Florida physicians' reported use of AFIX-based strategies for human papillomavirus vaccination

Kasting, Monica L.; Christy, Shannon M.; Sutton, Steven K.; Lake, Paige; Malo, Teri L.; Roetzheim, Richard G.; Schechtman, Tommy; Zimet, Gregory D.; Walkosz, Barbara J.; Salmon, Daniel A.; Kahn, Jessica A.; Giuliano, Anna R.; Vadaparampil, Susan T.

doi:10.1016/j.ypmed.2018.09.004

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…Rural HPV vaccination orders that empower clinical support staff to proactively provide HPV vaccination9,25 and regular conduct of assessment and feedback evaluations with providers and clinics to monitor patient vaccination rates 27 are evidence-based strategies proven to improve HPV vaccination outcomes. Lastly, it is vital that rural safety net providers, such as federally qualified health centers, rural health clinics, and local health departments, participate in the VFC Program, which provides HPV vaccination at no cost to Medicaid-eligible children.…”

Section: Community Little "P"mentioning

confidence: 99%

Policy opportunities to increase HPV vaccination in rural communities

Vanderpool

Stradtman

Brandt

2019

Human Vaccines & Immunotherapeutics

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Rural communities experience health disparities, including elevated incidence and mortality of human papillomavirus (HPV)-associated cancers and correspondingly low HPV vaccination rates. There are numerous policy strategies that are available at multiple levelspatient, provider, clinic, community, state, and nationalto address geographic, clinical, and communication barriers to HPV vaccination across rural America. Examples include policy development, implementation, and evaluation of healthcare provider and clinic-based assessment and education initiatives; school entry requirements; school, pharmacy, and community-based vaccination programs; evidence-based, community-driven communication efforts; and increased interventional research in rural communities. Strategically implemented policy measures will contribute to reduction in the incidence and mortality from HPV-related cancers through increased access to HPV vaccination in our rural communities.

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Section: Community Little "P"mentioning

confidence: 99%

Policy opportunities to increase HPV vaccination in rural communities

Vanderpool

Stradtman

Brandt

2019

Human Vaccines & Immunotherapeutics

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“…Our recruitment methods were also a strength, as we partnered with the Florida Chapter of the American Academy of Pediatrics (FCAAP) and the Florida Association of Family Medicine Physicians (FAFP) who assisted us with recruiting their member physicians and endorsed our study. 38 This, coupled with our repeat mailings, helped increase our response rate. Additionally, obtaining qualitative data on physicians suggestions for improving vaccination rates among adolescents helped us further explore barriers and facilitators of vaccination uptake, which we would not have uncovered otherwise.…”

Section: Strengths and Limitationsmentioning

confidence: 90%

“…Detailed recruitment methods have been previously published. 15,38 Briefly, in 2016, we mailed 770 surveys to Family Medicine physicians and Pediatricians in Florida; 367 surveys were completed and returned to study staff. After accounting for undeliverable (n = 46) and duplicate (n = 16) surveys, our overall response rate was 48.5% (351/724).…”

Section: Methodsmentioning

confidence: 99%

Provider perspectives on multilevel barriers to HPV vaccination

Lake

Kasting

Christy

et al. 2019

Human Vaccines & Immunotherapeutics

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Understanding physician recommendation practices for HPV vaccination is a crucial step to developing interventions that can increase high quality recommendations and improve vaccination acceptance. Florida physicians (n = 340) completed a survey assessing recommendation strategies, specifically strength, consistency, and presentation. Physicians were also asked to provide suggestions for improving HPV vaccination in Florida. Responses were dichotomized for each outcome: strength (i.e., strongly recommend vs. other), consistently recommend (i.e., always recommend vs. other), and recommendation presentation (i.e., presented in the same manner as mandatory vaccines for adolescents vs. other). Bivariate logistic regression was conducted to determine the association between physician/practice characteristics and each outcome. Variables significant (p < .05) in bivariate analyses were included in multivariable logistic regression analyses. Vaccines for Children (VFC) provider status (OR = 2.62, 95% CI = 1.23-5.59 [strong]; OR = 2.84, 95% CI = 1.26-6.39 [consistent]) and not limiting the number of vaccines during a visit (OR = .283, 95% = CI .111-.722 [strong]; OR = .210, 95% = CI .066-.673 [consistent]) were significantly associated with strong and consistent recommendation. Reminders from the healthcare team were associated with consistency (OR = 2.26, 95% CI = 1.23-4.16) and EMR-based reminders were associated with presentation (OR = 2.00, 95% CI = 1.11-3.61). Multinomial logistic regression analysis examined factors associated with level of engagement in recommendation strategies. Multinomial regression indicated VFC providers (OR = 12.61, 95% CI = 1.89-82.20), and those receiving EMR-based reminders (OR = 4.02, 95% = CI 1.28-12.63), among others, were more likely to engage in all 3 types of recommendation practices. Physician suggestions for improving HPV vaccination rates included improving parent/patient/provider education and reducing vaccine costs. Future interventions should emphasize key components of delivering effective HPV vaccine recommendations, include information about insurance coverage, and improve provider awareness of VFC benefits.

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“…General HCV-related questions include the PCPs' personal screening practices, birth cohort recommendation awareness, and HCV-related reminders [24][25][26]. HCV recommendation practices assessed included: 1) strength (i.e.…”

Section: General Screening Practices and Remindersmentioning

confidence: 99%

There’s just not enough time: a mixed methods pilot study of hepatitis C virus screening among baby boomers in primary care

et al. 2020

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Background Liver cancer rates are rising and hepatitis C virus (HCV) is the primary cause. The CDC recommends a one-time HCV screening for all persons born 1945–1965 (baby boomers). However, 14% of baby boomers have been screened. Few studies have examined primary care providers’ (PCP) perspectives on barriers to HCV screening. This study examines current HCV screening practices, knowledge, barriers, and facilitators to HCV screening recommendation for baby boomers among PCPs. Methods We conducted a mixed methods pilot study of PCPs. Quantitative: We surveyed PCPs from 3 large academic health systems assessing screening practices, knowledge (range:0–9), self-efficacy to identify and treat HCV (range:0–32), and barriers (range:0–10). Qualitative: We conducted interviews assessing patient, provider, and clinic-level barriers to HCV screening for baby boomers in primary care. Interviews were audio recorded, transcribed, and analyzed with content analysis. Results The study sample consisted of 31 PCPs (22 survey participants and nine interview participants). All PCPs were aware of the birth cohort screening recommendation and survey participants reported high HCV testing recommendation, but qualitative interviews indicated other priorities may supersede recommending HCV testing. Provider knowledge of viral transmission was high, but lower for infection prevalence. While survey participants reported very few barriers to HCV screening in primary care, interview participants provided a more nuanced description of barriers such as lack of time. Conclusions There is a need for provider education on both HCV treatment as well as how to effectively recommend HCV screening for their patients. As HCV screening guidelines continue to expand to a larger segment of the primary care population, it is important to understand ways to improve HCV screening in primary care.

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Florida physicians' reported use of AFIX-based strategies for human papillomavirus vaccination

Cited by 8 publications

References 23 publications

Policy opportunities to increase HPV vaccination in rural communities

Policy opportunities to increase HPV vaccination in rural communities

Provider perspectives on multilevel barriers to HPV vaccination

There’s just not enough time: a mixed methods pilot study of hepatitis C virus screening among baby boomers in primary care

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