Identifying the multi-level factors influencing provider recommendations of adolescent vaccines: A mixed methods study

确定影响青少年疫苗提供者建议的多层次因素：混合方法研究

• 批准号: 10758516
• 负责人: Mallory Ellingson
• 金额: $ 4.77万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10758516
• 关键词: Address; Adolescence; Adolescent; Attitude; Belief; Characteristics; Child; Communities; County; Data; Decision Making; Development; Education; Educational Status; Ethnic Origin; Foundations; Frequencies; Goals; Health Personnel; Hispanic; Human Papilloma Virus Vaccine; Individual; Insurance Coverage; Intervention; Intervention Studies; Interview; Knowledge; Literature; Maps; Methods; Neighborhoods; Observational Study; Parents; Patients; Pattern; Perception; Persons; Population Heterogeneity; Poverty; Process; Provider; Race; Recommendation; Research; Services; Teenagers; Urbanicity; Vaccinated; Vaccination; Vaccines; Variant; adolescent health; community-level factor; falls; improved; multilevel analysis; novel; parental influence; public health intervention; response; sociodemographics; uptake; vaccine acceptance; vaccine platform

PROJECT SUMMARY Healthcare provider (HCP) recommendations are one of the most important factors influencing parents’ acceptance of adolescent vaccines. A large body of literature across qualitative, observational and intervention studies has demonstrated that parents who receive a vaccine recommendation from a healthcare provider are much more likely to vaccinate their child. However, provider recommendations are not universal and high- quality recommendations are even more uncommon. Provider recommendations for adolescent vaccines can vary in strength, consistency, and timeliness, but the factors that influence the frequency and quality of these recommendations have not been well explored. The vaccine decision making process is influenced by factors at multiple levels including the individual, interpersonal, and community levels. Provider vaccine recommendations can be conceptualized in the same way–HCPs are influenced not only by their own attitudes and knowledge about the vaccine, but also their perceptions and knowledge of the patient and community in which they practice. Additionally, these factors do not work in isolation and can interact across levels to influence recommendations. In the proposed project, we will conduct a sequential mixed-methods study to explore how provider recommendations vary by individual, interpersonal and community level factors. First, we will conduct a multi- level analysis of nationally-representative zip code level data from NIS-Teen to examine how provider recommendations vary by interpersonal factors (i.e. patient characteristics - race/ethnicity, education level, insurance coverage) and community-level factors (i.e. urbanicity, poverty level) as well as how these factors interact (Specific Aim 1). To better understand our findings from Aim 1, we will conduct in-depth interviews with adolescent HCPs to explore how individual-level factors (i.e. provider attitudes) inform interpersonal and community level variation (Specific Aim 2). These interviews will be conducted in New Haven County among HCPs who both represent and provide service to a socio-demographically diverse population. Through this sequential mixed-methods approach, we will identify both how provider recommendations vary as well as explore the underlying beliefs and biases that guide provider recommendation practices. So far, research has primarily focused on the impact of provider recommendations for the HPV vaccine; examining the entire adolescent vaccine platform in this proposal will allow us to expand this limited body of literature. Our results will provide a foundation for the development and targeting of interventions to improve the quality of provider recommendations for greater coverage for all adolescent vaccines.

项目摘要 医疗保健提供者（HCP）的建议是影响父母的最重要因素之一， 青少年接种疫苗。大量的定性、观察和干预文献 研究表明，从医疗保健提供者那里得到疫苗建议的父母， 更有可能给孩子接种疫苗。然而，供应商的建议并不普遍和高- 高质量的推荐更是罕见。提供者对青少年疫苗的建议可以 不同的强度，一致性和及时性，但影响这些频率和质量的因素 这些建议尚未得到充分探讨。 疫苗决策过程受到多个层面因素的影响， 人际关系和社区层面。提供者疫苗建议可以概念化， HCP不仅受到他们自己对疫苗的态度和知识的影响， 患者和社区的认知和知识，他们的做法。此外，这些因素 它不是孤立地工作，可以跨级别交互以影响建议。 在建议的项目中，我们将进行一个顺序的混合方法研究，以探讨如何提供 建议因个人、人际和社区层面的因素而异。首先，我们将开展多... 对来自NIS-Teen的全国代表性邮政编码水平数据进行水平分析，以检查供应商如何 建议根据人际因素（即患者特征-种族/民族，教育水平， 保险覆盖率）和社区一级的因素（即城市化程度、贫困程度），以及这些因素 具体目标1（Specific Aim 1）为了更好地了解我们在目标1中的发现，我们将对以下人员进行深入采访： 青少年HCP探讨个人层面的因素（即提供者的态度）如何影响人际关系， 社区水平变化（具体目标2）。这些采访将在纽黑文县进行， 代表社会人口多样化人群并为其提供服务的HCP。 通过这种顺序混合方法，我们将识别提供者的建议如何变化， 并探索指导提供者推荐实践的潜在信念和偏见。到目前为止， 研究主要集中在HPV疫苗提供者建议的影响;检查 本提案中的整个青少年疫苗平台将使我们能够扩展这一有限的文献。我们 成果将为制定和确定干预措施的目标提供基础， 提供者建议扩大所有青少年疫苗的覆盖范围。