A Multiple Streams analysis of the decisions to fund gender-neutral HPV vaccination in Canada

PREVENTIVE MEDICINE

卷:100

Review

Shapiro, Gilla K.^1,2  Guichon, Juliet³  Prue, Gillian⁴  Perez, Samara^1,2  Rosberger, Zeev^1,2,5,6,7 

[1] McGill Univ, Dept Psychol, 1205 Dr Penfield Ave, Montreal, PQ H3A 1B1, Canada

[2] Jewish Gen Hosp, Lady Davis Inst Med Res, 4333 Cote St Catherine Rd, Montreal, PQ H3T 1E4, Canada

[3] Dept Community Hlth Sci, 3280 Hosp Dr, Calgary, AB T2N 4N1, Canada

[4] Queens Univ Belfast, Med Biol Ctr, Sch Nursing & Midwifery, 97 Lisburn Rd, Belfast BT9 7BL, Antrim, North Ireland

[5] Jewish Gen Hosp, Louise Granofsky Psychosocial Oncol Program, 4333 Cote St Catherine Rd, Montreal, PQ H3T 1E4, Canada

[6] McGill Univ, Dept Psychiat, 1205 Dr Penfield Ave, Montreal, PQ H3A 1B1, Canada

[7] McGill Univ, Dept Oncol, 1205 Dr Penfield Ave, Montreal, PQ H3A 1B1, Canada

关键词: Canada;    Cancer prevention;    Health policy;    Human papillomavirus;    Men's health;    Kingdon Multiple Streams framework;    Policy analysis;    Vaccination;    Vaccine policy;   

DOI  :  10.1016/j.ypmed.2017.04.016

来源: Elsevier

【 摘 要 】

In Canada, the human papillomavirus (HPV) vaccine is licensed and recommended for females and males. Although all Canadian jurisdictions fund school-based HPV vaccine programs for girls, only six jurisdictions fund school-based HPV vaccination for boys. The research aimed to analyze the factors that underpin government decisions to fund HPV vaccine for boys using a theoretical policy model, Kingdon's Multiple Streams framework. This approach assesses policy development by examining three concurrent, but independent, streams that guide analysis: Problem Stream, Policy Stream, and Politics Stream. Analysis from the Problem Stream highlights that males are affected by HPV-related diseases and are involved in transmitting HPV infection to their sexual partners. Policy Stream analysis makes clear that while the inclusion of males in HPV vaccine programs is suitable, equitable, and acceptable; there is debate regarding cost-effectiveness. Politics Stream analysis identifies the perspectives of six different stakeholder groups and highlights the contribution of government officials at the provincial and territorial level. Kingdon's Multiple Streams framework helps clarify the opportunities and barriers for HPV vaccine policy change. This analysis identified that the interpretation of cost-effectiveness models and advocacy of stakeholders such as citizen-advocates and HPV-affected politicians have been particularly important in galvanizing policy change. (C) 2017 Elsevier Inc. All rights reserved.

【 授权许可】

Free