An Educational Intervention to Improve HPV Vaccination: A Cluster Randomized Trial
Mené aux Etats-Unis auprès de parents de 1 596 adolescents âgés entre 11 et 17 ans, cet essai randomisé évalue l'effet, sur leur choix de faire vacciner ou non leur enfant, d'une intervention pédagogique dispensée en salle d'examen à partir d'un support vidéo et expliquant les risques et les bénéfices d'une vaccination contre le papillomavirus
BACKGROUND: Human papillomavirus (HPV) infection can lead to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal.
METHODS: In a cluster randomized trial, an intervention used to target parents of adolescents (11–17 years) eligible for a dose of HPV vaccine, was tested in pediatric clinics part of an urban health system. Parents watched a digital video outlining the risks and benefits of vaccine using a tablet in the examination room. The primary outcome was change in HPV vaccine status 2 weeks after the clinic visit. An intention-to-treat analysis for the primary outcome used generalized estimating equations to accommodate the potential cluster effect of clinics.
RESULTS: A total of 1596 eligible adolescents were observed during the 7-month trial. One-third of adolescents visited an intervention clinic. Adolescents who attended an intervention clinic were more likely to be younger (11–12 years) than those who attended a control clinic (72.4% vs 49.8%; P < .001). No differences in race or sex were observed. The proportion of adolescents with an observed change in vaccine status was higher for those attending an intervention clinic (64.8%) versus control clinic (50.1%; odds ratio, 1.82; 95% confidence interval, 1.47–2.25; P < .001). Adolescents whose parents watched the video had a 3-times greater odds of receiving a dose of the HPV vaccine (78.0%; odds ratio, 3.07; 95% confidence interval, 1.47–6.42; P = .003).
CONCLUSIONS: Educational interventions delivered within a clinical setting hold promise to improve vaccination behaviors.
Pediatrics , résumé, 2017