Improving Healthcare Providers' Communication about HPV Vaccine

改善医疗保健提供者有关 HPV 疫苗的沟通

• 批准号: 9128414
• 负责人: Melissa B Gilkey
• 金额: $ 14.26万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-17 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9128414
• 关键词: Address; Adolescent; Age; Area; Behavior; Behavior Therapy; Behavioral; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Clinic; Communication; Consensus; Data; Disease; Dose; Educational Intervention; Effectiveness; Family; Feasibility Studies; Federally Qualified Health Center; Female Adolescents; Frequencies; Goals; Guidelines; Health; Health Personnel; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papillomavirus; Influentials; Intervention; K-Series Research Career Programs; Knowledge; Lead; Life; Literature; Low income; Male Adolescents; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical; Medical Records; Melissa; Methods; Minority; Parents; Patients; Perception; Prevention program; Primary Health Care; Principal Investigator; Program Evaluation; Provider; Randomized Clinical Trials; Randomized Controlled Trials; Recommendation; Research; Research Personnel; Resources; Scientist; Self Efficacy; Surveys; Testing; Time; Training; Training Activity; Training Programs; Translating; Translational Research; Trust; United States; Vaccination; Vaccines; Visit; Woman; Work; adolescent patient; base; boys; cancer prevention; career; clinical practice; cost; design; evidence base; improved; innovation; killings; multidisciplinary; prevent; programs; quality improvement organization; skills; social cognitive theory; uptake; vaccine delivery

DESCRIPTION (provided by applicant): Despite national guidelines for routine administration of human papillomavirus (HPV) vaccine, only 33% of adolescent girls and 7% of adolescent boys in the U.S. currently receive all three recommended doses. Healthcare providers are highly influential in parents' decisions to get their adolescent children HPV vaccine, and yet providers often fail to recommend it. Further, recommendations providers do deliver are often weak. The overall goal of this study is to develop and evaluate a brief training program to improve providers' communication about HPV vaccine. This study will focus specifically on providers in Federally Qualified Health Centers because the low-income and minority adolescents served by these clinics are more likely to suffer from HPV-related cancers later in life. HPV vaccination is, thus, especially important in this setting. In terms of methods, we will first identify provider communication characteristics associated with HPV vaccine delivery (Aim 1). Using existing data, we will conduct a mixed-methods analysis of 204 audio-recorded medical encounters between providers, adolescent patients, and their parents. We will use findings from this analysis to develop a brief educational intervention for providers practicing in low-resource settings (Aim 2). Informed by social cognitive theory, the training's purpose will be to improve providers' knowledge, skills, and confidence for communicating about HPV vaccine. Finally, we will deliver the training to 16 providers in 4 Federally Qualified Health Centers to investigate the intervention's feasibility (Aim 3). Using audio-recordings of medical encounters and surveys of providers, patients, and parents, we will assess the intervention's ability to improve provider perceptions and recommendation practices as well as its acceptability to providers and families. The proposed study builds on Dr. Melissa Gilkey's prior work in survey research and program evaluation aimed at identifying and overcoming barriers to HPV vaccination. The candidate's long-term career goal is to translate research into evidence-based cancer prevention programs for adolescents. Her immediate career goals are to gain content knowledge in patient-provider communication, skills in developing behavioral interventions, and expertise in conducting randomized clinical trials to test those interventions. The proposed career development award will enable Dr. Gilkey to grow as an independent investigator by providing focused training as well as protected time for research. The proposed program of research will lay the groundwork for Dr. Gilkey's first R01-level study to establish the effectiveness of communication training for raising coverage of HPV vaccine.

描述（由申请人提供）：尽管人类乳头瘤病毒（HPV）疫苗的常规给药指南，但目前在美国，只有33％的青春期女孩和7％的青春期男孩接受了所有三种建议的剂量。医疗保健提供者在父母的决策中对获得青春期儿童HPV疫苗的决策具有很高的影响力，但提供商通常没有推荐它。此外，建议提供者确实提供的建议通常很弱。这项研究的总体目标是制定和评估一个简短的培训计划，以改善提供商对HPV疫苗的沟通。这项研究将专门关注联邦资格的卫生中心的提供者，因为这些诊所为这些诊所服务的低收入和少数族裔青少年更有可能遭受与HPV相关的癌症的困扰。 HPV疫苗接种是， 因此，在这种情况下尤其重要。 在方法方面，我们将首先确定与HPV疫苗输送相关的提供商通信特征（AIM 1）。使用现有数据，我们将对提供者，青少年患者及其父母之间的204次音频录制的医疗相遇进行混合方法分析。我们将使用此分析中的发现来开发简短的教育干预措施，以用于在低资源环境中实践的提供者（AIM 2）。在社会认知理论中，培训的目的是提高提供者的知识，技能和信心来传达有关HPV疫苗的信息。最后，我们将在4个联邦合格的卫生中心的16个提供者提供培训，以调查干预措施的可行性（AIM 3）。使用提供者，患者和父母的医疗遭遇和调查的音频录制，我们将评估干预措施改善提供者的看法和建议惯例的能力，以及对提供者和家庭的可接受性。 拟议的研究基于梅利莎·吉尔基（Melissa Gilkey）博士在调查研究和计划评估方面的先前工作，旨在识别和克服HPV疫苗接种的障碍。候选人的长期职业目标是将研究转化为基于证据的青少年癌症预防计划。她的直接职业目标是在患者提供者的沟通，发展行为干预方面的技能以及进行随机临床试验以测试这些干预措施方面的专业知识。拟议的职业发展奖将使吉尔基博士通过提供专注的培训以及受保护的研究时间来成长为独立研究者。拟议的研究计划将为吉尔基博士的首次R01级研究奠定基础，以确立沟通培训的有效性 提高HPV疫苗的覆盖范围。