An environmental scan to examine stakeholder perspectives on human papillomavirus vaccination: A mixed methods study

Abstract

Results suggest the need for parent/adolescent education, specifically targeting key areas we identified: importance and benefits of HPV vaccine, and education and skill building in vaccine communication for HCPs.

Provider perspectives on multilevel barriers to HPV vaccination

“…This indicates an important area for improvement because recent research shows engaging in these high quality recommendation practices significantly increases vaccination rates. 16 Consistent with previous research, 13,14,24,25 education for parents/adolescents and providers was often mentioned by our participants as a necessary step to increase vaccination rates among adolescents. Physicians believed that it would be important to provide education for adolescents by the school system during health and wellness classes.…”

“…Similarly, another study by our team focused on key Florida stakeholders (physicians, nurses, DOH professionals, and parents) found that stakeholders believe there is a perception among health care providers that HPV vaccination is less important because it is not a mandatory vaccine for school entry. 13 Additional research has found parent and physician support for mandatory vaccination. [34][35][36] Our quantitative results indicate that physicians who did not limit the number of vaccines administered during the visit were more likely to recommend HPV vaccine strongly and consistently.…”

“…10,11 Thus, understanding physician behaviors and their communication with parents of 11-12 year olds is particularly important, as there are multiple barriers to HPV vaccination at the parent/patient-, provider-, and systems-levels. 5,[12][13][14][15][16] Healthcare providers believe that parents of age-eligible adolescents demonstrate low knowledge about HPV vaccination and may hold negative attitudes about the vaccine due to misinformation. 14,17 Similarly, providers may lack the necessary education about the vaccine and effective communication strategies.…”

“…14,17 Similarly, providers may lack the necessary education about the vaccine and effective communication strategies. 13 They may also be concerned that recommending HPV vaccination too strongly will damage the patientprovider relationship or anticipate that the patient or parent will express hesitancy and will decline the vaccine. 14 Vaccine cost is an additional well-documented barrier at both the parent/patient-and the systems-level.…”

Understanding the Factors Influencing Health Care Provider Recommendations about Adolescent Vaccines: A Proposed Framework

“…This includes both clinic-level factors, such as the ability of the clinic to stock the vaccine, the presence of tools like provider prompts and reminder-recall systems and peer influences as well as the characteristics of the broader community in which the provider practices . HCP peers may influence provider attitudes about vaccines or recommendation practices (P. W. Lake et al, 2019a , 2019b ). Providers who were characterized as “Ambivalent HPV recommenders”—those who did not consistently or strongly recommend the HPV vaccine—were also less likely to perceive their peers as thinking the HPV vaccine was important for adolescents or strongly recommending the vaccine (Hopfer et al, 2019 ).…”