Leshem Edan, Malone Sara, Solsrud Andrew, Dodd Sherry, Rook Shannon, Graham Sharon, Ericson Lauren, Wang Ruoyun, Plax Katie, Newland Jason
Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
Pediatric Infectious Diseases, Nationwide Children's Hospital, Columbus, OH, USA.
BMC Pediatr. 2024 Dec 19;24(1):824. doi: 10.1186/s12887-024-05169-0.
Human papillomavirus (HPV), a common sexually transmitted infection in the US, contributes to oropharyngeal and urogenital cancers. To improve HPV vaccine uptake, quality improvement (QI) interventions that address barriers to vaccination in primary care may help. This study aims to understand pediatric primary care providers' (PCP) perspectives on participating in an HPV QI intervention that utilized practice facilitation to improve HPV vaccine uptake in pediatric primary care clinics.
Participants were pediatric PCPs whose clinics completed a QI intervention that utilized practice facilitation led by an outside facilitator. One PCP from each practice completed a 15-min semi-structured exit interview. The interview guide contained questions about PCPs' experiences during the intervention, skills learned, and thoughts on the use of practice facilitation. Transcribed interviews were analyzed with consensual inductive and deductive techniques.
Ten participants completed the interview. PCPs had a median experience of 13 years (range: 0-20) in practice, most were female (8/10), white (8/10), and non-Hispanic (9/10). PCPs reported positive experiences and the intervention encouraged them to investigate their current and target vaccination rates more thoroughly. Frequently mentioned practice-wide changes included consistent messaging among all PCPs and staff in a clinic which also extended to other aspects of their care. PCPs liked facilitation and thought that it motivated change. Although they appreciated the flexibility of virtual facilitation meetings with the practice facilitator, they recommended less frequent sessions, focusing some meetings on HPV misinformation, and more support during the intervention (e.g., analyzing data in the context of the practice's outcomes, communication between participating practices).
PCPs viewed the facilitation HPV intervention positively. Areas that would improve the intervention include addressing the timing and duration of facilitation sessions, communication strategies, and logistical support (e.g., evidence-based resources for patient education, technological support for data analysis).
人乳头瘤病毒(HPV)是美国一种常见的性传播感染,可导致口咽癌和泌尿生殖系统癌症。为提高HPV疫苗接种率,针对初级保健中疫苗接种障碍的质量改进(QI)干预措施可能会有所帮助。本研究旨在了解儿科初级保健提供者(PCP)对参与一项HPV QI干预措施的看法,该干预措施利用实践促进来提高儿科初级保健诊所的HPV疫苗接种率。
参与者为其诊所完成了一项QI干预措施的儿科PCP,该干预措施利用外部促进者引导的实践促进。每个诊所的一名PCP完成了一次15分钟的半结构化离职访谈。访谈指南包含有关PCP在干预期间的经历、学到的技能以及对实践促进使用的看法的问题。使用共识归纳和演绎技术对转录的访谈进行分析。
10名参与者完成了访谈。PCP的实践经验中位数为13年(范围:0 - 20年),大多数为女性(8/10)、白人(8/10)和非西班牙裔(9/10)。PCP报告了积极的经历,并且该干预措施鼓励他们更彻底地调查当前和目标疫苗接种率。经常提到的全诊所范围的变化包括诊所所有PCP和工作人员之间一致的信息传递,这也扩展到了他们护理的其他方面。PCP喜欢促进并认为它推动了变革。尽管他们赞赏与实践促进者进行虚拟促进会议的灵活性,但他们建议减少会议频率,将一些会议重点放在HPV错误信息上,并在干预期间提供更多支持(例如,根据诊所结果分析数据、参与诊所之间的沟通)。
PCP对促进HPV干预措施持积极看法。可以改进该干预措施的方面包括解决促进会议的时间和持续时间、沟通策略以及后勤支持(例如,基于证据的患者教育资源、数据分析的技术支持)。