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)：尽管美国关于人乳头瘤病毒(HPV)疫苗常规接种的国家指南，但目前只有33%的美国少女和7%的青春期男孩接种了所有三种推荐剂量。医疗保健提供者在父母为处于青春期的孩子接种HPV疫苗的决定中具有很大的影响力，但提供者往往不推荐。此外，提供商确实提供的建议往往很弱。这项研究的总体目标是开发和评估一个简短的培训计划，以改善提供者对HPV疫苗的沟通。这项研究将特别关注联邦合格健康中心的提供者，因为这些诊所服务的低收入和少数族裔青少年更有可能在以后的生活中患上HPV相关癌症。HPV疫苗接种是， 因此，在这种情况下尤为重要。 在方法方面，我们将首先确定与HPV疫苗交付相关的提供者沟通特征(目标1)。利用现有的数据，我们将对204次录音医疗接触进行混合方法分析，这些接触发生在提供者、青少年患者及其父母之间。我们将利用这项分析的结果，为在低资源环境下执业的提供者开发一个简短的教育干预措施(目标2)。在社会认知理论的指导下，培训的目的将是提高提供者对HPV疫苗的知识、技能和沟通的信心。最后，我们将向4个联邦合格卫生中心的16个提供者提供培训，以调查干预措施的可行性(目标3)。使用医疗会面的录音和对提供者、患者和父母的调查，我们将评估干预措施改善提供者认知和推荐做法的能力，以及提供者和家庭的接受度。 这项拟议的研究建立在梅丽莎·吉尔基博士之前在调查研究和项目评估方面的工作基础上，旨在确定和克服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针对青少年的循证癌症预防计划。她目前的职业目标是获得患者-提供者沟通方面的内容知识，开发行为干预措施的技能，以及进行随机临床试验以测试这些干预措施的专业知识。拟议的职业发展奖将通过提供有重点的培训和受保护的研究时间，使Gilkey博士能够成长为一名独立的调查员。拟议的研究计划将为Gilkey博士的第一个R01级研究奠定基础，以建立沟通培训的有效性 提高HPV疫苗覆盖率。