Primary Care Physicians’ Perspectives About HPV Vaccine

Allison, Mandy A.; Hurley, Laura P.; Markowitz, Lauri E.; Crane, Lori A.; Brtnikova, Michaela; Beaty, Brenda; Snow, Megan; Cory, Janine; Stokley, Shannon; Roark, Jill; Kempe, Allison

doi:10.1542/peds.2015-2488

Cited by 86 publications

(98 citation statements)

References 26 publications

(26 reference statements)

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“…Differences in HPV vaccination coverage by race/ethnicity and poverty status have been observed previously (8). Higher HPV vaccination coverage among adolescents living below the poverty level might, in part, be because of the routine provision of strong recommendations for HPV vaccination and consistent coadministration of vaccines by clinicians caring for adolescents from lower income households (5,6). Other factors might include clinicians' participation in, and adolescents' eligibility for, the Vaccines for Children (VFC) program*** and differential vaccine acceptance by poverty status.…”

Section: Discussionmentioning

confidence: 87%

“…Strong clinician recommendations for HPV vaccination, and coadministration of the first HPV vaccine dose with Tdap and MenACWY vaccine at age 11-12 years during the same visit, would improve HPV vaccination coverage. Reasons for low HPV vaccination coverage, particularly among younger adolescents, include lack of a strong clinician recommendation for HPV vaccine at age 11-12 years, recommending vaccination inconsistently based on perceived risk for adolescents' HPV exposure, or not recommending coadministration of routine vaccines (5,6). Clinicians also might overestimate parental concerns and underestimate HPV vaccine demand (7).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2015

Reagan‐Steiner¹,

Yankey²,

Jeyarajah³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

318

329

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Local areas that received Federal Section 317 immunization funds were sampled separately: Chicago, Illinois; New York, New York; Philadelphia County, Pennsylvania; Bexar County, Texas; and Houston, Texas. Two local areas (in Texas) were oversampled: El Paso County and Hidalgo County. Three territories was sampled separately in 2015: Guam, Puerto Rico, and the U.S. Virgin Islands. ¶ All identified cellular telephone households were eligible for interview. Sampling weights were adjusted for dual-frame (landline and cellular telephone), nonresponse, noncoverage, and overlapping samples of mixed telephone users. A description of NIS-Teen dual-frame survey methodology and its effect on reported vaccination estimates is available at http://www.cdc. gov/vaccines/imz-managers/coverage/nis/child/dual-frame-sampling.html. ** The overall Council of American Survey Research Organizations (CASRO) response rate was 33.0%. Response rates for the landline and cell phone samples were 56.4% and 29.8%, respectively. For completed interviews in the states and local areas, 4,784 landline calls (53.4%) and 17,091 cell phone calls (48.9%) had adequate provider data. Overall, for states and local areas, 22% of completed interviews with adequate provider data were from landlines and 78% were from cell phones. For U.S. territories, the landline and cell phone sample CASRO rates were 52.1% and 22.6% for Guam, 57.8% and 37.4% for Puerto Rico, and 69.6% and 41.5% for the U.S. Virgin Islands, respectively. The CASRO response rate is the product of three other rates: 1) the resolution rate (the proportion of telephone numbers that can be identified as either for business or residence), 2) the screening rate (the proportion of qualified households that complete the screening process), and 3) the cooperation rate (the proportion of contacted eligible households for which a completed interview is obtained National Vaccination CoverageIn 2015, among males, coverage with ≥1 HPV vaccine dose was 49.8% and with ≥3 doses was 28.1%; among females coverage with ≥1 dose was 62.8% and with ≥3 doses was 41.9% (Table 1) (Figure 1) Vaccination Coverage by Selected CharacteristicsIn 2015, ≥1-dose HPV vaccination coverage among females aged 13 years was lower than coverage among females aged ≥15 years, but was similar among males in all age groups (Table 1). Although HPV vaccination coverage remained higher among females than among males, the percentage point difference in coverage estimates decreased over time (Figure 1). Coverage with each HPV vaccine dose and with ≥1 MenACWY dose was higher among Hispanic adolescents than among non-Hispanic white (white) adolescents; however, coverage with ≥2 measles, mumps, and rubella vaccine (MMR) doses and ≥3 hepatitis B vaccine doses was lower among Hispanic adolescents (Table 2). Coverage with ≥1 HPV vaccine dose was higher among non-Hispanic black (black) adolescents, compared with white adolescents. Adolescents living below the federal poverty level had higher ≥1-and ≥2-dose HPV vaccination coverage than did a...

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2015

Reagan‐Steiner¹,

Yankey²,

Jeyarajah³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

318

329

View full text Add to dashboard Cite

show abstract

“…(17) To our knowledge, only one study has examined both consistency and strength of physicians’ HPV vaccine recommendations as part of a larger recommendation quality measure, but did not focus solely on male patients. (16) Because available literature demonstrates a disparity in recommendation practices such that fewer physicians report consistent and strong HPV vaccine recommendations for males compared to females,(15–18) it is important to further explore factors associated with physicians’ HPV vaccine recommendations for males.…”

Section: Introductionmentioning

confidence: 99%

Missing the Target for Routine Human Papillomavirus Vaccination: Consistent and Strong Physician Recommendations Are Lacking for 11- to 12-Year-Old Males

Vadaparampil

Malo

Sutton

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Rates of routine human papillomavirus (HPV) vaccination of adolescent males in the U.S. are low. Leading health organizations advocate consistent and strong physician recommendations to improve HPV vaccine dissemination. This study describes the prevalence and correlates of consistent and strong physician recommendations for HPV vaccination of adolescent males. Methods We surveyed pediatric and family medicine physicians in Florida about their HPV vaccine recommendations for male vaccine-eligible age groups (11–12, 13–17, 18–21 years). Descriptive statistics compared consistency and strength of HPV recommendations across age groups. Multivariable logistic regression examined factors associated with of consistent and strong recommendations for 11–12 year olds. Results We received 367 completed surveys (51% response rate). Physicians most often consistently and strongly recommended HPV vaccine to males 13–17 (39%) compared to ages 11–12 (31%) and 18–21 (31%). Consistent and strong recommendation for 11–12 year old males was more likely to be delivered by Vaccine for Children providers and less likely among physicians who reported more personal barriers to vaccination, particularly concerns about vaccine safety, concerns about adding vaccines to the vaccine schedule, and difficulty remembering to discuss HPV vaccination. Conclusion Physicians’ current consistency and strength of HPV vaccine recommendations do not align with national recommendations. Interventions to improve HPV vaccine recommendations must also consider the influence of physicians’ personal barriers to HPV vaccine delivery. Impact As one of the first studies to examine both consistency and strength of physicians’ HPV vaccine recommendations for males, our findings can inform future interventions focused on facilitating physicians’ recommendations.

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“…2 A high-quality recommendation by a health care provider is a uniquely potent motivator of HPV vaccine uptake, 5,6 yet many providers make these recommendations hesitantly, late, or not at all. 5,[7][8][9] Provider concerns include the time it takes to recommend the vaccine, 10 -12 anticipation of an uncomfortable conversation related to sex 5,13,14 and a false perception that parents do not value HPV vaccination. 5,15 One intriguing approach to addressing these issues is to use presumptive "announcements, " or brief statements that assume parents are ready to vaccinate.…”

mentioning

confidence: 99%

Announcements Versus Conversations to Improve HPV Vaccination Coverage: A Randomized Trial

Hall²,

et al. 2017

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OBJECTIVE: Improving provider recommendations is critical to addressing low human papillomavirus (HPV) vaccination coverage. Thus, we sought to determine the effectiveness of training providers to improve their recommendations using either presumptive "announcements" or participatory "conversations." METHODS:In 2015, we conducted a parallel-group randomized clinical trial with 30 pediatric and family medicine clinics in central North Carolina. We randomized clinics to receive no training (control), announcement training, or conversation training. Announcements are brief statements that assume parents are ready to vaccinate, whereas conversations engage parents in open-ended discussions. A physician led the 1-hour, in-clinic training. The North Carolina Immunization Registry provided data on the primary trial outcome: 6-month coverage change in HPV vaccine initiation (≥1 dose) for adolescents aged 11 or 12 years. RESULTS:The immunization registry attributed 17 173 adolescents aged 11 or 12 to the 29 clinics still open at 6-months posttraining. Six-month increases in HPV vaccination coverage were larger for patients in clinics that received announcement training versus those in control clinics (5.4% difference, 95% confidence interval: 1.1%-9.7%). Stratified analyses showed increases for both girls (4.6% difference) and boys (6.2% difference). Patients in clinics receiving conversation training did not differ from those in control clinics with respect to changes in HPV vaccination coverage. Neither training was effective for changing coverage for other vaccination outcomes or for adolescents aged 13 through 17 (n = 37 796). CONCLUSIONS:Training providers to use announcements resulted in a clinically meaningful increase in HPV vaccine initiation among young adolescents.

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Primary Care Physicians’ Perspectives About HPV Vaccine

Cited by 86 publications

References 26 publications

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2015

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2015

Missing the Target for Routine Human Papillomavirus Vaccination: Consistent and Strong Physician Recommendations Are Lacking for 11- to 12-Year-Old Males

Announcements Versus Conversations to Improve HPV Vaccination Coverage: A Randomized Trial

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