Abstract：
UNASSIGNED: In 2019, the United States Advisory Committee on Immunization Practices (ACIP) updated their meningococcal serogroup B (MenB) vaccination recommendation for 16-23-year-olds from individual to shared clinical decision-making (SCDM). SCDM recommendations are individually based and informed by a decision process between patients and healthcare providers (HCPs). MenB vaccination among 16-23-year-olds remains low. We examined recorded conversations in which MenB vaccine-related discussions between HCPs and patients/caregivers took place, and how these interactions changed following the updated SCDM recommendation.
UNASSIGNED: An analysis of recordings where MenB vaccination was discussed between HCPs and patients (16-23 years old)/caregivers was conducted using retrospective anonymized dialogue data (January 2015-October 2022). Shared decision-making strength was measured using a modified OPTION5 framework.
UNASSIGNED: Of 97 included recorded conversations, the average duration was 11.3 min. Within these conversations, MenB disease was discussed for 0.25 min (38.9% of words in total vaccine-preventable diseases discussion) and MenB vaccination was discussed for 1.36 min (60.9% of words in total vaccine discussion), on average. HCPs spoke 78.8% of MenB vaccine-related words and most (99.0%) initiated the MenB vaccination discussion. In 40.2% of recordings, HCPs acknowledged the MenB vaccine without providing a clear recommendation. HCP recommendations often favored MenB vaccination (87.0%) and recommendations were 21.4% stronger post-recommendation change to SCDM. As measured by the modified OPTION5 framework, most recordings did not reflect a high degree of shared decision-making between HCPs and patients/caregivers.
UNASSIGNED: MenB vaccination discussions were brief, and the degree of shared decision-making was low. Targeted education of HCPs and patients/caregivers may improve MenB vaccination awareness, SCDM implementation, and vaccine uptake.
Meningitis is a serious and sometimes deadly disease. In the United States (US), the Centers for Disease Control and Prevention (CDC) recommends that 16–23-year-olds get vaccinated against meningococcal serogroup B (MenB), which causes a specific type of meningitis called invasive meningococcal disease. As of 2019, the CDC recommends that healthcare providers and patients or their caregivers have a shared decision-making discussion about deciding to get vaccinated against MenB. Despite these recommendations, vaccination against MenB among 16–23-year-olds is very low. Only about 3 in 10 17-year-olds had received the MenB vaccine in 2022. We studied conversations between healthcare providers and patients or their caregivers that included discussions of MenB vaccination. These discussions were largely brief and led by the healthcare providers. We found that healthcare providers most often made recommendations that were in favor of their patients getting vaccinated against MenB. However, we also found that healthcare providers missed many opportunities to have these shared decision-making discussions about MenB vaccination with patients or their caregivers. Providing education and resources for patients, caregivers, and healthcare providers focused on increasing awareness about MenB vaccination and the role they can play in having shared decision-making discussions may lead to more adolescents and young adults getting vaccinated against MenB. More research is needed to find out how we can improve MenB vaccination coverage in the US.
UNASSIGNED: An analysis of recordings where MenB vaccination was discussed between HCPs and patients (16-23 years old)/caregivers was conducted using retrospective anonymized dialogue data (January 2015-October 2022). Shared decision-making strength was measured using a modified OPTION5 framework.
UNASSIGNED: Of 97 included recorded conversations, the average duration was 11.3 min. Within these conversations, MenB disease was discussed for 0.25 min (38.9% of words in total vaccine-preventable diseases discussion) and MenB vaccination was discussed for 1.36 min (60.9% of words in total vaccine discussion), on average. HCPs spoke 78.8% of MenB vaccine-related words and most (99.0%) initiated the MenB vaccination discussion. In 40.2% of recordings, HCPs acknowledged the MenB vaccine without providing a clear recommendation. HCP recommendations often favored MenB vaccination (87.0%) and recommendations were 21.4% stronger post-recommendation change to SCDM. As measured by the modified OPTION5 framework, most recordings did not reflect a high degree of shared decision-making between HCPs and patients/caregivers.
UNASSIGNED: MenB vaccination discussions were brief, and the degree of shared decision-making was low. Targeted education of HCPs and patients/caregivers may improve MenB vaccination awareness, SCDM implementation, and vaccine uptake.
Meningitis is a serious and sometimes deadly disease. In the United States (US), the Centers for Disease Control and Prevention (CDC) recommends that 16–23-year-olds get vaccinated against meningococcal serogroup B (MenB), which causes a specific type of meningitis called invasive meningococcal disease. As of 2019, the CDC recommends that healthcare providers and patients or their caregivers have a shared decision-making discussion about deciding to get vaccinated against MenB. Despite these recommendations, vaccination against MenB among 16–23-year-olds is very low. Only about 3 in 10 17-year-olds had received the MenB vaccine in 2022. We studied conversations between healthcare providers and patients or their caregivers that included discussions of MenB vaccination. These discussions were largely brief and led by the healthcare providers. We found that healthcare providers most often made recommendations that were in favor of their patients getting vaccinated against MenB. However, we also found that healthcare providers missed many opportunities to have these shared decision-making discussions about MenB vaccination with patients or their caregivers. Providing education and resources for patients, caregivers, and healthcare providers focused on increasing awareness about MenB vaccination and the role they can play in having shared decision-making discussions may lead to more adolescents and young adults getting vaccinated against MenB. More research is needed to find out how we can improve MenB vaccination coverage in the US.
摘要：
目标：2019年，美国免疫实践咨询委员会（ACIP）将其16-23岁人群的脑膜炎球菌血清群B（MenB）疫苗接种建议从个人更新为共享临床决策（SCDM）。SCDM建议是基于个人的，并由患者和医疗保健提供者（HCP）之间的决策过程提供信息。16-23岁青少年的MenB疫苗接种仍然很低。我们检查了记录的对话，其中HCP与患者/护理人员之间进行了与MenB疫苗相关的讨论，以及更新后的SCDM建议后这些交互如何变化。方法：使用回顾性匿名对话数据（8/2015-9/2022）对HCPs与患者（16-23岁）/护理人员之间讨论MenB疫苗接种的记录进行分析。使用修改后的OPTION5框架测量共享决策强度。结果：在97个记录的对话中，平均持续时间为11.3分钟.在这些谈话中,对MenB疾病进行了0.25分钟的讨论（占总疫苗可预防疾病讨论中的38.9％），对MenB疫苗接种进行了1.36分钟的讨论（占总疫苗讨论中的60.9％），平均而言。HCP说出了78.8％的MenB疫苗相关单词，大多数（99.0％）发起了MenB疫苗接种讨论。在40.2%的录音中，HCP承认MenB疫苗没有提供明确的建议。HCP建议通常支持MenB疫苗接种（87.0％），建议在推荐后更改为SCDM的建议为21.4％。根据修改后的OPTION5框架，大多数记录未反映HCP与患者/护理人员之间的高度共同决策.结论：MenB疫苗接种的讨论很简短，共同决策的程度很低。对HCPs和患者/护理人员进行有针对性的教育可能会提高MenB疫苗接种意识，SCDM实施，和疫苗摄取。
脑膜炎是一种严重且有时致命的疾病。在美国（US），疾病控制和预防中心（CDC）建议16-23岁的青少年接种脑膜炎球菌血清群B（MenB）疫苗，导致一种特殊类型的脑膜炎，称为侵袭性脑膜炎球菌病。截至2019年，CDC建议医疗保健提供者和患者或其护理人员就决定接种MenB疫苗进行共同的决策讨论。尽管有这些建议,在16-23岁的人群中，针对MenB的疫苗接种非常低。2022年，只有大约3/10的17岁儿童接种了MenB疫苗。我们研究了医疗保健提供者与患者或其护理人员之间的对话，其中包括对MenB疫苗接种的讨论。这些讨论在很大程度上是简短的，由医疗保健提供者领导。我们发现，医疗保健提供者最常提出的建议是支持他们的患者接种MenB疫苗。然而,我们还发现,医疗保健提供者错过了许多与患者或其护理人员进行这些关于MenB疫苗接种的共同决策讨论的机会.为患者提供教育和资源，看护者,医疗保健提供者专注于提高对MenB疫苗接种的认识，以及他们在共同决策讨论中可以发挥的作用，可能会导致更多的青少年和年轻人接种MenB疫苗。需要更多的研究来了解我们如何提高美国的MenB疫苗接种覆盖率。
脑膜炎是一种严重且有时致命的疾病。在美国（US），疾病控制和预防中心（CDC）建议16-23岁的青少年接种脑膜炎球菌血清群B（MenB）疫苗，导致一种特殊类型的脑膜炎，称为侵袭性脑膜炎球菌病。截至2019年，CDC建议医疗保健提供者和患者或其护理人员就决定接种MenB疫苗进行共同的决策讨论。尽管有这些建议,在16-23岁的人群中，针对MenB的疫苗接种非常低。2022年，只有大约3/10的17岁儿童接种了MenB疫苗。我们研究了医疗保健提供者与患者或其护理人员之间的对话，其中包括对MenB疫苗接种的讨论。这些讨论在很大程度上是简短的，由医疗保健提供者领导。我们发现，医疗保健提供者最常提出的建议是支持他们的患者接种MenB疫苗。然而,我们还发现,医疗保健提供者错过了许多与患者或其护理人员进行这些关于MenB疫苗接种的共同决策讨论的机会.为患者提供教育和资源，看护者,医疗保健提供者专注于提高对MenB疫苗接种的认识，以及他们在共同决策讨论中可以发挥的作用，可能会导致更多的青少年和年轻人接种MenB疫苗。需要更多的研究来了解我们如何提高美国的MenB疫苗接种覆盖率。
