PDF(Pubmed)
Abstract：
Cervical cancer remains a public health issue in the United States, particularly among stigmatized racial and ethnic populations. The human papillomavirus (HPV) vaccine has been clinically proven to prevent cervical cancers, and other HPV-associated cancers, among men and women. However, HPV vaccine uptake is suboptimal; only 55% of adolescents complete the two-dose series by age 15. Past research has shown that provider HPV vaccine communication for people of marginalized races/ethnicities is subpar. This article focuses on provider communication strategies to promote HPV vaccine uptake effectively and equitably. The authors reviewed the literature on evidence-based patient-provider HPV vaccine communication techniques to create a set of communication language providers could use and avoid using to enhance HPV vaccine acceptance and uptake among adolescents of marginalized racial and ethnic groups. Evidence has shown that information and the manner of dissemination are critical for influencing HPV vaccine uptake. These communication strategies must be suited to the context of the targeted population, and the message content can be broadly categorized into source, content, and modality. Strategies to improve patient-provider communication among adolescents of color using source, modality, and content include the following: (1) Source: increase provider self-efficacy to provide the recommendation, building rapport between providers and parents; (2) Content: persistent, forceful language with minimal acquiescence should be employed, reframing the conversation focus from sex to cancer; and (3) Modality: use multiple vaccine reminder modalities, and work with the community to culturally adapt the vaccination language. Utilizing effective behavior-change communication adapted for adolescents of color can reduce missed opportunities for HPV prevention, potentially decreasing racial and ethnic disparities in HPV-related morbidity and mortality.
摘要：
宫颈癌仍然是美国的公共卫生问题，特别是在被污名化的种族和族裔人群中。人乳头瘤病毒（HPV）疫苗已被临床证明可以预防宫颈癌，和其他HPV相关的癌症，在男人和女人之间。然而,HPV疫苗的摄取次优；只有55％的青少年在15岁时完成了两次剂量系列。过去的研究表明，为边缘化种族/种族的人提供HPV疫苗的沟通是不够的。本文重点介绍提供者沟通策略，以有效和公平地促进HPV疫苗的摄取。作者回顾了有关基于证据的患者提供者HPV疫苗沟通技术的文献，以创建一套沟通语言提供者可以使用和避免使用来增强边缘化种族和族裔青少年对HPV疫苗的接受度和吸收。证据表明，信息和传播方式对于影响HPV疫苗的摄取至关重要。这些沟通策略必须适合目标人群的情况，消息内容可以大致分为来源，内容,和模态。改善青少年色彩使用来源的患者与提供者沟通的策略，模态，内容包括以下内容:(1)来源:提高提供者自我效能提供推荐,在提供者和父母之间建立融洽的关系；(2)内容：持久的，应采用最少默许的有力语言，将谈话重点从性转向癌症；以及(3)模式：使用多种疫苗提醒模式，并与社区合作，在文化上适应疫苗接种语言。利用适合有色人种青少年的有效行为改变沟通可以减少错过的HPV预防机会，可能减少HPV相关发病率和死亡率的种族和族裔差异。
