确定系统级战略,在口腔卫生和初级保健机构中开展 HPV 预防工作。

IF 5.2 3区 医学 Q1 IMMUNOLOGY
Vaccines Pub Date : 2024-10-19 DOI:10.3390/vaccines12101194
Sarah B Maness, Kathleen L Egan, Leslie Sanchez, Mahmoud Al-Dajani, Essie Torres, Andres Flores, Alice R Richman
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引用次数: 0

摘要

导言:接种人乳头瘤病毒疫苗可预防大多数与人乳头瘤病毒相关的癌症,但接种率仍然很低。在美国,估计有 70% 的口咽癌 (OPC) 与人乳头瘤病毒有关,而且与人乳头瘤病毒相关的宫颈癌病例也多于人乳头瘤病毒。并非所有口咽癌都能通过常规筛查发现,因此接种 HPV 疫苗是一种更有效的初级预防策略。然而,由于诊所之间缺乏转诊网络,连接初级保健和口腔保健面临挑战。本研究旨在确定东南部某州牙科诊所学术实践网络和合作社区卫生诊所的关键基础设施要素和政策,以及 HPV 预防策略:研究人员对东南部某州的六家牙科诊所和八家相关社区诊所的主任进行了访谈,并对员工进行了焦点小组讨论。研究小组的两名成员使用 Nvivo 软件对牙科诊所和社区诊所的访谈和焦点小组进行了专题分析:共有 90 人参加了所有焦点小组和访谈(N = 14 个访谈,10 个焦点小组(每个焦点小组 5-13 人))。大多数参与者为白人(58.9%)和女性(70%),平均年龄为 38.5 岁。研究人员确定了 9 个关键研究主题:3 个与牙科诊所与患者的 HPV 对话有关,2 个与社区诊所的疫苗供应有关,4 个涉及牙科诊所与同处一地的社区诊所之间的关系。牙科诊所工作人员目前不与患者讨论 HPV。他们对与患者讨论人类乳头瘤病毒持开放态度,但预计会遇到一些障碍,需要做好克服这些障碍的准备。社区诊所曾在 HPV 疫苗接种方面取得过成功,但 18 岁以上的患者在接种疫苗方面面临经济障碍。社区诊所和牙科诊所表示,他们目前没有转诊网络,但如果有基础设施支持,他们愿意在诊所之间建立转诊系统:我们的调查结果表明,牙科患者有兴趣更多地讨论人乳头瘤病毒,牙科诊所和社区诊所之间也有可能在人乳头瘤病毒疫苗接种转介方面开展合作。这项调查的结果可用于制定干预策略,通过牙科诊所和附近社区诊所之间的转诊来提高 HPV 疫苗接种率。最终,这项工作可以减少人乳头瘤病毒相关癌症在健康方面的不平等,成为美国牙科实践的典范,并有可能影响公共卫生政策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identifying System-Level Strategies to Engage in HPV Prevention Across Oral Health and Primary Care Settings.

Introduction: HPV vaccination prevents most HPV-related cancers, yet uptake remains low. HPV is linked to an estimated 70% of oropharyngeal cancers (OPCs) in the US and outnumber cases of HPV-related cervical cancers. Not all OPCs can be detected through routine screening, making HPV vaccination a more effective primary prevention strategy. However, bridging primary and oral healthcare faces challenges due to a lack of referral networks between practices. The purpose of this study is to identify key infrastructure elements and policies, as well as HPV prevention strategies, among an academic practice network of dental clinics and partnering community health clinics in a southeastern state.

Methods: Researchers held interviews with directors and focus groups with staff at six dental clinics and eight associated community clinics in a southeastern state. Interviews and focus groups at dental and community clinics were analyzed by two study team members using thematic analysis with Nvivo software.

Results: A total of 90 participants participated in all focus groups and interviews (N = 14 interviews, 10 focus groups (5-13 participants per focus group). Most participants identified as white (58.9%) and female (70%), with an average age of 38.5 years. Researchers identified nine key study themes: three specific to the dental clinics' HPV conversations with patients, two related to community clinics' vaccine provision, and four involving the relationship between the dental and co-located community clinics. Dental clinic staff do not currently discuss HPV with patients. They are open to discussing HPV with patients but anticipate barriers that require preparation to overcome them. Community clinics have demonstrated previous success with HPV vaccination, but patients over the age of 18 face financial barriers to vaccination. Community clinics and dental clinics report that they do not currently have existing referral networks but are open to a referral system between practices if infrastructure is put into place to support it.

Conclusions: Our findings indicate that there is interest in, and potential for, increased discussion of HPV with dental patients and collaboration between dental and community clinics for HPV vaccination referral. The results of this investigation can be used to develop intervention strategies to increase HPV vaccination through referrals between dental clinics and nearby community clinics. Ultimately, this work can reduce health inequities in HPV-related cancers, serve as a model for US dental practices, and possibly influence public health policy.

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来源期刊
Vaccines
Vaccines Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
8.90
自引率
16.70%
发文量
1853
审稿时长
18.06 days
期刊介绍: Vaccines (ISSN 2076-393X) is an international, peer-reviewed open access journal focused on laboratory and clinical vaccine research, utilization and immunization. Vaccines publishes high quality reviews, regular research papers, communications and case reports.
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