以提供者为中心的干预措施可最大限度地提高年轻癌症幸存者的 HPV 疫苗接种率
实施以提供者为中心的干预措施,以最大限度地提高在儿科肿瘤实践中接受后续护理的年轻癌症幸存者的 HPV 疫苗摄取:一项整群随机试验
研究概览
详细说明
由于持续感染人乳头瘤病毒 (HPV),儿童癌症幸存者患上新癌症(如宫颈癌和肛门癌)的风险很高。 与年龄和性别匹配的一般人群相比,女性和男性癌症幸存者患 HPV 相关恶性肿瘤的风险分别高出 1.4 至 2.5 倍。 幸运的是,由于非价 HPV 疫苗的可用性,与 HPV 相关的恶性肿瘤在很大程度上是可以预防的,该疫苗可针对约 90% 的致癌 HPV 亚型提供保护。 我们之前已经表明,与普通人群相比,癌症幸存者的 HPV 疫苗接种率显着降低(22.0% 在 13-17 岁的人群中这一比例为 42.5%),而缺乏医疗保健提供者的建议是癌症幸存者未接种 HPV 疫苗的最强预测因素。 在普通人群中提高 HPV 疫苗接种率最成功的策略侧重于提高医疗保健提供者对 HPV 疫苗的了解,提高医疗保健提供者向年轻人及其父母有效推荐疫苗所需的技能,并减少接受 HPV 疫苗的障碍疫苗。
本研究将评估基于证据的干预措施 (HPV-PROTECT) 的有效性和实施情况,该干预措施适合儿科肿瘤诊所的医疗保健提供者使用,以增加年轻癌症幸存者(9 至 17 岁及以上)的 HPV 疫苗接种率癌症治疗完成后至少一年)。 HPV-PROTECT 干预包括三个组成部分:i) 提供者沟通培训; ii) 评估和同行反馈/辅导; iii) 提供者工具包,旨在增加提供者关于在癌症幸存者人群中使用 HPV 疫苗的知识,提高提供者向年轻癌症幸存者的父母提供简短、令人信服的 HPV 疫苗建议的技能,向提供者提供有关诊所的持续反馈- 和提供者级别的幸存者 HPV 疫苗接种率,并通过提供疫苗行动计划减少幸存者接受疫苗的障碍。 如果该干预措施能够有效改善和维持年轻癌症幸存者对 HPV 疫苗的摄入增加,则该研究将提供重要信息,以推动测试该干预措施在儿科肿瘤学实践中的广泛应用。
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Alabama
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Birmingham、Alabama、美国、35233
- University of Alabama at Birmingham
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Georgia
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Atlanta、Georgia、美国、30322
- Emory University
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Minnesota
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Minneapolis、Minnesota、美国、55455-0341
- University of Minnesota
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North Carolina
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Winston-Salem、North Carolina、美国、27157-0001
- Wake Forest University Health Sciences
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Oregon
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Portland、Oregon、美国、97239-3098
- Oregon Health and Science University
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Texas
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Houston、Texas、美国、77030-3411
- Baylor College of Medicine
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
描述
纳入标准:
医疗保健提供者(肿瘤学家、高级实践提供者)
- ≥18岁
- 照顾在目标诊所就诊的年龄在 9-17 岁、停止治疗 ≥ 1 年且居住在诊所所在州的癌症幸存者
- 获准订购疫苗
- 愿意完成调查和/或采访
儿童癌症幸存者
- 9-17岁
- 完成癌症治疗后≥1y
- 居住在诊所所在的州
- 在参与地点接受后续护理(亲自或通过远程医疗)
排除标准:
不适用
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:顺序分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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其他:延迟干预
随机分配到延迟干预组(站点 A、B、C)的站点将在第 1 年和第 2 年分配到控制条件,在第 3 年分配到 HPV-PROTECT 干预,在第 4 年分配到可持续性条件
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HPV-PROTECT 是一种以提供者为中心的多组分干预措施,专门为儿科肿瘤学环境量身定制,解决重要的幸存者特异性疫苗问题。
该干预措施由三个部分组成,i) 供应商沟通培训; ii) 评估和同伴反馈/辅导; iii) 提供商工具包。
HPV-PROTECT 干预旨在增加提供者关于在癌症幸存者人群中使用 HPV 疫苗的知识,提高提供者向年轻癌症幸存者的父母提供简短、令人信服的 HPV 疫苗建议的技能,向提供者提供关于临床和提供者层面的幸存者 HPV 疫苗接种率,并通过提供适合当地情况的疫苗行动计划减少幸存者接受疫苗的障碍。
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其他:早期干涉
随机分配到早期干预组的站点(站点 D、E、F)将在第 1 年分配到控制条件,在第 2 年分配到 HPV-PROTECT 干预,在第 3 年和第 4 年分配到可持续性条件
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HPV-PROTECT 是一种以提供者为中心的多组分干预措施,专门为儿科肿瘤学环境量身定制,解决重要的幸存者特异性疫苗问题。
该干预措施由三个部分组成,i) 供应商沟通培训; ii) 评估和同伴反馈/辅导; iii) 提供商工具包。
HPV-PROTECT 干预旨在增加提供者关于在癌症幸存者人群中使用 HPV 疫苗的知识,提高提供者向年轻癌症幸存者的父母提供简短、令人信服的 HPV 疫苗建议的技能,向提供者提供关于临床和提供者层面的幸存者 HPV 疫苗接种率,并通过提供适合当地情况的疫苗行动计划减少幸存者接受疫苗的障碍。
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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HPV Vaccine Initiation Rates
大体时间:The survivor must have initiated the HPV vaccine as of the final day of the study year
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The primary outcome was the percentage of cancer survivors, age 9-17y and ≥1y post-completion of cancer therapy, who completed a clinic visit (in-person or via telehealth) at one of the participating sites during the study year, and who had initiated the HPV vaccine series as of the final day of the study year, as measured via state vaccine registry records.
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The survivor must have initiated the HPV vaccine as of the final day of the study year
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Provider Perspectives Regarding Intervention Feasibility, Acceptability, Appropriateness, Fidelity
大体时间:Qualitative interviews: Months 11-12 of the Intervention Year (i.e., Year 2 for sites D, E, F, and Year 3 for sites A, B, C); Quantitative survey: Administered to providers at end of pre-intervention, intervention, and sustainability phases of the study.
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Descriptive statistics summarizing provider survey data and qualititatively coded provider interview data were integrated to evaluate the feasability, acceptability, and appropriateness of the HPV-PROTECT intervention to the pediatric oncology setting, and provider adherence (fidelity) to intervention components.
Quantitative item: Change in healthcare provider practice of recommending HPV vaccine to their patients (item 13c): Percentage of participants reporting "often/always"
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Qualitative interviews: Months 11-12 of the Intervention Year (i.e., Year 2 for sites D, E, F, and Year 3 for sites A, B, C); Quantitative survey: Administered to providers at end of pre-intervention, intervention, and sustainability phases of the study.
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Change in Provider HPV Vaccine-related Knowledge
大体时间:Quantitative survey administered to providers at end of pre-intervention, intervention, and sustainability phases of the study.
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Change in healthcare provider HPV and HPV vaccine-related knowledge, as measured quantitatively via 16 survey items, and reported as a combined mean score of proportion of items answered correctly (lowest possible mean score: 0; highest possible mean score: 1.0).
A higher score indicates more HPV vaccine-related knowledge.
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Quantitative survey administered to providers at end of pre-intervention, intervention, and sustainability phases of the study.
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Change in Provider HPV Vaccine-related Practices
大体时间:Quantitative survey administered to providers at end of pre-intervention, intervention, and sustainability phases of the study.
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Change in HPV vaccine-related practices, as measured by the mean score +/- standard deviation of the healthcare provider survey responses to the following items: (a) "I order the HPV vaccine to be given to my patients in the pediatric oncology clinic" and (b) "I check to make sure that my patients complete the HPV vaccine series."
Each of these two items were rated by the providers using a Likert scale with the lowest possible score of 1 ("Never") and the highest possible score of 5 ("Always").
Outcomes are reported as the Mean and Standard Deviation of the Likert scale score for each of these two survey items.
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Quantitative survey administered to providers at end of pre-intervention, intervention, and sustainability phases of the study.
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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HPV Vaccine Series Completion Rates
大体时间:The survivor must have completed the 3-dose HPV vaccine series as of the final day of the study year
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The percentage of cancer survivors, age 9-17y and ≥1y post-completion of cancer therapy, who completed a clinic visit (in-person or via telehealth) at one of the participating sites during the study year, and who had completed the 3-dose HPV vaccine series as of the final day of the study year, as measured via state vaccine registry records.
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The survivor must have completed the 3-dose HPV vaccine series as of the final day of the study year
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Sustainability of HPV Vaccine Initiation Rates
大体时间:The survivor must have initiated the HPV vaccine as of the final day of the study year
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The percentage of cancer survivors, age 9-17y and ≥1y post-completion of cancer therapy, who completed a clinic visit (in-person or via telehealth) at one of the participating sites during the study year, and who had initiated the HPV vaccine series as of the final day of the study year, as measured via state vaccine registry records.
Applies only to the Sustainability condition.
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The survivor must have initiated the HPV vaccine as of the final day of the study year
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合作者和调查者
调查人员
- 首席研究员:Wendy Landier, PhD、University of Alabama at Birmingham
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- IRB-300005305
- 1U01CA246567-01A1 (美国 NIH 拨款/合同)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
在美国制造并从美国出口的产品
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