多层次干预和人类乳头瘤病毒疫苗接种差异:对集群随机试验的二次分析
Wei Yi Kong1, Lila J Finney Rutten1,2, Jeph Herrin3,4
1Division of Epidemiology, Mayo Clinic, Rochester, Minnesota.
JAMA network open
|July 7, 2025
概括
多层次干预增加了大多数儿童的人类乳头瘤病毒 (HPV) 疫苗接种率. 然而,这项干预措施对黑人儿童,农村地区的儿童和最贫困社区的儿童有效性有限,这突显了HPV疫苗接种率的差异.
科学领域:
- 公共卫生 公共卫生
- 疫苗学 疫苗学 疫苗学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 人类乳头瘤病毒 (HPV) 疫苗接种在不同的人口群体中有所不同,导致对HPV相关癌症的保护不平等.
- 识别HPV疫苗接种方面的差异对于制定有针对性的公共卫生干预措施至关重要.
研究的目的:
- 评估多层次干预措施在提高11至12岁儿童HPV疫苗接种率方面的有效性.
- 确定干预对HPV疫苗接种启动和完成的影响是否因种族和种族,农村和地区贫困指数 (ADI) 而有所不同.
主要方法:
- 在6个初级保健实践中进行了一项阶梯集群随机试验.
- 干预涉及家长提醒/召回信和医疗保健专业人员审计/反报告.
- 分析了HPV疫苗启动和完成率,二次分析侧重于亚组差异.
主要成果:
- 多层次干预显著增加了大多数儿童的HPV疫苗启动和完成.
- 然而,对于黑人,生活在农村地区或居住在最高贫困四分位数 (ADI Q4) 的儿童来说,干预措施的效果较低.
- 疫苗接种率通常随着ADI的增加而下降,即使是在干预期间.
结论:
- 虽然多层次干预改善了HPV疫苗接种覆盖率,但它的有效性在社会经济弱势和农村人口中是有限的.
- 需要有针对性的策略来解决差异,并改善服务不足儿童的HPV疫苗接种率.
- 进一步的研究应侧重于为贫困地区的家庭开发有效的干预措施,以减少HPV疫苗接种差距.
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