A Practice-Provider-Parent-Adolescent intervention to increase HPV vaccination

描述（由申请人提供）：青少年对人乳头瘤病毒（HPV）疫苗的摄取落后于最近推荐的其他青少年疫苗。许多研究记录了接受HPV疫苗的许多广泛障碍，但迄今为止，还没有针对青少年卫生保健决策人群的所有组成部分的综合计划来解决这些低疫苗接种水平。该指导培训计划将利用行为科学的指导，开发一个多管齐下的综合干预工具包，其组件针对医生办公室/实践，个人医疗保健提供者，青少年及其父母，以提高人乳头瘤病毒疫苗的吸收。 迄今为止，我在流行病学方面的培训主要集中在传染病的定量分析和疫苗相关研究上。此前，我进行了研究，以更好地了解HPV疫苗接受的障碍，同时担任国家疫苗咨询委员会主席助理。在目睹了疫苗政策决策是如何制定的，以及提出这些建议所需的信息类型之后，我正在寻求利用这一经验进入我职业生涯的新阶段，寻求在一个新领域（行为科学）的培训，并利用这一点来开发解决美国青少年疫苗接种率不佳的方法。通过这项指导性研究，我预计将获得可用于开发更多R 01赠款申请的证据，以继续研究改善青少年健康的行为干预措施。这些未来的研究将是我的研究组合的主要组成部分，因为我过渡到工作作为一个独立的研究人员在终身教职的学术任命。 通过这个职业发展奖，我将通过课程和定向阅读获得行为科学和健康教育方面的教育，重点是开发和实施材料，以影响青少年卫生保健决策方面的行为改变。在四年的时间里，我将（a）利用课堂教育和定向阅读来更好地理解这些行为科学方法，（B）进行关键的知情人访谈和焦点小组，以澄清HPV疫苗接种的障碍，并确定减轻这些障碍的最佳方法，以及（c）开发一个工具包，其中包含针对青少年卫生保健决策系统四个级别的组件（医疗办公室/实践，医疗保健提供者[医生和护理人员]，青少年及其父母）。研究的最后一部分将是评估该工具包在改善HPV疫苗接种方面的有效性，通过基线和随访调查之间的差异进行衡量。这些活动将在佐治亚州的社区儿科实践中进行。

DESCRIPTION (provided by applicant): Uptake of the human papillomavirus (HPV) vaccine among adolescents has trailed that of other recently recommended adolescent vaccines. Numerous studies have documented a number of wide-ranging barriers to receipt of HPV vaccine, but to date, there has not been a comprehensive program targeted to all components of the adolescent health care decision making population to address these low vaccination levels. This mentored training program will utilize instruction in behavioral sciences to lead to development of a multi- pronged, comprehensive intervention toolkit with components targeted to physician offices/practices, individual health care providers, adolescents, and their parents, t improve uptake of the human papillomavirus vaccine. To date, my training in epidemiology has focused on quantitative analysis of infectious disease and vaccine-related studies. Previously, I conducted research to better understand the barriers to HPV vaccine acceptance, while serving as the Assistant to Chair of the National Vaccine Advisory Committee. Having witnessed how vaccine policy decisions are made, and the types of information that needed to make these recommendations, I am seeking to leverage this experience to move to a new phase of my career, seeking training in a new field (behavioral sciences) and using this to develop methods to address suboptimal adolescent vaccine rates in the US. Through this mentored research, I anticipate obtaining evidence that can be utilized to develop additional R01 grant applications to continue studying behavioral interventions to improve adolescent health. These future studies will be a primary component of my research portfolio as I transition to working as an independent investigator in a tenure-track academic appointment. Through this career development award, I will obtain education in behavioral science and health education through coursework and directed readings, with a focus on developing and implementing materials to effect behavioral change with regard to adolescent health care decision making. Over a four-year period, I will (a) utilize in-class education and directed readings to better understand these behavioral science methods, (b) conduct key informant interviews and focus groups to clarify barriers to HPV vaccination and identify the best ways to mitigate these barriers, and (c) develop a toolkit with components directed at four levels of the adolescent health care decision making system (medical office/practice, healthcare providers [physicians and nursing staff], adolescents, and their parents). The final component of the research will be an evaluation of the effectiveness of this toolkit in improving HPV vaccine uptake, as measured through differences between baseline and follow-up surveys. These activities will occur within community-level pediatric practices in the state of GA.