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Text and Talk: A multi-level intervention to increase provider HPV vaccine recommendation effectiveness

文本和谈话：提高 HPV 疫苗推荐有效性的多层次干预

基本信息

批准号：
10657508
负责人：
Stephanie A S Staras
金额：
$ 52.81万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10657508
关键词：
12 year old 15 year old Address Adolescent Age Behavior Child Child Rearing Clinic Clinic Visits Clinical Research Clinical effectiveness Consolidated Framework for Implementation Research Dose Effectiveness Evaluation Florida Goals Health Health Personnel Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Human Papilloma Virus-Related Malignant Neoplasm Human Papillomavirus Incentives Individual Intervention Malignant Neoplasms Modeling Parents Planning Theory Primary Care Provider Public Health Randomized Recommendation Reporting Research Resources Schedule Sum Teenagers Testing Text Text Messaging Training United States Vaccinated Vaccines Visit age group arm boys cancer diagnosis cancer prevention clinical practice design effectiveness evaluation girls health organization implementation determinants implementation strategy innovation live text patient oriented practice factors prevent preventive intervention primary care clinic provider behavior recruit relative effectiveness social cognitive theory synergism theories unvaccinated vaccine efficacy vaccine safety

项目摘要

PROJECT SUMMARY Multi-level implementation strategies targeting parents and health care providers have potential to substantially increase the low human papillomavirus (HPV) vaccination rates among the targeted age group of 11- to 12-year-olds. Florida adolescents are particularly vulnerable due to the state’s rank of 4th for HPV- related cancer diagnoses, but 39th for HPV vaccine initiation and up-to-date rates. The problem addressed by this proposal is the need for more effective and pragmatic preventive interventions to increase provider HPV vaccine recommendations. Existing interventions increase HPV vaccine rates only moderately (approximately 5 to 15 percentage points). A multi-leveled focus on provider recommendations and parent receptiveness is warranted because 90% of unvaccinated teens actually had well visits, provider recommendations increase HPV vaccination rates 9- to 170-fold, and parents make vaccine decisions. Additionally, national health agencies endorse two approaches for recommendation: mentioning HPV as one of the needed adolescent vaccines (bundled) or emphasizing the HPV vaccine benefits (benefits). Yet, the relative effectiveness of recommendation approaches and effectiveness of approach concordance across provider-parent levels is unclear. The goal of the proposal is to evaluate the effectiveness of a multi-level (provider and parent) intervention of two implementation strategies (brief provider training and parent-targeted interactive text message reminders) on HPV vaccination rates among 11- to 12-year-old boys and girls. Guided by the Integrated Behavior Model, a meta-theory combining the Theory of Reasoned Action, the Social Cognitive Theory, and the Theory of Planned Behavior, the central hypotheses are that brief provider trainings will increase providers’ intentions to recommend the HPV vaccine and the parent-targeted interactive text messages will increase parents’ salience. Specific Aims are to: (1) To test the overall effectiveness of brief provider trainings with an embedded comparison of bundled and benefits approaches. (2) To test the overall effectiveness of interactive text messages for parents with an embedded comparison of bundled and benefits approaches. (3) Evaluate the effectiveness of the combined brief provider trainings and interactive text messages for parents with an embedded comparison of concordant and distinct approaches. (4) Evaluate moderation of the implementation strategies’ effectiveness by clinical practice factors. Hypotheses will be evaluated with a doubly randomized, two-level nested design for testing two nested implementation factors (provider training and parent text messaging with bundled or benefits approaches). Thirty clinics will be recruited from the OneFlorida Clinical Research Consortium. The innovations are the factorial-designed evaluation estimating the value-added of multi-level implementation and the evaluation of concordant recommendation approaches across provider- and parent-levels. The significance lies in the potential to lead the field closer to a sustainable, scalable, and efficacious approach to decreasing HPV-related cancer rates.

项目概要针对家长和医疗保健提供者的多层次实施战略有可能大幅提高目标年龄组中低人乳头瘤病毒（HPV）疫苗接种率 11 至 12 岁的孩子。佛罗里达州的青少年特别容易受到感染，因为该州的 HPV 排名第四。相关癌症诊断，但 HPV 疫苗接种和最新率排名第 39。所解决的问题该建议是需要更有效和务实的预防干预措施来增加提供者的 HPV 疫苗建议。现有干预措施只能适度提高 HPV 疫苗接种率（大约 5 至 15 个百分点）。多层次关注提供者的建议和家长的接受度这是有道理的，因为 90% 的未接种疫苗的青少年实际上进行了健康检查，提供者的建议增加 HPV 疫苗接种率提高 9 至 170 倍，由家长做出疫苗接种决定。此外，国民健康各机构认可两种推荐方法：将 HPV 列为青少年所需的疫苗之一疫苗（捆绑）或强调 HPV 疫苗的好处（好处）。然而，相对有效性推荐方法和方法的有效性跨提供商-母公司级别的一致性不清楚。该提案的目标是评估多层次（提供者和家长）的有效性两项实施策略的干预（简短的提供者培训和针对家长的互动文本消息提醒）了解 11 至 12 岁男孩和女孩的 HPV 疫苗接种率。指导下综合行为模型，结合理性行动理论、社会认知理论的元理论理论和计划行为理论的中心假设是，简短的提供者培训将提高提供者推荐 HPV 疫苗和针对家长的互动文本的意愿信息将增加父母的显着性。具体目标是： (1) 测试简要的整体有效性提供者培训，其中嵌入了捆绑方法和福利方法的比较。 (2) 整体测试为家长提供交互式短信的有效性，并嵌入捆绑和福利的比较接近。 (3) 评估提供者简短培训和互动文本相结合的有效性通过对一致和不同方法的嵌入比较向家长传达的信息。 (4) 评估通过临床实践因素调节实施策略的有效性。假设将是使用双重随机、两级嵌套设计进行评估，以测试两个嵌套实施因素（通过捆绑或福利方法提供培训和家长短信）。将有三十个诊所从 OneFlorida 临床研究联盟招募。创新是析因设计的评估多层次实施的附加值和一致性评价跨提供商和家长级别的推荐方法。其意义在于领导的潜力该领域更接近于一种可持续、可扩展且有效的方法来降低 HPV 相关癌症发病率。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

A novel method for evaluating physician communication: A pilot study testing the feasibility of parent-assisted audio recordings via Zoom.

一种评估医生沟通的新方法：一项试点研究，测试通过 Zoom 进行家长辅助录音的可行性。

DOI：
10.1016/j.pecinn.2022.100020
发表时间：
2022
期刊：
PEC innovation
影响因子：
0
作者：
Staras,StephanieAS;Bylund,CarmaL;Desai,Shivani;Harle,ChristopherA;Richardson,Eric;Khalil,GeorgesE;Thompson,LindsayA
通讯作者：
Thompson,LindsayA

Messaging preferences among Florida caregivers participating in focus groups who had not yet accepted the HPV vaccine for their 11- to 12-year-old child.