Web enhanced adoption of HPV vaccine in minority communities

最近开发和监管批准的第一种疫苗（Gardasil-Merck），以减少人类 乳头瘤病毒（HPV）感染代表了一项重要的医学创新，可以潜在地减少 宫颈癌的发病率。初次性行为前的女性青少年（年龄范围9-12岁）的疫苗接种 年）将导致两种特定的HPV类型16和18的减少，已知这两种类型会导致大多数人感染。 (-70%）的宫颈癌。与许多其他基于科学的医学创新一样，疫苗 采用并不总是迅速的，往往取决于各种社会和文化因素，以及 创新本身的性质在这种特殊情况下，HPV疫苗接种的传播和采用可能是 由于HPV与性行为和传播有关，因此特别复杂。这些 在少数民族社区，获得有关医疗保健的有效信息的问题可能会很突出。 创新往往缺乏，文化和社区的作用被忽视，在提供医疗服务， 服务这里提出的是一个调查，将采用创新理论的扩散，以及 减少不确定性，以指导基于网络的工具的迭代开发，促进知情的采用 HPV疫苗。将开发三套网络工具：1）专为专职医疗服务设计的网络工具 团队成员将帮助他们沟通HPV疫苗; 2）为父母设计的网络工具， 女性早期青少年，将提供信息，并减少周围的决定， 让她们的女儿接种疫苗，3）为女性青少年设计的网络工具， 还提供信息并减少HPV疫苗接种的不确定性。一项随机疗效试验， 计划在新墨西哥州的学校卫生诊所进行网络干预。参与的SBHC 将随机接受一套疫苗接种网络工具或在通常情况下提供HPV疫苗 和惯例网络工具将根据文化特点加以调整，并适当适用。结局指标将 包括评估父母和青少年对疫苗了解程度，减少疫苗接种 不确定性，以及疫苗采用和接种坚持措施。

The recent development and regulatory approval of the first vaccine (Gardasil-Merck) to reduce human papillomavirus (HPV) infections represents an important medical innovation that can potentially reduce the incidence of cervical cancer. Vaccination of female eariy adolescents prior to sexual debut (age range 9-12 years) will have a consequent reduction in two specific HPV types 16 and 18, known to cause a majority (-70%) of cervical cancer woridwide. As with many other science-based medical innovations, vaccine adoption is not always rapid and often depends on a variety of social and cultural factors, as well as the nature of the innovation itself In this particular case, the diffusion and adoption of HPV vaccination may be especially complicated because of the association of HPV with sexual behavior and transmission. These issues are likely to be pronounced in minority communities where access to valid information about medical innovations is often lacking, and the role of culture and community is neglected in the provision of medical services. Proposed here is an investigation that will employ Diffusion of Innovations theory as well as uncertainty reduction to guide the iterative development of web-based tools to prompt the informed adoption of the HPV vaccines. Three sets of web tools will be developed: 1) web tools designed for allied health care team members that will aid in their communication about HPV vaccine; 2) web tools designed for parents of female early adolescents that will provide information and reduce uncertainty surrounding the decision to have their daughters vaccinated, and 3) web tools designed for female eariy adolescents themselves that wil also provide information and reduce uncertainty about HPV vaccination. A randomized efficacy trial of this web intervention is planned for school-based health clinics (SBHCs) in New Mexico. Participating SBHCs would be randomized to either receive the set of vaccination web tools or offer HPV vaccine under the usual and customary protocol. The web tools will be culturally tailored and appropriate. Outcome measures will include assessments of parent and adolescent vaccine understanding, reduction of vaccination adoption uncertainty, and vaccine adoption and inoculation adherence measures.