在初级保健中增加人类乳头瘤病毒疫苗接种率的多元组件策略:集群随机临床试验
Ruoyun Wang1, Lei Liu2, Sherry Dodd1
1Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri.
JAMA network open
|February 26, 2026
概括
多组件策略在13岁时没有显著增加人类乳头瘤病毒 (HPV) 疫苗接种率. 然而,针对HPV疫苗启动的干预效应随着时间的推移显著增加,这表明可能需要更长的评估期.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 儿科 儿科 儿科
背景情况:
- 人类乳头瘤病毒 (HPV) 疫苗接种对于预防HPV相关癌症至关重要.
- 目前在初级保健机构的HPV疫苗接种率低于国家目标.
- 需要评估改善及时接种HPV疫苗的策略.
研究的目的:
- 评估多组分干预措施的有效性,旨在增加HPV疫苗接种率,并在13岁之前完成疫苗接种.
- 确定实践促进,审计和反,教育和沟通的综合战略是否可以改善HPV疫苗接种率.
主要方法:
- 一个集群随机临床试验,涉及20个初级保健儿科实践.
- 干预包括24个月的实践便利,审计/反,教育和沟通策略.
- 主要结局测量了13岁时开始和完成HPV疫苗接种,并在24个月和36个月评估.
主要成果:
- 在24个月后,干预组和对照组之间没有观察到HPV疫苗接种开始或完成率的显著差异.
- 在36个月后,启动率分别为82.0% (干预) 和74.6% (控制),完成率分别为57.8%和49.9%.
- 虽然整体差异并不显著,但疫苗接种启动的干预效应随着时间的推移显示出统计学上显著的增加 (P=.04).
结论:
- 测试的多组件干预措施在评估的时间范围内,在13岁时没有显著改善HPV疫苗接种率.
- 随着时间的推移,观察到的干预效应增加的趋势表明,以系统为中心的策略可能需要更长的评估期.
- 进一步的研究可能会探索优化干预组件或持续时间,以对青少年疫苗接种产生持续影响.
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