Increasing HPV Vaccination Rates through Virtual Immersive Communication Training on Recommending Immunizations: An Efficacy Study of VICTORI

项目总结 尽管有强有力的证据，人类乳头瘤病毒(HPV)疫苗在预防某些肛门生殖疾病方面是有效的 在美国，只有69%的青春期女性和63%的男性发起了这一系列癌症。研究表明， 证明父母决定给孩子接种HPV疫苗的主要预测因素是强有力的 医生的推荐。最近的干预措施侧重于改善医生的 通过演示文稿、网络研讨会、电子健康记录进行国家建议的教育 警报和质量改进激励。尽管使用了严谨和创新的方法，但这些研究 导致了不同的效果，部分原因可能是缺乏身临其境的、刻意的练习 传达疫苗建议。我们研究团队的长期目标是增加HPV疫苗接种 这将降低青少年HPV相关癌症和癌前病变的发病率。的目标是 本应用是为了评估一种新型的虚拟现实干预方法--虚拟沉浸式的有效性 关于推荐免疫的沟通培训(Victori)，旨在增强 医生通过深思熟虑的实践推荐HPV疫苗。我们将评估维克托里是否 提高11至17岁患者的HPV疫苗启动率和完成率，以及 医生对HPV疫苗接种的态度、自我效能和推荐力度。我们的假设是 维克托里疫苗的实施将与疫苗启动率和完成率的提高密切相关， 这种联系将通过医生态度、自我效能和力量的改善来调节 推荐。拟议研究的理由是，对Victori的评估将提供有效的信息 以及可扩展的战略，以培训医生提供强有力的疫苗建议，从而增加 HPV疫苗接种率和最终较低的HPV相关癌症发生率。为了实现我们的目标，我们将 实现这些具体目标：(1)评估Victori的可接受性和可行性，以及(2)进行单一的- 现场干预评估维多利在提高HPV疫苗接种率方面的有效性。拟议的研究是 意义重大，因为这是确定使用虚拟现实进行刻意练习的效果的第一步 模拟以提高HPV疫苗的启动率和完成率。这种方法是创新的，因为它是第一次 严格努力开发和评估虚拟现实作为教授最佳做法的培训平台的效果 与HPV疫苗咨询相关的沟通技巧。这项工作的预期结果是成功的 实施Victori，旨在增加医生强烈的HPV疫苗接种建议， 这反过来将增加HPV疫苗接种率。

PROJECT SUMMARY Despite strong evidence the human papillomavirus (HPV) vaccine is effective in preventing certain anogenital cancers, only 69% of adolescent females and 63% of males in the U.S. have initiated the series. Research has demonstrated that the leading predictor of parents’ decision to vaccinate their child against HPV is a strong recommendation from physicians. Recent interventions have focused on improving physicians’ recommendations through education about national recommendations via presentations, webinars, electronic health record alerts, and quality improvement incentives. Despite the rigorous and innovative methods used, these studies have resulted in variable effects, perhaps, in part, because of the lack of immersive, deliberate practice of communicating vaccine recommendations. Our research team’s long-term goal is to increase HPV vaccination rates in adolescents, which will decrease rates of HPV-associated cancers and pre-cancers. The objective of this application is to evaluate the effectiveness of a novel virtual reality intervention, Virtual Immersive Communication Training on Recommending Immunizations (VICTORI), designed to enhance the strength of physicians’ HPV vaccine recommendations through deliberate practice. We will evaluate whether VICTORI improves HPV vaccine initiation and completion rates among 11 to 17-year-old patients, as well as improves physicians’ HPV vaccine attitudes, self-efficacy, and strength of recommendation. Our hypothesis is that the implementation of VICTORI will be positively associated with an increase in vaccine initiation and completion rates, and that this association will be mediated by improvements in physician attitudes, self-efficacy, and strength of recommendation. The rationale for the proposed research is that an evaluation of VICTORI will inform effective and scalable strategies to train physicians to provide strong vaccine recommendations, resulting in increased HPV vaccine rates and ultimately lower rates of HPV-associated cancers. To achieve our objective, we will accomplish these specific aims: (1) evaluate VICTORI for acceptability and feasibility, and (2) conduct a single- site intervention assessing the efficacy of VICTORI in increasing HPV vaccine rates. The proposed research is significant because it is the first step in determining the effect of deliberate practice using virtual reality simulations to increase HPV vaccine initiation and completion rates. The approach is innovative because it is the first rigorous effort to develop and evaluate the efficacy of virtual reality as a training platform to teach best-practice communication skills related to HPV vaccine counseling. The expected outcome of this work is successful implementation of VICTORI, designed to increase strong HPV vaccination recommendations by physicians, which in turn will increase HPV vaccination rates.