Participatory Research to Understand the Translation of HPV Vaccine Policy

描述(申请人提供)：2006年6月，FDA批准了默克公司的疫苗“Guardasil”，该疫苗可预防4种类型的HPV感染，其中两种会导致宫颈异常发育不良，两种会导致生殖器疣。自从免疫实践咨询委员会(ACIP)批准并随后建议将疫苗常规接种给11-12岁的女孩以来的15个月里，41个州和哥伦比亚特区的立法者提出了立法，要求、资助或教育公众有关HPV疫苗的知识，至少有17个州颁布了某种立法，包括新墨西哥州。在这份申请中，我们建议研究新墨西哥州实施HPV疫苗政策的过程，以及向家长和公众提供疫苗和相关教育的相关规划努力。这项研究响应了就三个行动领域开展研究的建议：公共政策、卫生保健和疾病预防。具体目标如下：1.利用参与性进程，确定并召集一个由参与卫生政策背景的个人组成的利益攸关方小组2.探讨卫生政策倡议在新墨西哥州公立学校和初级保健机构传播HPV疫苗和促进知情决策方面的转化和影响。A.与卫生政策制定者、初级保健提供者、学校保健提供者和学校管理人员进行半结构化访谈，以确定他们对这些角色的看法；b.与五年级儿童的家长进行焦点小组讨论；c.对正在进行的关于HPV疫苗传播政策的辩论进行人种学观察3.与利益相关者团体一起，解释数据，制定和传播卫生政策建议，以支持HPV疫苗传播和明智的决策，从而减少新墨西哥州的宫颈癌健康差距。与公共卫生相关：最近批准的HPV疫苗是一项重要的科学进步，但在传播和实施方面面临挑战。这项研究将有助于更好地了解有助于制定HPV疫苗政策的因素。这些发现将被用于在初级保健和卫生政策层面上制定战略，以促进患者对HPV疫苗做出与社区价值观一致的知情决定。

DESCRIPTION (provided by applicant): In June of 2006, the FDA approved Merck's vaccine "Guardasil" which protects against 4 types of HPV infections, two which cause abnormal cervical dysplagia and two which cause genital warts. In the 15 months since the approval and the subsequent recommendation by the Advisory Committee on Immunization Practice (ACIP) that the vaccine be routinely administered to 11-12 year old girls, legislators in 41 states and the District of Columbia have introduced legislation to require, fund, or educate the public about the HPV vaccine, and at least 17 states have enacted some sort of legislation, including the state of New Mexico. In this application we propose to study the process of implementing policy regarding the HPV vaccine in the state of New Mexico, and related programmatic efforts to offer the vaccine and relevant education to parents and the public. This study is responsive to the call for proposals to conduct research on three areas of action: public policy, health care, and disease prevention. The Specific Aims are as follows: 1. Using a participatory process, identify and convene a stakeholder group composed of individuals involved in the health policy context 2. Explore the translation and impact of health policy initiatives regarding the dissemination of HPV vaccine and the promotion of informed decision making in New Mexico public schools and primary care settings. a. Conduct semi structured interviews with health policy makers, primary care providers, school based health providers and school administrators, in order to determine their perceptions of the roles b. Conduct focus group discussions with parents of 5th grade children c. Conduct ethnographic observations of the ongoing debate about the HPV vaccine dissemination policy 3. Together with the stakeholder group, interpret the data, develop and disseminate health policy recommendations regarding initiatives to support HPV vaccine dissemination and informed decision making leading to the reduction of cervical cancer health disparities in New Mexico. PUBLIC HEALTH RELEVANCE: The recent approval of the HPV vaccine is an important scientific advance but faces challenges in dissemination and implementation. This study will help to develop a better understanding of the factors that contribute to the development of HPV vaccine policy. These findings will be used to work toward the creation of strategies, both at the primary care and health policy level, to promote informed decision among patients with regard to the HPV vaccine that are consistent with community values.