Impact of a shared medical decision-making aid on patient decisional conflict regarding human papillomavirus vaccination: a mixed-methods study.
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| Titel: | Impact of a shared medical decision-making aid on patient decisional conflict regarding human papillomavirus vaccination: a mixed-methods study. |
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| Autoren: | Hagiu DP; Department of General Practice, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Université de Lyon, Saint-Etienne 42100, France.; CIC-INSERM 1408, CHU de Saint-Etienne, Saint-Priest-en-Jarez 42270, France.; Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon 69007, France., Saquet M; Department of General Practice, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Université de Lyon, Saint-Etienne 42100, France.; CIC-INSERM 1408, CHU de Saint-Etienne, Saint-Priest-en-Jarez 42270, France.; Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon 69007, France., Partouche H; Department of General Practice, Université Paris Cité, Paris 75006, France., Gilberg S; Department of General Practice, Université Paris Cité, Paris 75006, France., Gagneux-Brunon A; CIC-INSERM 1408, CHU de Saint-Etienne, Saint-Priest-en-Jarez 42270, France.; Centre International de Recherche en Infectiologie, Team GIMAP, Univ. de Lyon, Univ. Jean Monnet, Univ. Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, Lyon 69007, France., Michel M; ECEVE UMR 1123, Université Paris Cité, Paris 75006, France.; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service de santé publique, équipe REPERES, Paris 75019, France., Le Duc-Banaszuk AS; Centre Régional de Coordination des Dépistages des cancers-Pays de la Loire, Angers 49000, France., Mueller JE; Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, Paris 75006, France.; EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS (Recherche sur les Services et Management en Santé)-U1309, University Rennes, Rennes 35000, France., Gauchet A; Univ. Savoie Mont Blanc, Univ. Grenoble Alpes, LIP/PC2S, Grenoble 38000, France., Thilly N; Inserm, INSPIIRE, Université de Lorraine, Nancy 54000, France.; Département Méthodologie, Promotion, Investigation, Université de Lorraine, CHRU-Nancy, Nancy 54000, France., Bruel S; Department of General Practice, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Université de Lyon, Saint-Etienne 42100, France.; CIC-INSERM 1408, CHU de Saint-Etienne, Saint-Priest-en-Jarez 42270, France.; Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon 69007, France. |
| Quelle: | Family practice [Fam Pract] 2025 Oct 21; Vol. 42 (6). |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Oxford University Press Country of Publication: England NLM ID: 8500875 Publication Model: Print Cited Medium: Internet ISSN: 1460-2229 (Electronic) Linking ISSN: 02632136 NLM ISO Abbreviation: Fam Pract Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford : Oxford University Press, [c1983- |
| MeSH-Schlagworte: | Papillomavirus Vaccines*/therapeutic use , Papillomavirus Infections*/prevention & control , Decision Support Techniques* , Decision Making, Shared* , Vaccination*/psychology, Humans ; Female ; Male ; Adolescent ; Health Knowledge, Attitudes, Practice ; France ; Adult ; Surveys and Questionnaires ; Uterine Cervical Neoplasms/prevention & control ; Qualitative Research ; Decision Making ; Human Papillomavirus Viruses |
| Abstract: | Introduction: Human papillomaviruses (HPVs) cause several vaccine-preventable cancers, including cervical cancer. In France, HPV vaccination coverage remains low. Decision aids (DAs) can help individuals make informed health choices. This study assessed the impact of an online DA (SOSHPV) on decisional conflict and vaccination intention, and explored user perceptions in real-life contexts. Methods: A convergent mixed-methods design was used (November 2023-June 2024). The quantitative component included a pre-post questionnaire assessing knowledge, vaccination intention, and decisional conflict. The qualitative component involved semistructured interviews with a subsample of users, analyzed using grounded theory. Results: Among 943 website visitors, 187 participants (54 males, 12 adolescents) completed the presurvey, and 44 (12 males, 6 adolescents) completed both assessments. Over half (54%) were young parents using the tool to support HPV vaccination decisions for their child. Post-intervention, knowledge improved (P < 0.001), and decisional conflict decreased (P < 0.001). Vaccination intention shifted: 55%-75% in favor and 32%-18% undecided (P < 0.001). Qualitative analysis (n = 12) revealed three themes: social ambivalence around vaccination, the DA as a support for informed choices, and its role in enhancing communication with healthcare providers. Discussion: This study showed a reduction in decisional conflict and increased vaccination intention. These findings suggest that DAs may play an important role in addressing vaccine hesitancy and supporting value-aligned choices in real-world settings. Conclusion: This study highlights the potential of an online DA to improve vaccine acceptance by reducing decisional conflict and enhancing dialog. Further research is needed to assess its large-scale impact on vaccine uptake. (© The Author(s) 2025. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Grant Information: | ITMO Cancer AVIESAN |
| Contributed Indexing: | Keywords: adolescent health services; decision support techniques; health communication; papillomavirus vaccines; primary healthcare; vaccination |
| Substance Nomenclature: | 0 (Papillomavirus Vaccines) |
| Entry Date(s): | Date Created: 20251028 Date Completed: 20251028 Latest Revision: 20251028 |
| Update Code: | 20251028 |
| DOI: | 10.1093/fampra/cmaf077 |
| PMID: | 41148008 |
| Datenbank: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstract: | Introduction: Human papillomaviruses (HPVs) cause several vaccine-preventable cancers, including cervical cancer. In France, HPV vaccination coverage remains low. Decision aids (DAs) can help individuals make informed health choices. This study assessed the impact of an online DA (SOSHPV) on decisional conflict and vaccination intention, and explored user perceptions in real-life contexts.<br />Methods: A convergent mixed-methods design was used (November 2023-June 2024). The quantitative component included a pre-post questionnaire assessing knowledge, vaccination intention, and decisional conflict. The qualitative component involved semistructured interviews with a subsample of users, analyzed using grounded theory.<br />Results: Among 943 website visitors, 187 participants (54 males, 12 adolescents) completed the presurvey, and 44 (12 males, 6 adolescents) completed both assessments. Over half (54%) were young parents using the tool to support HPV vaccination decisions for their child. Post-intervention, knowledge improved (P < 0.001), and decisional conflict decreased (P < 0.001). Vaccination intention shifted: 55%-75% in favor and 32%-18% undecided (P < 0.001). Qualitative analysis (n = 12) revealed three themes: social ambivalence around vaccination, the DA as a support for informed choices, and its role in enhancing communication with healthcare providers.<br />Discussion: This study showed a reduction in decisional conflict and increased vaccination intention. These findings suggest that DAs may play an important role in addressing vaccine hesitancy and supporting value-aligned choices in real-world settings.<br />Conclusion: This study highlights the potential of an online DA to improve vaccine acceptance by reducing decisional conflict and enhancing dialog. Further research is needed to assess its large-scale impact on vaccine uptake.<br /> (© The Author(s) 2025. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
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| ISSN: | 1460-2229 |
| DOI: | 10.1093/fampra/cmaf077 |