Enhancing Adolescent Immunization through Parent and Teacher Interventions

说明(申请人提供)：迫切需要提高青少年疫苗接种率。美国疾病控制与预防中心2010年健康人群倡议的目标之一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。佐治亚州尚未在推荐的四种青少年疫苗中的任何一种实现这一目标：TDAP、MCV4、HPV和流感疫苗。该提案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，我们将确定仅由家长参与的策略还是以家长和青少年为重点(教师授课)的多成分干预策略是否会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。这一点具有特别重要的意义，因为青少年疫苗的数量近年来有所增加，而且可能继续上升。我们将使用系统的平衡复制设计进行一项三臂对照试验，以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。我们将随机选择2所高中和3所中学作为三个分支中的一个。在第一个手臂中，我们将实施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。在第二个手臂中，我们将实施两个周期的针对家长和青少年的多成分干预，通过教师授课的干预。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。这项研究的结果可能具有重要的政策意义，为可移植和相关的教育干预奠定基础，这些干预已被证明有效地增加了青少年的免疫接种。 公共卫生相关性：这项建议评估了两种流感疫苗接种策略的有效性，一种是仅由家长参与的干预，另一种是以家长和青少年为重点、由教师提供的多成分干预，相对于护理对照组的标准，评估了在不同文化背景的青少年中提高免疫接种率的效果。它还将确定增加免疫接种所需的最低干预措施。

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: This proposal evaluates the efficacy of two influenza vaccine delivery strategies, a parent-only intervention and a multi-component parent and adolescent focused, teacher-delivered, intervention, relative to a standard of care control group, in enhancing immunization rates among culturally diverse adolescents. It will also determine the minimum intervention necessary to increase immunizations.