Identifying human papillomavirus vaccination practices among primary care providers of minority, low-income and immigrant patient populations

Abstract

Objective Minority populations in the United States are disproportionally affected by Human Papillomavirus (HPV) infection and HPV-related cancer. We sought to understand physician practices, knowledge and beliefs that affect utilization of the HPV vaccine in primary care settings serving large minority populations in areas with increased rates of HPV-related cancer. Study Design Cross-sectional survey of randomly selected primary care providers, including pediatricians, family practice physicians and internists, serving large minority populations in Brooklyn, N.Y. and in areas with higher than average cervical cancer rates. Results Of 156 physicians randomly selected, 121 eligible providers responded to the survey; 64% were pediatricians, 19% were internists and 17% were family practitioners. Thirty-four percent of respondents reported that they routinely offered HPV vaccine to their eligible patients. Seventy percent of physicians reported that the lack of preventive care visits for patients in the eligible age group limited their ability to recommend the HPV vaccine and 70% of those who reported this barrier do not routinely recommend HPV vaccine. The lack of time to educate parents about the HPV vaccine and cost of the vaccine to their patients were two commonly reported barriers that affected whether providers offered the vaccine. Conclusions Our study found that the majority of providers serving the highest risk populations for HPV infection and HPV-related cancers are not routinely recommending the HPV vaccine to their patients. Reasons for providers' failure to recommend the HPV vaccine routinely are identified and possible areas for targeted interventions to increase HPV vaccination rates are discussed.

Factors influencing the recommendation of the Human Papillomavirus vaccine by South African doctors working in a tertiary hospital

“…31 Another study from the USA reported about 33% of physicians offering the HPV vaccine routinely to their eligible patients. 32 Investigations of the awareness and attitudes about the HPV vaccines among pediatricians, obstetricians and gynecologists in Turkey, showed that HPV vaccines were recommended by 59.4%, 82.6%, 66.7% and 80.6% of pediatricians, OBG specialists, OBG residents and pediatric residents, respectively. 33 High acceptability of the HPV vaccine was found among French general practitioners and the acceptability rate increased from 79.9% to 87.1% between the years 2007 and 2010.…”

Provider communication about HPV vaccination: A systematic review

“…30,45,47 Studies assessing the relationship between provider characteristics and HPV vaccine recommendations most often focused on clinical specialty and demographics. Most studies found that pediatricians reported more positive HPV vaccine recommendation practices than family physicians 9,11,12,30,33,[48][49][50][51] or other types of providers. 12,32 Other studies failed to find variation in recommendations by specialty, 23,[34][35][36]40,52,53 but several of these studies did not include pediatricians.…”

“…12,32 Other studies failed to find variation in recommendations by specialty, 23,[34][35][36]40,52,53 but several of these studies did not include pediatricians. 34,52,53 Most studies did not find variation in HPV vaccine recommendations by provider sex, 9,23,30,36,39,44,[47][48][49]54 but those that did most often favored female providers. 24,25,29,33,53 Similarly, most studies did not find variation in HPV vaccine recommendations by provider age or years in practice, 30,33,36,47,49 although a few did with mixed results.…”

“…34,52,53 Most studies did not find variation in HPV vaccine recommendations by provider sex, 9,23,30,36,39,44,[47][48][49]54 but those that did most often favored female providers. 24,25,29,33,53 Similarly, most studies did not find variation in HPV vaccine recommendations by provider age or years in practice, 30,33,36,47,49 although a few did with mixed results. 9,24,50 Studies assessing provider race/ethnicity suggested that minority status was associated with recommending HPV vaccine.…”

Human papillomavirus infection and vaccination: Knowledge and attitudes among young males in Italy

“…7,8 In Italy, the vaccination is currently recommended and provided free for girls aged 11 and 12 y, and only in few geographic areas also for men. Numerous studies in different countries have evaluated individuals' knowledge, attitudes, and behaviors toward the vaccination mainly among health care providers, [9][10][11] adolescents, [13][14][15][16] and women and men for themselves [17][18][19][20][21][22][23][24][25] or for their adolescent daughters [26][27][28] or sons. [29][30][31] Unfortunately all these issues among young males have only been studied to a limited extent.…”