Improving Healthcare Providers' Communication about HPV Vaccine

项目总结/摘要 尽管国家有常规接种人乳头瘤病毒（HPV）疫苗的指导方针，但只有33%的人 目前，美国有7%的青春期女孩和7%的青春期男孩接受了所有三种推荐剂量。 医疗保健提供者对父母决定是否给青少年儿童接种HPV疫苗具有很大的影响力， 而且，提供者提供的建议往往很薄弱。 本研究的总体目标是开发和评估一个简短的培训计划，以提高供应商的 关于HPV疫苗的信息这项研究将特别关注联邦合格卫生服务提供者 中心，因为这些诊所服务的低收入和少数民族青少年更有可能遭受 与HPV相关的癌症。因此，HPV疫苗接种在这种情况下尤为重要。 在方法方面，我们将首先确定与HPV疫苗相关的提供者沟通特征 交付（目标1）。利用现有的数据，我们将对204个音频记录的医疗记录进行混合方法分析。 提供者、青少年患者和他们的父母之间的接触。我们将利用这项分析的结果， 为在低资源环境中执业的提供者制定简短的教育干预措施（目标2）。通知 社会认知理论，培训的目的将是提高提供者的知识，技能和信心 关于HPV疫苗的信息最后，我们将在联邦4个州向16个供应商提供培训， 合格的保健中心调查干预措施的可行性（目标3）。使用医疗记录 通过对提供者、患者和父母的接触和调查，我们将评估干预措施改善 提供者的看法和推荐做法以及提供者和家庭的接受程度。 Melissa Gilkey博士先前在调查研究和项目评估方面的工作， 识别和克服HPV疫苗接种的障碍。候选人的长期职业目标是翻译 研究青少年循证癌症预防计划。她的近期职业目标是 获得患者-提供者沟通的内容知识，制定行为干预措施的技能，以及 在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 该奖项将使Gilkey博士能够通过提供重点培训以及 保护时间进行研究。拟议中的研究计划将为吉尔基博士的第一个项目奠定基础。 R 01级研究，以确定沟通培训对提高HPV疫苗覆盖率的有效性。

PROJECT SUMMARY/ABSTRACT 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.