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Implementation of a Postpartum HPV Vaccination Program in a Southeast Texas Hospital: A Qualitative Study Evaluating Health Care Provider Acceptance

机译:在德克萨斯州东南部医院实施产后HPV疫苗接种计划:一项定性研究,评估医疗保健提供者的接受程度

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Introduction The objective of this qualitative study was to assess healthcare providers' acceptability of an ongoing postpartum human papillomavirus (HPV) vaccination program in Southeast Texas and its integration into everyday clinical care. Methods In 2012, the Department of Obstetrics & Gynecology at the University of Texas Medical Branch (UTMB) began offering HPV vaccination as part of standard postpartum care to increase vaccination rates among young women in Galveston County. Initial vaccine doses were offered on the postpartum unit while subsequent doses were coordinated with postpartum and well-baby visits. Thirty months after project initiation, semi-structured interviews of physicians (n = 12) and nurses (n = 6) involved in postpartum and pediatric care at UTMB were conducted. Interview transcripts were analyzed using thematic analysis in Nvivo10. Results Overall, providers demonstrated "pro-vaccine" attitudes and stated the program was an effective strategy for vaccinating hard-to-reach women. Cancer prevention was the main perceived benefit while follow-up compliance was the primary perceived patient barrier. The initial challenges with integrating postpartum HPV vaccination included miscommunication between providers regarding vaccine orders and coordination issues with well-baby visits for follow-up doses. One novel finding was providers' beliefs that women's personal HPV vaccine practices may positively impact their decisions about later vaccinating their children against HPV. Providers' suggestions to improve the program included: enhancing postpartum HPV vaccine education for patients, offering more continuing education for providers, and increasing community awareness of HPV vaccination. Discussion These findings can help providers of postpartum care understand how to integrate postpartum HPV vaccination into their current practices and how to overcome perceived vaccination barriers.
机译:引言这项定性研究的目的是评估医疗保健提供者对德克萨斯州东南部正在进行的产后人乳头瘤病毒(HPV)疫苗接种计划的接受程度,并将其纳入日常临床护理中。方法2012年,德克萨斯大学医学分院(UTMB)的妇产科开始提供HPV疫苗接种,作为标准的产后护理的一部分,以提高加尔维斯顿县年轻女性的疫苗接种率。产后单位提供最初的疫苗剂量,随后的剂量要与产后和良好的就诊时间协调。项目启动后的30个月,对参与UTMB产后和儿科护理的医生(n = 12)和护士(n = 6)进行了半结构化访谈。访谈记录在Nvivo10中使用主题分析进行了分析。结果总体而言,提供者表现出“亲疫苗”态度,并表示该计划是为难以接触的妇女接种疫苗的有效策略。预防癌症是主要的感知益处,而随访依从性是主要的感知患者障碍。整合产后HPV疫苗接种的最初挑战包括提供者之间在疫苗订购方面的沟通不畅以及协调问题以及对婴儿进行后续剂量的拜访。提供者的一项新发现是服务提供者认为,妇女的个人HPV疫苗接种做法可能会对她们以后为孩子接种HPV疫苗的决定产生积极影响。提供者改善该计划的建议包括:加强对患者的产后HPV疫苗教育,为提供者提供更多的继续教育,以及提高社区对HPV疫苗接种的认识。讨论这些发现可以帮助产后护理提供者了解如何将产后HPV疫苗接种纳入其目前的做法以及如何克服已知的疫苗接种障碍。

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