Factors influencing pediatricians' intention to recommend human papillomavirus vaccines.
ABSTRACT The objectives of this qualitative study were to describe the range of pediatricians' attitudes about human papillomavirus (HPV) vaccines and to explore factors influencing their intention to recommend HPV vaccines, extending the findings of previous quantitative studies.
A diverse sample of pediatricians participated in semistructured individual interviews to assess attitudes and intentions regarding HPV immunization. Framework analysis was used for qualitative analysis.
The mean age of the 31 participants was 47 years, 17 (55%) were female, 9 (29%) were black, and 4 (13%) were Latino. The efficacy, safety, and potential health impact of vaccination were the primary factors driving participants' decisions about recommending HPV vaccines. Perceived benefits of HPV vaccination included prevention of HPV-related disease and the opportunity to educate adolescents. Perceived barriers included anticipated parental beliefs (eg, parental denial that their child would be at risk) and provider beliefs (eg, reluctance to discuss sexuality with preadolescents). Participants reported high intention to recommend HPV vaccines overall, but intention varied according to patient age, patient gender, and HPV vaccine type. The primary reasons underlying this variation included perceptions about the health impact of vaccination and relevance of HPV vaccines to the provider's patients. The main factors driving intention to recommend HPV vaccines included knowledge, personal and professional characteristics, office procedures, vaccine cost and reimbursement, parental factors, and specific attitudes about HPV vaccination.
These findings provide a framework for understanding pediatricians' decisions to recommend HPV vaccines and may be used to guide the design of interventions to maximize vaccine recommendations.
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ABSTRACT: Background: The role of human papillomavirus (HPV) in oropharyngeal squamous cell cancer (OSCC) has now been well established. Clinicians’ experiences and challenges of talking to patients about HPV have yet to be explored.Methods: Fifteen health professionals caring for OSCC patients were interviewed. Interviews were analysed thematically.Results: Participants expressed mixed views about explaining the causal role of HPV to their patients. Normalising HPV and emphasising the positive prognosis associated with it were regarded as key messages to be communicated. Challenging experiences included managing couples in a consultation and patients’ concerns about transmitting HPV to their partners. Some participants described limitations to their HPV knowledge and identified the need for further information and training.Conclusion: This study identified challenges experienced by health professionals working with OSCC patients and highlights some key messages to convey to patients. Clinical guidance for health professionals and further information for patients about HPV-OSCC is needed. Head Neck, 2014Head & Neck 10/2014; · 2.83 Impact Factor
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ABSTRACT: Background: Little is known about physicians' human papillomavirus (HPV) vaccine recommendations for males while the Advisory Committee on Immunization Practices' (ACIP) permissive guidelines for male vaccination were in effect. The purpose of this study was to examine and explore factors associated with U.S. physicians' HPV vaccine recommendations to early (ages 11-12), middle (13-17), and late adolescent/young adult (18-26) males. Methods: Nationally representative samples of family physicians and pediatricians were selected in 2011 (n=1,219). Physicians reported the frequency with which they recommended HPV vaccine to male patients ("always" [>75% of the time] vs. other) for each age group. Statistically significant predictors of vaccine recommendation were identified using multivariable logistic regression. Results: The prevalence of physicians reporting they "always" recommended HPV vaccination for males was 10.8% for ages 11-12, 12.9% for ages 13-17, and 13.2% for ages 18-26. Pediatrician specialty and self-reported early adoption of new vaccines were significantly associated with recommendation for all patient age groups. Additionally, physician race and patient payment method were associated with physician recommendations to patients ages 11-12, and patient race was associated with recommendations to ages 13-17 and 18-26. Conclusions: Less than 15% of physicians surveyed reported "always" recommending HPV vaccine to male patients following national guidelines for permissive vaccination. Vaccine financing may have affected physicians' vaccine recommendations. Impact: If these recommendation practices continue following the ACIP's routine recommendation for males in October 2011, then interventions designed to increase recommendations should target family physicians and possibly utilize early adopters to encourage support of HPV vaccination guidelines.Cancer Epidemiology Biomarkers & Prevention 07/2014; 23(10). · 4.32 Impact Factor
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ABSTRACT: Vaccination against Human Papillomavirus (HPV) is recommended for adolescent young women prior to sexual debut to reduce cervical cancer related mortality and morbidity. Understanding factors affecting decision-making of HPV vaccination of young women is important so that effective interventions can be developed which address barriers to uptake in population groups less likely to receive the HPV vaccine.BMC Public Health 07/2014; 14(1):700. · 2.32 Impact Factor