. Several other vaccines (Tdap, influenza, MMR) have been integrated into postpartum hospital care for catch-up immunization, but not so the HPV vaccine. We aim to promote integration of inpatient postpartum HPV immunization (IPP-HPV) into routine care by developing an electronic medical record (EMR)-based tool modeled on current practices used for other vaccines administered during inpatient postpartum care and on stakeholder preferences. We will evaluate the feasibility of using the EMR-based tool as an implementation strategy for achieving high fidelity and sustainability of IPP- HPV immunization. This study will help inform development of an implementation toolkit for IPP-HPV immunization to use in a subsequent full-scale hybrid implementation and effectiveness trial. Upon completion of this award, Dr. Sheth will have expertise in D&I science research methods. She will have established the groundwork for conducting future studies to translate IPP-HPV immunization into a national model and will be well poised to become an independent clinician-scientist.

项目摘要 /摘要 Sheth博士是一位妇产科医生，其长期目标是优化实施 预防妇科癌的循证建议。拟议的培训和指导 研究经验将使她能够实现她在进行进行专业知识的短期目标 人类乳头瘤病毒（HPV）疫苗的传播和实施（D＆I） 定性方法和医学信息学作为研究工具。 Sheth博士集会了专家 诺言是导师和顾问团队来帮助她的。 Linda Niccolai博士（主要导师）是公认的领导者 在HPV疫苗研究和定性方法中，史蒂芬·伯恩斯坦（Steven Bernstein）（Co-Incertor）是D＆I的专家 预防癌症研究。 Sheth博士将通过UCSF完成D＆I科学证书计划， 耶鲁大学的高级课程有关定性方法，临床信息学以及临床设计和行为 试验，并通过俄勒冈州健康与科学大学完成有关健康IT工具设计的课程。 每年在美国，HPV会导致大约330,000例癌前颈发育不良， 和12,000例宫颈癌。自2006年以来，已获得FDA批准的HPV疫苗。 建议对所有11-12岁的年轻人通常进行免疫接种，并以26岁的追赶免疫接种 年。但是，在美国，HPV疫苗的摄取很差：总体而言，只有43％的青少年完全免疫。 持续的追赶免疫措施对于解决妇女免疫的错失机会至关重要 HPV相关疾病。即使是在免疫之前一直在性活跃的女性中 可以预防疾病的重大负担，尤其是因为当前的疫苗可防止9种不同的疾病 HPV类型负责80％的宫颈癌。提高HPV免疫率的一种策略是 容易接触患者时，在住院期间为产后疫苗接种。这也会 减少完成多剂量系列所需的访问次数。其他几种疫苗（TDAP，流感， MMR）已被整合到产后医院护理中以进行追赶免疫，但不是HPV疫苗。 我们旨在促进住院产后HPV免疫（IPP-HPV）的整合到常规护理中 开发基于电子病历的电子病历（EMR）的工具，该工具以其他疫苗的当前实践为模型 在住院产后护理和利益相关者的偏好期间进行管理。我们将评估可行性 使用基于EMR的工具作为实现IPP的高保真度和可持续性的实施策略 HPV免疫。这项研究将有助于为IPP-HPV的实施工具包提供信息 免疫用于随后的全尺度混合实施和有效性试验。完成后 在该奖项中，Sheth博士将在D＆I科学研究方法方面拥有专业知识。她将建立 进行未来研究以将IPP-HPV免疫转化为国家模型的基础工作，将是 准备成为独立的临床医生科学家。

项目成果

Disparities in adherence to retesting guidelines in women with Trichomonas vaginalis infection.

阴道毛滴虫感染女性遵守重新检测指南的差异。

• DOI: 10.1016/j.ajog.2023.06.045
• 发表时间: 2023
• 期刊: American journal of obstetrics and gynecology
• 影响因子: 9.8
• 作者: Getaneh,FevenW;Oliveira,CarlosR;Pathy,Shefali;Sheth,SanginiS
• 通讯作者: Sheth,SanginiS

Effectiveness of HPV vaccine by age at vaccination and number of doses: protocol for a population-based matched case-control study.

• DOI: 10.1136/bmjopen-2020-043093
• 发表时间: 2021-04-19
• 期刊: BMJ open
• 影响因子: 2.9
• 作者: Oliveira CR;Ortiz AM;Sheth SS;Shapiro ED;Niccolai LM
• 通讯作者: Niccolai LM

State Laws Permitting Adolescent Consent to Human Papillomavirus Vaccination and Rates of Immunization.

允许青少年同意接种人乳头瘤病毒疫苗和免疫率的州法律。

• DOI: 10.1001/jamapediatrics.2021.4591
• 发表时间: 2022
• 期刊: JAMA pediatrics
• 影响因子: 26.1
• 作者: Torres,AshlynnR;Johnson,NicholausP;Ellingson,MalloryK;Hansen,CaitlinE;Oliveira,CarlosR;Niccolai,LindaM;Sheth,SanginiS
• 通讯作者: Sheth,SanginiS

Inpatient Immunization With HPV Vaccine: A Qualitative Study With Postpartum Women.

• DOI: 10.1016/j.whi.2021.02.002
• 发表时间: 2021-07
• 期刊: Women's health issues : official publication of the Jacobs Institute of Women's Health
• 作者: Avni-Singer L;Oliveira CR;Torres A;Shapiro ED;Niccolai LM;Sheth SS
• 通讯作者: Sheth SS

Association of Inadvertent 9-Valent Human Papillomavirus Vaccine in Pregnancy With Spontaneous Abortion and Adverse Birth Outcomes.

• DOI: 10.1001/jamanetworkopen.2021.4340
• 发表时间: 2021-04-01
• 期刊: JAMA network open
• 影响因子: 13.8
• 作者: Kharbanda EO;Vazquez-Benitez G;DeSilva MB;Naleway AL;Klein NP;Hechter RC;Glanz JM;Donahue JG;Jackson LA;Sheth SS;Greenberg V;Panagiotakopoulos L;Mba-Jonas A;Lipkind HS
• 通讯作者: Lipkind HS