Engaging practices and communities in the development of interventions to promote HPV vaccine uptake

项目摘要 《2020年健康人群》报告指出，青少年中80%的人接受推荐疫苗的目标， 包括人乳头瘤病毒疫苗。然而，HPV疫苗的接种率一直在下降。 相对于青少年系列中的其他疫苗，HPV疫苗的接种方法 据估计，2017年青少年的发病率为48.6%，这将导致可预防疾病的发病率和死亡率过高， HPV相关的癌症造成这种情况的原因是多方面的，包括提供者一级的因素， 初级保健实践，病人和家庭，以及社区。以前制定的干预措施往往侧重于 只在这些方面之一，往往是在学术环境中测试，普遍性是困难的。 因此，开发对现实世界中的这些多因素障碍做出反应的干预措施， 环境是研究的优先领域。本提案将使用靴子Camp Translation（BCT） 将HPV疫苗接种的指南和证据转化为实践和提供者的方法 水平干预，旨在提高HPV疫苗的可接受性。作为社区参与 BCT是一个6-9个月的迭代过程，将多个利益相关者聚集在一起， 将循证指南和建议转化为与当地相关且有意义的信息、材料， 程序.在加速执行与若干问题有关的准则方面， 健康主题和我们自己的试点工作表明，这种方法是可行的， 适用于HPV疫苗接种。我们建议在科罗拉多的三个县实施以HPV为重点的BCT， a低于县级平均接种率。通过一个迭代的、便利的六个月过程，每个BCT 该小组将设计一个多管齐下的干预措施，针对患者，家长，供应商和一般 社区，然后在随后的六年里在参与的实践和社区中传播， 月期间。这种方法的优点是，BCT产生的干预措施， 准备好传播，结合实践和社区背景，并改进 以证据为基础的干预措施对个别社区的可接受性。长期目标是 开发一种可复制的方法和低成本的方法来增加HPV疫苗的摄取， 不同的环境和社会人口背景。本项目的具体目标-参与实践 和社区在制定干预措施，以促进HPV疫苗的吸收-是（1） 在三个地理位置不同科罗拉多社区实施靴子营翻译， 将HPV疫苗接种纳入旨在增加疫苗接种的当地相关干预措施的证据;以及（2） 评估BCT设计的干预措施对实践水平HPV疫苗启动率的影响。我们 假设BCT设计的干预措施将增加实践中HPV疫苗的启动率。

Project Summary The Healthy People 2020 report states a goal of 80% uptake of recommended vaccines among adolescents, including the human papillomavirus (HPV) vaccine. However, the rate of uptake of the HPV vaccine has been slow relative to the other vaccines in the adolescent series. The series completion of the HPV vaccine among adolescents is estimated at 48.6% in 2017, which will lead to excess morbidity and mortality from preventable, HPV-related cancers. Reasons for this are multifactorial and include factors at the level of the provider, primary care practice, patient and family, and the community. Previously developed interventions often focus only on one of these aspects and are often tested in academic settings where generalizability is difficult. Therefore, the development of interventions that are responsive to these multifactorial barriers in real-world settings is a priority area for research. This proposal will use the Boot Camp Translation (BCT) methodology to translate the guidelines and evidence for the HPV vaccination into a practice- and provider- level intervention designed to improve the acceptability of the HPV vaccine. As a community engagement approach, BCT is a 6-9 month iterative process that brings together multiple stakeholders to translate evidence-based guidelines and recommendations into locally relevant and meaningful messages, materials, and programs. BCT has demonstrated success in expediting the implementation of guidelines related to several health topics and our own pilot work demonstrates that this methodology is feasible and acceptable when applied to HPV vaccination. We propose to implement an HPV-focused BCT in three counties in Colorado with a below average county-level vaccination rate. Through an iterative, facilitated six-month process, each BCT group will design a multi-pronged intervention targeted at patients, parents, providers, and the general community to then be disseminated in the participating practices and communities over the subsequent six- month period. The strength of this approach is that BCT produces interventions that are dissemination-ready, incorporate both practice and community context, and improve the acceptability of evidence-based interventions to individual communities. The long-term goal is to develop a replicable approach and low-cost method of increasing HPV vaccine uptake that is easily adaptable to different settings and sociodemographic contexts. The Specific Aims of this project - Engaging practices and communities in the development of interventions to promote HPV vaccine uptake - are to (1) implement Boot Camp Translation in three geographically distinct Colorado communities to translate current evidence for HPV vaccination into locally relevant interventions designed to increase vaccine uptake; and (2) evaluate the impact of the BCT-designed intervention on practice-level HPV vaccine initiation rates. We hypothesize that the BCT-designed intervention will increase the rate of HPV vaccine initiation in the practices.