Abstract
BackgroundHuman papillomavirus (HPV) vaccination is below national goals in the United States. Health care providers are at the forefront of improving vaccination in the United States, given their close interactions with patients and parents.ObjectiveThe objective of this study was to assess the associations between demographic and practice characteristics of the health care providers with the knowledge of HPV vaccination and HPV vaccine guidelines. Furthermore, our aim was to contextualize the providers’ perceptions of barriers to HPV vaccination and strategies for improving vaccination in a state with low HPV vaccine receipt.MethodsIn this mixed-methods study, participating providers (N=254) were recruited from statewide pediatric, family medicine, and nursing organizations in Utah. Participants completed a Web-based survey of demographics, practice characteristics, HPV vaccine knowledge (≤10 correct vs 11-12 correct answers), and knowledge of HPV vaccine guidelines (correct vs incorrect). Demographic and practice characteristics were compared using chi-square and Fisher exact tests for HPV knowledge outcomes. Four open-ended questions pertaining to the barriers and strategies for improving HPV vaccination were content analyzed.ResultsFamily practice providers (52.2%, 71/136; P=.001), institutional or university clinics (54.0%, 20/37; P=.001), and busier clinics seeing 20 to 29 patients per day (50.0%, 28/56; P=.04) had the highest proportion of respondents with high HPV vaccination knowledge. Older providers aged 40 to 49 years (85.1%, 57/67; P=.04) and those who were a Vaccines for Children provider (78.7%, 133/169; P=.03) had the highest proportion of respondents with high knowledge of HPV vaccine recommendations. Providers perceived the lack of parental education to be the main barrier to HPV vaccination. They endorsed stronger, consistent, and more direct provider recommendations for HPV vaccination delivered to parents through printed materials available in clinical settings and public health campaigns. Hesitancy to recommend the HPV vaccine to patients persisted among some providers.ConclusionsProviders require support to eliminate barriers to recommending HPV vaccination in clinical settings. Additionally, providers endorsed the need for parental educational materials and instructions on framing HPV vaccination as a priority cancer prevention mechanism for all adolescents.
Highlights
The vaccines are recommended by the U.S Advisory Committee on Immunization Practices (ACIP) for males and females ages 11-12 with “catch-up” doses for females up to age 26 and for males up to age 21 who were not vaccinated earlier in adolescence
Parents’ and other caregivers’ knowledge, attitudes, and beliefs affect whether their children receive vaccines, including human papillomavirus (HPV) vaccines
2.1: Centers for Disease Control and Prevention (CDC) should develop, test, and collaborate with partner organizations to deploy integrated, comprehensive communication strategies directed at parents and other caregivers, and at adolescents
Summary
We have two safe and effective vaccines that prevent infection by the two most prevalent cancer-causing HPV types. In 2012, only 33 percent of adolescent females and less than 7 percent of males across the U.S had completed the threedose series These low vaccination rates reveal countless missed opportunities to prevent cancers and other serious diseases. During 2012-2013, the Panel explored underuse of HPV vaccines and ways to accelerate vaccine uptake and protect today’s children as well as future generations against cancers caused by HPV. We provide concrete, targeted, and actionable recommendations—supported by evidence and input from key stakeholders—to address these barriers and achieve greater uptake of HPV vaccines by both boys and girls. Your Panel is proud of this report and hopes for aggressive implementation of our recommendations for supporting widespread HPV vaccination programs throughout the U.S and the world. No man or woman should have to suffer or die from cancers or other diseases when the means by which to protect them is within our grasp
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