Recommend, but also Discuss: Different Patterns of Physician-Perceived Barriers to Discussing HPV Vaccination and Their Association with Vaccine Administration in 11–12 Year-Old Girls

Abstract

Objectives We examined variation in primary care physicians' (PCPs') perceptions of barriers to physician-initiated discussion of HPV vaccination, and how this is associated with the rates at which they discuss, initiate and continue to administer vaccination with 11-12 year-old girls. Methods We surveyed 301 PCPs using systematic random sampling. PCP variation in perceived barriers to discussing HPV vaccination was modeled using latent class analysis (LCA). The distinct PCP groups identified were compared with each other using three iterative logistic regression models to predict the likelihood of initiating vaccine discussion and the reported percentages of 11-12 year-old patients who initiated HPV vaccination and received follow-up shots. Results LCA revealed three groups of PCPs who perceived major, moderately significant and relatively minor barriers (17.9, 41.9 and 40.2 % of respondents, respectively). Pediatricians, PCPs who were female, had minority racial/ethnic status and who perceived only minor barriers had significantly higher odds of initiating discussion. PCPs were more likely to initiate HPV vaccination if they had initiated discussion and perceived minor or moderate communication barriers. Increased likelihood to administer follow-up HPV vaccine was associated with having initiated discussion, perceiving only minor barriers and working outside Deep South states, but not with having initiated vaccination. Conclusions for Practice PCPs who discuss HPV vaccination with girls aged 11-12 and their mothers are more likely to start and sustain vaccine administration. However, different PCPs perceive barriers to discussion in different ways. Interventions tailored to different groups of PCPs should assist them in overcoming barriers to discussing their recommendations when necessary.

Primary care pediatricians’ attitudes and practice towards HPV vaccination: A nationwide survey in Italy

“…Therefore, for the successful implementation of the HPV vaccination, health care providers, particularly in primary care, are a key component in promoting the vaccination and its acceptability, since they have general influence over the health behavior of their patients. While there has been published research on the levels of knowledge and awareness about HPV in different groups [ 14 – 18 ] also in this geographic area [ 19 – 21 ], relatively little public health investigation has focused on primary care pediatricians (PCPs) [ 22 – 25 ]. Understanding their perception and practice in relation to HPV vaccination is crucial because PCPs could be a key element in the promotion of HPV prevention and the design of effective educational efforts.…”

Optimizing the immunization activities of community chain pharmacists: Insights from a national survey

“…Further, pharmacists were asked to rate their comfort in actually implementing the tasks of assessment and recommendation with respect to the 2 NVAC Standards shown to have particularly pronounced effects on the likelihood of patients' receipt of immunization. 25,26 All these questions had scaled response categories ranging from 1 (strongly disagree) to 5 (strongly agree).…”

Recommendations and barriers to vaccination in systemic lupus erythematosus

“…Another study of HPV vaccine administration identified three main communication barriers: reluctance of parents and patients to discuss HPV vaccination, limited awareness among patients, and inadequate patient access to health care. Specific discussions initiated and sustained by providers to encourage completion of the vaccine series at the recommended age of 11–12 years were identified as a potential approach to improve vaccination rates [133].…”