Primary Care Physicians’ Role in Parental Decision to Vaccinate with HPV Vaccine: Learnings from a South Texas Hispanic Patient Population

Abstract

Hispanic populations have low HPV vaccination rates, although the vaccine is safe and efficacious. We surveyed a low-income Hispanic population to characterize knowledge gaps about the HPV vaccine and understand factors associated with the decision to vaccinate a child to determine how physicians can enhance vaccination rates. Surveys in English and Spanish were distributed to parents of children under age 18. Statistical analysis included logistic regression. Knowledge that the vaccine can prevent invasive cervical cancer most impacted intent to vaccinate. Physician recommendation to vaccinate was far more influential in a parent's decision compared to TV and other sources. Girls are more likely to receive the HPV vaccine over boys. While physician recommendation is critical, they have minimal time for education. Our results suggest that physicians should focus on the vaccine's link to cancer prevention, leaving other knowledge areas for the interdisciplinary care team.

Parental predictors of HPV vaccine initiation among low-income Hispanic females aged 11–17 years

“…Previous studies have found intention correlated with HPV vaccine initiation for adolescent girls [36,39,40]. However, a paucity of studies exist examining the association between parental intentions and vaccination outcomes among Hispanic adolescent females specifically, and few have examined psychosocial correlates of intention to vaccinate among Hispanic parents [41]. Our study contributes to the literature by describing the associations between IBM constructs and vaccination behaviors among this population to inform future intervention development.…”

Parental knowledge gaps and barriers for children receiving human papillomavirus vaccine in the Rio Grande Valley of Texas

“…Research has shown that healthcare provider / physician recommendation and parents' trust in healthcare providers is positively associated with parents' uptake of the HPV vaccine. 20,21,25,26,33 Survey respondents reported higher vaccination rates when they were recommended to get the HPV vaccine for their child by their healthcare provider compared to those who did not receive recommendations. Previous research has shown that parents who vaccinate their children are more likely to remember and report higher quality recommendations from providers, i.e., providers recommending HPV as high importance for patients at ages 11-12.…”

“…11 In addition to parents, healthcare providers play a crucial role in ensuring its administration. [21][22][23][24][25][26][27][28] It is important for healthcare providers to bundle HPV vaccines with other required vaccines, such as tetanus-diphtheria-pertussis (Tdap) and meningococcal vaccine (MCV4, MenB). 29,30 They are encouraged to consistently and equally recommend HPV vaccination to parents of female and male children.…”

“…[31][32][33] A recent survey of Texas healthcare providers found that 94% self-reported giving a consistent recommendation of HPV vaccination to 9-12-year-old children of both sexes. 34 Factors associated with vaccine uptake Factors shown to be positively associated with parents' uptake of HPV vaccines for their children include: (1) healthcare providerphysician recommendation and parents' trust in healthcare providers, 20,21,25,26,33 (2) mother as HPV vaccine decision-maker versus both parents, 20 (3) parents' vaccine beliefs, attitudes, and intentions, 20,35 (4) preventive healthcare utilization for child, 28 (5) insurance / costhealth insurance coverage of HPV vaccination, 28 (6) parents' HPV risk history, 20 7parents' HPV-related knowledge and awareness, 28 and (8) sociodemographic factorsurban versus rural location and child's age. 20,21,25,26,33 For those who have chosen to not vaccinate against HPV, parents cite lack of knowledge and worry about the side effects or safety of the vaccine as the primary reasons for vaccine hesitancy.…”

Which primary care practitioners have poor human papillomavirus (HPV) knowledge? A step towards informing the development of professional education initiatives

“…They may positively or negatively influence women’s screening participation decisions and decision-making around HPV vaccination [4–6]. For example, US studies consistently show that health professional recommendation is one of the strongest influences on parental decisions regarding HPV vaccination of their children [7,8]. However, in theoretically-robust research, we found that lack of HPV knowledge among PCPs was a key barrier to them performing cervical cancer prevention-related behaviours appropriately [2].…”