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首页> 美国卫生研究院文献>Preventive Medicine Reports >Youre never really off time: Healthcare providers interpretations of optimal timing for HPV vaccination
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Youre never really off time: Healthcare providers interpretations of optimal timing for HPV vaccination

机译：您永远不会真正有时间：医疗保健提供者对HPV疫苗接种最佳时机的解释

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Healthcare providers have a strong influence on human papillomavirus (HPV) vaccination decisions, yet they often fail to recommend the vaccine to the 11- and 12-year-olds who are targeted by practice guidelines. We sought to understand how providers interpret and value age-based guidelines.We conducted a secondary analysis of data from two qualitative studies of healthcare providers' HPV vaccination attitudes and practices. Participants were physicians, nurse practitioners, and physician assistants in Minnesota (n = 27) and in Washington (n = 17) interviewed in 2012 and 2014 respectively. Verbatim transcripts from each study were analyzed independently using content analysis, and collective findings were then jointly analyzed. The research team worked via consensus to derive codes and describe representative themes.A high proportion of providers reported either a lack of concern about HPV vaccine completion, or concern beginning several years past the recommended target age. Many providers perceived a gradient of HPV vaccination timeliness ranging from age 12 to 26. Instead of age-based recommendations, providers timed recommendations based on perceptions of access to care and patient risk. They often offered “gentle” recommendations and deferred vaccination discussions as a tool to building trust with families.Interventions aimed at helping providers deliver effective recommendations for timely HPV vaccination are needed. Our findings suggest that changing the norm of provider culture to one in which “catch-up” schedules are seen as a suboptimal way to achieve vaccine uptake may be an important goal.
机译：医疗保健提供者对人乳头瘤病毒（HPV）疫苗接种决定具有强大影响力，但他们常常无法向实践指南所针对的11岁和12岁儿童推荐该疫苗。我们试图了解医疗服务提供者如何解释和重视基于年龄的指南。我们对两项关于医疗服务提供者HPV疫苗接种态度和做法的定性研究进行了数据的二次分析。参加者分别是2012年和2014年在明尼苏达州（n = 27）和华盛顿州（n = 17）接受采访的医师，护理从业人员和医师助理。使用内容分析对来自每个研究的逐字记录进行独立分析，然后对共同的发现进行联合分析。该研究小组通过共识来制定代码并描述代表性主题。很大比例的提供者表示对HPV疫苗完成缺乏关注，或者对建议的目标年龄后几年开始关注。许多提供者认为HPV疫苗接种及时性的梯度范围从12岁到26岁。提供者不是基于年龄的建议，而是基于对获得医疗服务和患者风险的看法来对建议进行计时。他们经常提供“温和的”建议和推迟的疫苗接种讨论，以建立与家人的信任。需要采取干预措施，以帮助提供者为及时接种HPV疫苗提供有效的建议。我们的研究结果表明，将提供者文化规范更改为“追赶”时间表被视为实现疫苗摄入的次优方法可能是一个重要目标。

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