Influence of patient's relationship status and HPV history on physicians' decisions to recommend HPV vaccination

This study asked whether physicians would prioritize HPV vaccination on the basis of a young woman's relationship status and HPV history (i.e., abnormal Pap test, HPV infection or HPV-related disease). Eight hundred physicians identified as HPV vaccinators in a US claims database were surveyed. Prioritization was assessed on a 0-10 rating scale (from extremely low to extremely high priority). Physicians gave lower priority to vaccinating patients who were married or in a long-term monogamous relationship, with mean (SD) scores of 5.76 (2.82) and 6.80 (2.48), respectively, than for patients who were single and either dating or not dating, with mean (SD) scores of 9.8 (0.68) and 9.22 (1.61), respectively; p < .0001 for all pair-wise comparisons. Physicians did not differentially prioritize vaccination on the basis of previous HPV-related disease or abnormal Pap test. Despite epidemiologic evidence that women in long-term relationships remain at risk for HPV infection, physicians gave them lower priority for vaccination.     

Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children

PurposeWe tested the hypotheses that consistency and strength of clinician recommendation of the human papillomavirus (HPV) vaccination would be associated with vaccine delivery rates.MethodsFrom October 2015 through January 2016, we conducted a survey of primary care clinicians (n = 227) in Southeastern Minnesota to evaluate clinician behaviors regarding HPV vaccination. The survey response rate was 41.0% (51 clinical sites). We used the Rochester Epidemiology Project, a clinical data linkage infrastructure, to ascertain clinical site-level HPV vaccination rates. We examined associations of clinician self-reports of both the consistency and strength of their recommendations for HPV vaccination for patients aged 11–12 years (n = 14,406) with site-level vaccination rates.ResultsThe majority of clinicians reported consistently (always or usually) recommending the HPV vaccine to females (79.0%) and to males (62.2%); 71.9% of clinicians reported strongly recommending the vaccine to females while 58.6% reported strongly recommending to males. Consistency and strength of recommending the HPV vaccine was significantly higher among those practicing in pediatrics and board certified in pediatrics compared to family medicine. Higher rates of initiation (1 dose) [Incidence Rate Ratio (IRR) = 1.05; 95% CI (1.01–1.09)] and completion (3 doses) [IRR = 1.08; 95% CI (1.02–1.13)] were observed among clinical sites where, on average, clinicians more frequently reported always or usually recommending the vaccine for females compared to sites where, on average, clinicians reported recommending the vaccine less frequently. Similarly, higher rates of initiation [IRR = 1.03; 95% CI (1.00–1.06)] and completion [IRR = 1.04; CI (1.00, 1.08)] were observed among sites where clinicians reported strongly recommending the vaccine to females more frequently compared to sites where, on average, clinicians reported strongly recommending the HPV vaccine less frequently; similar associations were observed for male initiation [IRR = 1.05; CI (1.02,1.08)] and completion [IRR = 1.05; 95% CI (1.01, 1.09)].ConclusionsConsistency and strength of HPV vaccination recommendation was associated with higher vaccination rates.     

Rapid surveillance for health events following a mass meningococcal B vaccine program in a university setting: A Canadian Immunization Research Network study

An outbreak of Neisseria meningitidis serotype B infection occurred at a small residential university; public health announced an organizational vaccination program with the 4-component Meningococcal B (4CMenB) vaccine (Bexsero^TM, Novartis/GlaxoSmithKline Inc.) several days later. Since there were limited published data on reactogenicity of 4CMenB in persons over 17 years of age, this study sought to conduct rapid surveillance of health events in vaccinees and controls using an online survey. Vaccine uptake was 84.7% for dose 1 (2967/3500) and 70% (2456/3500) for dose 2; the survey response rates were 33.0% (987/2967) and 18.7% (459/2456) in dose 1 and dose 1 recipients respectively, and 12% in unvaccinated individuals (63/533). Most students were 20–29 years of age (vaccinees, 64.0%; controls, 74.0). A new health problem or worsening of an existing health problem was reported by 30.0% and 30.3% of vaccine recipients after doses 1 and 2 respectively; and by 15.9% of controls. These health problems interfered with the ability to perform normal activities in most vaccinees reporting these events (74.7% post dose 1; 62.6% post dose 2), and in 60% of controls. The health problems led to a health care provider visit (including emergency room) in 12.8% and 14.4% of vaccinees post doses 1 and 2, respectively and in 40% of controls. The most common reactions in vaccinees were injection site reactions (20.6% post dose 1, 16.1% post dose 20 and non-specific systemic complaints (22.6% post dose 1, 17.6% post dose 2). No hospitalizations were reported. An online surveillance program during an emergency meningococcal B vaccine program was successfully implemented, and detected higher rates of health events in vaccinees compared to controls, and high rates of both vaccinees and controls seeking medical attention. The types of adverse events reported by young adult vaccinees were consistent with those previously.     

HPV vaccination series completion and co-vaccination: Pairing vaccines may matter for adolescents

Very little is known about the effect of concurrent co-vaccination on HPV series completion. This study utilized a retrospective review of a Clinical Data Repository to assess whether concurrent vaccination had an impact on HPV vaccination series completion, and whether there were differences based on age. 3371 patients who received the HPV vaccine at a single academic medical center between the years 2009–2013 were included in this analysis. The adjusted odds ratio (aOR) for effect of concurrent vaccination on series completion for the age group 9–18 was 1.32 (95% CI 1.09, 1.60). Although not statistically significant, the aOR for effect of concurrent vaccination on completion changed direction for the 19–25 age group and was 0.44 (95% CI 0.17, 1.12). This study provides preliminary evidence that pairing the HPV vaccine with one or more co-vaccines may yield a higher HPV vaccination completion rate among adolescents age 9–18.     

Outsmart HPV: Acceptability and short-term effects of a web-based HPV vaccination intervention for young adult gay and bisexual men

BackgroundEffective interventions to promote human papillomavirus (HPV) vaccination are needed, particularly among populations at increased risk of HPV-related disease. We developed and pilot tested a web-based intervention, Outsmart HPV, to promote HPV vaccination among young gay and bisexual men (YGBM).MethodsIn 2016, we recruited a national sample (n = 150) of YGBM ages 18–25 in the United States who had not received any doses of HPV vaccine. Participants were randomized to receive either standard HPV vaccination information (control) or population-targeted, individually-tailored content (Outsmart HPV intervention). We assessed between group differences in HPV vaccination attitudes and beliefs immediately following the intervention using multiple linear regression.ResultsThere were no differences in HPV vaccination attitudes, beliefs and intentions between groups at baseline. Compared to participants in the control group, intervention participants reported: greater perception that men who have sex with men are at higher risk for anal cancer relative to other men (b = 0.34); greater HPV vaccination self-efficacy (b = 0.15); and fewer perceived harms of HPV vaccine (b = −0.34) on posttest surveys (all p < .05). Overall, intervention participants reported high levels of acceptability and satisfaction with the Outsmart HPV intervention (all > 4.4 on a 5-point scale).ConclusionsFindings from this study provide preliminary support for a brief, tailored web-based intervention in improving HPV vaccination attitudes and beliefs among YGBM. An important next step is to determine the effects of Outsmart HPV on HPV vaccine uptake.Clinical trials registrationClinicalTrials.gov identifier NCT02835755.     

Using the Theory of Planned behavior to identify correlates of HPV vaccination uptake among college students attending a rural university in Alabama

IntroductionHumanpapillomavirus (HPV) has infected nearly 80 million people in the U.S., and is associated with most cervical cancer cases. Alabama ranks first in the country for cervical cancer mortality and third for incidence. Although the HPV vaccine can prevent HPV and reduce cancer rates, Alabama is well-below the national average for HPV vaccination. Using the Theory of Planned Behavior (TPB), this Alabama-based study aimed to examine college students’ intentions to get the HPV vaccine; to examine the relationship between the relationship between religious beliefs and HPV vaccination uptake status among college students.MethodsStudents (n = 257) from a university in rural Alabama completed the survey. Multiple regression analysis, Mann-Whitney U tests, and moderation analysis were used to examine associations among the variables of interest.FindingsConsistent with TPB, results showed that attitudes and subjective norms were significant predictors of intention to get vaccinated. Knowledge that both sexes can experience HPV-related health problems, that HPV can cause genital warts, and that the vaccine protects against HPV were each associated with higher attitude scores. The results indicated that the odds of getting at least one HPV shot were higher for females than for males for non-Caucasians than for Caucasians. Students who were not vaccinated were more likely to report that religion influenced their health beliefs. *Abstract.ConclusionTPB was helpful in understanding HPV-related intentions. Communication and education efforts are needed to increase understanding of HPV illnesses and HPV vaccination benefits among peers, parents, and other loved ones of students. in the rural areas of Alabama.     

上海某社区工作人员和医务人员对HPV及疫苗的认知调查

目的:了解上海市浦东新区高桥镇社区工作人员和医务人员对人乳头瘤病毒(HPV)及其疫苗的认知和态度,为已上市的HPV疫苗推广提供基础资料。方法:以高桥镇所辖区各居民委员会工作人员和2所社区卫生服务中心医务人员为研究对象,以填写调查问卷的形式进行调查。结果:社区工作人员和医务人员在HPV传播途径(81.81%vs. 85.79%)和高危因素(31.06%vs. 39.47%)两项知识认知情况中,差异无统计学意义(P>0.05);在其他HPV基本知识的比较中,医务人员掌握情况比社区工作人员好(均P<0.05)。二者在是否愿意自己或配偶接种和是否愿意让女儿接种的问题上,差异有统计学意义(P<0.05),社区工作人员更愿意自己或配偶接种疫苗,而让女儿接种的意愿低于医务人员。社区工作人员和医务人员在HPV疫苗可接受的来源、付费途径、价格、选择种类及接种地点的选择上,差异均有统计学意义(P<0.05),社区工作人员更倾向于接受由政府提供的疫苗,更青睐用较少的花费得到较多的效益。直系及三代以内旁系亲属中有癌症患者是社区工作人员和医务人员HPV疫苗接种意愿的影响因素(OR=4.006,95%CI:2.071~7.747,P=0.000)。结论:应加强社区工作人员和医务人员对于HPV预防措施和感染高危因素等知识的学习;对于HPV疫苗的宣传应将重点放在疫苗的安全性和功效性上,并应根据人群的健康观状况采取针对性的宣教;在疫苗的采购上宜由政府介入,规模化采购。     

宁夏地区大学生紧急避孕知识现状调查分析

目的了解宁夏地区两所高校在校大学生紧急避孕知识掌握情况,为开展在校大学生生殖健康教育提供依据。方法在宁夏地区选择两所本科高校,采用整群抽样方法,在每所高校的1～3年级本科班中抽取4个班级,4年级抽取1个班级,采取现场自填问卷形式对其进行调查。采用Epidata3.0对问卷核查录入,数据采用SPSS17.0软件包进行统计分析。结果两所高校回汉族4个年级1 721名男女大学生中听说过紧急避孕的占71.2%,但近80%的人完全不了解具体的紧急避孕方法。不同学校(χ2=0.97)、回汉族(χ2=0.54)及不同年级间(χ2=1.89)比较差异均无统计学意义(P<0.05);男女生(χ2=4.9)比较差异有统计学意义(P=0.03))。对听说过紧急避孕的同学,进一步比较其对紧急避孕方法的使用方法、作用机理、不良反应、适应证方面的认识发现,不同院校同学在不良反应、适应证方面的认识差异有统计学意义(P<0.05),而在使用方法和作用机理方面的认识差异无统计学意义(P>0.05);回汉族同学对紧急避孕的知识比较差异无统计学意义(P>0.05);不同年级及男生和女生对紧急避孕的使用方法、适应证、不良反应、作用机理方面的认识差异有统计学意义(P<0.05)。结论宁夏地区大学生紧急避孕知识均较欠缺,对相关知识信息等服务具有很大需求。     

1994～2003年全国各类学校食物中毒事件分析

目的 研究近10a来全国学校食物中毒的状况和特点，以便为预防和控制学校食物中毒事件提供依据。方法通过中国期刊网，检索1994～2003年报道的全国学校食物中毒资料，相关内容过录到调查表中，采用SAS8．1软件统计分析。结果10a间共发生学校食物中毒298起，中毒人数23996人。每年中毒人数、中毒次数未见下降趋势。其特点是食物中毒事件多发生在每年的二、三季度。298起食物中毒事件中中学占38，26％，大中专院校占26，51％，小学占23，49％，幼托机构占11，74％；微生物性食物中毒占60．40％、化学性的占23．15％，植物毒素的占13．09％。因加工不当、原料污染、生熟交叉导致的食物中毒分别占40.27％，19.13％和11.41％；65．10%中毒食品来源于学校食堂，来源于个体摊点和批发零售的占18.45％。结论进一步开展卫生法规和食品卫生知识宣传，提高卫生意识．加大监督、监测力度可有效预防学校食物中毒事件的发生。     

The controversy on HPV vaccination in Japan: Criticism of the ethical validity of the arguments for the suspension of the proactive recommendation

The Human Papillomavirus (HPV) vaccine was integrated into Japan’s national immunization program (NIP) in April 2013. However, numerous instances of serious adverse reactions were widely reported in the media, resulting in the Ministry of Health, Labor, and Welfare (MHLW) suspending the official recommendation of the HPV vaccine on June 14, 2013. Investigating the reported incidents, the Vaccine Adverse Reactions Review Committee (VARRC)—an MHLW advisory committee—found no high-quality evidence supporting a causal relationship between the reported events and the HPV vaccination. However, rather than lifting the suspension, they have opted to maintain a “pseudo informed consent” confirming the perceptions of Japanese citizens regarding the vaccine. Accordingly, there appears to be a fundamental difference in the approach to vaccine policymaking between Japan (MHLW/VARRC) and other countries and the World Health Organization, which base policy decisions on the effectiveness and safety of the vaccine. Consequently, the arguments for the suspension of the HPV vaccine recommendation are not ethically appropriate. Relevant bodies must make a clear decision regarding the HPV vaccine and its status in the NIP: the proactive recommendation must either be reinstated or the HPV vaccine legal framework altered to rely entirely on voluntary individual decisions.     

一起使用未经消毒河水致学校甲肝爆发的流行病学调查

目的了解某中学甲肝爆发的原因，为有效开展学校传染病防治工作提供参考。方法应用描述性流行病学方法分析病例的分布情况，提出初步病因假设，进行病例对照研究、访谈、现场观察和实验室检测，进一步验证假设。结果甲肝病例发病时间为2006年11月2日-12月8日，爆发时间为11月13日-12月8日，发病高峰为11月28日。男生罹患率显著高于女生；学生年龄越小，罹患率越高；病例有班级和宿舍集聚性。病例对照研究结果显示，使用河水洗手显著增加学生发生甲肝的相对危险性，是仅使用自来水洗手学生的7．53倍，且使用河水洗手次数越多，危险性越高。混用喝水杯也显著增加发生甲肝的相对危险性。病例组与对照组的饮食和饮水差异均无统计学意义（P〉0．05）。现场调查显示，该校取水口处于厕所排污口的下游，学校使用的河水被甲肝病毒污染。结论此次疫情爆发主要是由于早期发病的学生污染了河水，其他学生使用被污染的河水洗手、刷牙、漱口和刷碗，从而引起学校甲肝爆发。密切接触以及甲肝免疫空白也是此次疫情发病数较多的原因之一。     

Immunization effects of a communication intervention to promote preteen HPV vaccination in primary care practices

ObjectivesHPV vaccination at the recommended ages of 11–12 is highly effective yet has stalled well below the goal of 80% of the population. We evaluated a statewide practice-based communication intervention (tools: brochures, posters, online training for providers and resources for parents, video game for preteens) to persuade parents, preteens and providers to vaccinate against HPV. The 9-month intervention started May 1, 2015.MethodsWe compared vaccine initiation and completion rates over three 9-month periods (baseline, intervention, post-intervention) between practices enrolled in the intervention and a comparable comparison group. All practices reported to the North Carolina Immunization Registry (NCIR) and had at least 100 11- and 12-year-olds who had not completed the HPV vaccine series. Of 175 eligible practices, the 14 intervention practices included 19,398 individuals and the 161 comparison practices included 127,896 individuals. An extended Cox model was used to test the intervention effect.ResultsThe intervention had a significant effect on both initiation and completion during the intervention and post-intervention periods; the estimated hazard ratio (HR) for initiation was 1.17 (p = .004) during the intervention and 1.11 (p = .005) post-intervention. Likewise, completion during the intervention period was 17% higher in intervention practices, after controlling for baseline differences. This effect increased in the post-intervention period to 30% higher (p = .03).ConclusionsIndividuals in the intervention practices were 17% more likely to initiate and complete HPV vaccination than in the comparison practices during the intervention period and the effect was sustained post-intervention. This intervention is promising for increasing rates of HPV vaccination at ages 11–12.     

中西部地区女大学生HPV疫苗接种意愿的影响因素研究

目的 了解中西部地区女大学生HPV疫苗的接种意愿及相关影响因素。方法 2020年2月至4月,采用便利抽样、分层抽样和整群抽样相结合的方法,选择四川省某高校6个学院和山西省某高校2个学院的大一女生作为研究对象进行问卷调查。采用基于信息—动机—行为技巧（information-motivation-behavior skills, IMB）模型的问卷收集个人基本信息、HPV相关知晓情况、HPV疫苗认知、动机、行为技巧、接种意愿等数据。采用多因素logistic回归模型分析影响女大学生接种HPV疫苗意愿的相关因素。结果 954名研究对象中,仅有33.1%愿意接种HPV疫苗。HPV及HPV疫苗认知水平越高,其对HPV疫苗的接种意愿越高（P<0.001）。家人或亲朋癌症史（OR=1.67, 95% CI: 1.18~2.35）、性行为史（OR=3.89, 95%CI: 1.03~14.68）、听说过HPV疫苗（OR=1.79, 95%CI: 1.28~2.51）、动机中的感知到阻碍（OR=1.71, 95%CI: 1.32~2.21）、了解更多接种HPV疫苗相关社会动机（OR=1.63, 95%CI: 1.24~2.14）、掌握更多HPV疫苗接种的行为技巧（OR=2.65, 95%CI: 1.99~3.52）的女大学生对HPV疫苗的接种意愿更加强烈。结论 中西部地区女大学生HPV疫苗接种意愿不高,认知水平较低、对接种HPV疫苗相关的社会技巧和对疫苗的错误认知是主要原因。     

中国民航飞行学院学生体质调查

目的 了解中国民航飞行学院学生的体质状况,为下一步改善体育教学方法提供依据.方法 在中国民航飞行学院所有专业中,按照等比例、随机的抽样方法抽取1 000名学生,对1 000名学生按照《全国大学生体质健康状况调查研究工作手册》的内容和方法测试其身体形态指标、身体机能指标、身体素质指标.采用“校园学生体质健康标准数据管理与分析系统”和SPSS分析数据.结果 中国民航飞行学院男生的平均身高为(177.11±5.89) cm,女生的平均身高为(163.44±5.83) cm,男生的平均体重为(64.13±2.67) kg,女生的平均体重为(51.41±7.13) kg,男、女生的平均BMI分别为20.52±4.66和20.04±2.79;男、女生的肺活量分别为(3 900.45±25.19) ml和(2 760.64±15.73) ml,肺活量身高指数分别为1.62±2.61和18.04±2.99,肺活量体重指数分别为62.33±2.97和52.51±7.83;男、女生的握力分别为(42.14±5.19) kg和(29.64±1.73) kg,50 m成绩分别为(8.03±0.17)s和(9.05±0.83)s,立定跳远成绩分别为(234.62±26.1) cm和(174.04±12.09) cm,1 000m成绩分别为(209.15±15.7)s和(243.56±14.7)s,仰卧起坐成绩分别为(38.6±2.45)个和(43.0±3.11)个,以上体质状况均优于全国同年龄段男、女生水平.结论 飞行学院学生体质状况较好,这是由于加强学生体育锻炼的结果.     

信阳市高校大学生性行为及艾滋病知识干预调查

目的了解信阳市在校大学生艾滋病相关知识知晓情况,探索适合大学生的健康教育模式。方法选择信阳市在校大学生,自制调查问卷,采用不记名填写。结果学生艾滋病知识来源主要是学校教育(50.79%)和网络媒体(47.10%)。男女生性行为发生率差异无统计学意义,第一次性行为安全套使用率25.41%。干预前艾滋病知识平均知晓率为72.01%,干预后平均知晓率为85.53%,干预前后知晓率差异有统计学意义。结论在校大学生性观念和性行为越来越开放,保护意识不强,进行健康教育干预效果明显。     

"1985年身高标准体重"营养状况评价标准存在的问题

目的对“1985年身高标准体重”营养评价标准存在的问题进行探讨，以便为学生营养评价标准的修订提供依据。方法在3672名一年级新生体检时收集小于7岁无评价标准的学生；抽取7～18岁学生6418名，测得身高、体重值作营养状况评价，百分位数评价；对因高身材无营养评价标准的男生的身高分布进行分析。结果一年级新生中94．44％，的学生因小于7岁而无评价标准。少数男生11岁开始出现高身材而无评价标准，14岁、15岁分别高达26．32％和25．64％。7～18岁学生群体营养不良检出率高，其中身高、体重值均在P10～P90范围内的学生营养不良检出率同样很高，主要原因是该标准营养不良的界值点选择过高。结论应增补6岁年龄组和高身材男生评价标准；营养不良界值点选择低于80％的标准体重较合适；各年龄组应分性别制定标准。     

北京市房山区中小学校食堂建设与学生营养教育调查

目的 了解北京市中小学校食堂现状及其在学生营养健康教育中所起的作用，为加强学校食堂建设和学生营养健康教育提供科学依据。方法 采用随机抽样的方法，对房山区9所中小学校食堂及366名在校就餐的学生进行膳食及营养教育相关情况的问卷调查。结果 食堂硬件设备较好，但饮食服务人员文化程度较低，初中及以下文化程度者占86．0％，极少接受营养知识培训。在食堂就餐的学生较多，但食堂几乎从未结合学生饮食开展过任何形式的营养健康宣教。学生营养知识普遍欠缺，并且通过学校获得营养相关知识的机会少，只占18．0％；83．3％的学生希望食堂能够增加饮食营养宣传和指导服务。结论 学校食堂建设应与学生营养健康教育相结合。