Disparities in Healthcare Providers' Recommendation of HPV Vaccination for U.S. Adolescents: A Systematic Review.
Disparities in Healthcare Providers' Recommendation of HPV Vaccination for U.S. Adolescents: A Systematic Review.
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DOI：
10.1158/1055-9965.epi-21-0733
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发表时间：
2021-11
期刊：
影响因子：
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通讯作者：
Gilkey MB
中科院分区：
文献类型：
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作者：
Kong WY;Bustamante G;Pallotto IK;Margolis MA;Carlson R;McRee AL;Gilkey MB
很少提供者的建议仍然是人乳头瘤病毒（HPV）疫苗接种的主要障碍，包括未来HPV癌症风险较高的青少年。为了为未来的干预措施提供信息，我们试图描述医疗保健提供者对美国青少年HPV疫苗推荐的差异。我们系统地回顾了2012-2019年发表的研究，这些研究评估了9-17岁青少年的HPV疫苗建议。根据PRISMA指南，我们确定了52项符合条件的研究，并使用标准化的抽象表格来评估青少年人口统计学特征的推荐患病率。研究一致发现，报告接受HPV疫苗建议的男孩父母少于女孩父母（14项研究，差异范围：-11至-35个百分点）。研究还发现，对年龄较小的青少年（2项研究，-3%至12%），非白人（3项研究，-5%至7%，仅限女性），低收入（3项研究，-1%至8%）或无保险（1项研究，-21%，仅限男性）的建议较少。研究查明了南部和农村地区的地理差异。总之，本系统性综述的结果确定了HPV疫苗推荐的差异，可能导致疫苗摄取不佳。改善提供者HPV疫苗沟通的努力应侧重于提高推荐的一致性，特别是对低收入，非白人和农村青少年。
Infrequent provider recommendations continue to be a key barrier to human papillomavirus (HPV) vaccination, including among adolescents at higher risk for future HPV cancers. To inform future interventions, we sought to characterize disparities in healthcare providers’ HPV vaccine recommendation for US adolescents. We systematically reviewed studies published in 2012–2019 that assessed provider HPV vaccine recommendations for adolescents aged 9–17. Following PRISMA guidelines, we identified 52 eligible studies and used a standardized abstraction form to assess recommendation prevalence by adolescent demographic characteristics. Studies consistently found that fewer parents of boys than girls reported receiving HPV vaccine recommendations (14 studies, range of difference: −11 to −35 percentage points). Studies also found fewer recommendations for adolescents who were younger (2 studies, −3 to −12% points), non-White (3 studies, −5 to −7% points, females only), lower-income (3 studies, −1 to −8% points), or uninsured (1 study, −21% points, males only). Studies identified geographic disparities in Southern and rural areas. In conclusion, findings from this systematic review identify disparities in HPV vaccine recommendation that may contribute to suboptimal vaccine uptake. Efforts to improve providers’ HPV vaccine communication should focus on increasing recommendation consistency, especially for lower-income, non-White, and rural adolescents.