Clinical Staff Perceptions of Pay-for-Performance Financial Incentives for HPV Vaccine Promotion.

Abstract

The purpose was to investigate clinical staff perceptions of pay-for-performance human papillomavirus (HPV) vaccination financial incentives. In 2022, the authors conducted a national survey of clinical staff (N = 2527; response rate = 57%). Respondents were (1) certified to practice in the United States; (2) practiced as a physician, physician assistant, nurse practitioner, advanced practice nurse, registered nurse, licensed practical/vocational nurse, medical assistant, or certified nursing assistant; (3) worked in pediatrics, family medicine, or general medicine specialties; and (4) had a role in HPV vaccination for children ages 9 through 12 years. The team used ordered regressions to model whether respondents agreed with (ie, "Strongly agreed" or "Agreed" on a 5-point Likert scale) each of the 9 statements. The statements were mapped to domains based on the theory of planned behavior: attitudes (5 statements), perceived behavioral control (2), and norms (2). Favorable responses to 9 statements ranged from 32% to 85%; 5/9 items had more than 50% favorable responses. The following example odds ratios (ORs) are for "agree" versus "neutral" or "disagree" to change their behavior to obtain the incentive. Clinical staff with prior experience with incentives were more likely to agree with 8/9 positive statements about incentives (eg, OR = 1.32 [95% confidence interval {CI}: 1.12-1.57]). Family medicine clinics were more likely than pediatric clinics to agree with 5/9 statements (eg, OR = 1.42 [95% CI: 1.18-1.70]). Clinical staff with more years of experience were less likely to agree with 6/9 statements (eg, OR = 0.97 [95% CI: 0.97-0.98]). Clinical staff's perceptions of pay-for-performance HPV vaccination financial incentives were generally favorable.