Provider perspectives on multilevel barriers to HPV vaccination

Lake, Paige; Kasting, Monica L.; Christy, Shannon M.; Vadaparampil, Susan T.

doi:10.1080/21645515.2019.1581554

Cited by 25 publications

(14 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 The majority of studies have focused on one or two levels of influences (e.g., parents and/or clinicians); however, parents and clinicians have reported that their views on the HPV vaccine are influenced by each other as well as by factors related to the health care system. 6,12,13 Few studies have examined an integrated perspective that includes simultaneously elucidating the processes of care delivery and the role of primary care team members in facilitating the uptake of the HPV vaccine. [14][15][16] The purpose of this study was to examine clinicians, clinic support staff, and parents of adolescent HPV vaccine delivery experiences at the point of care across an integrated primary care network.…”

Section: Introductionmentioning

confidence: 99%

“There’s Always Next Year”: Primary Care Team and Parent Perspectives on the Human Papillomavirus Vaccine

Dang

Stewart²,

Blumberg

et al. 2020

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

Acceptance of the human papillomavirus (HPV) vaccination among parents and clinicians is high, but uptake remains low. Little is known about organizational and primary care team factors that influence the uptake of the HPV vaccine. Interviews with clinicians, clinic support staff, and parents of adolescent patients were conducted to better understand the interrelationships among the people and the organizational processes that influence HPV vaccine uptake at the point of care. Between July 2016 and February 2017, semi-structured interviews of 40 participants (18 clinicians, 12 clinic support staff, and 10 parents of adolescent patients) in a primary care network were conducted. Organizational structures and processes, such as electronic provider reminders, availability of "vaccination only" appointments, and knowledgeable primary care team members contributed to HPV vaccine uptake. Consistently high support of HPV vaccination was found among key informants; however, rather than refuse HPV vaccination, parents are opting to delay vaccination to a future visit. When parents express the desire to delay, clinicians and care team members described often recommending addressing HPV vaccination at a future visit, giving parents the impression that receiving the vaccine was not timesensitive for their child. Discordance in HPV vaccination recommendations among providers and clinic support staff may contribute to delayed HPV vaccination. Strong, high-quality HPV vaccine recommendations are needed from all primary team members. Clinic interventions to accelerate HPV vaccine uptake may benefit from a team-based approach where every member of the primary care team is delivering the same consistent messaging about the importance of timely HPV vaccination.

show abstract

Section: Introductionmentioning

confidence: 99%

“There’s Always Next Year”: Primary Care Team and Parent Perspectives on the Human Papillomavirus Vaccine

Dang

Stewart²,

Blumberg

et al. 2020

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

show abstract

“…This includes both clinic-level factors, such as the ability of the clinic to stock the vaccine, the presence of tools like provider prompts and reminder-recall systems and peer influences as well as the characteristics of the broader community in which the provider practices . HCP peers may influence provider attitudes about vaccines or recommendation practices (P. W. Lake et al, 2019a , 2019b ). Providers who were characterized as “Ambivalent HPV recommenders”—those who did not consistently or strongly recommend the HPV vaccine—were also less likely to perceive their peers as thinking the HPV vaccine was important for adolescents or strongly recommending the vaccine (Hopfer et al, 2019 ).…”

Section: A Multilevel Framework For Factors Influencing Provider Reco...mentioning

confidence: 99%

“…Improving reimbursement policies for the HPV vaccine has been associated with an increase in both initiation and completion of the series (Tsai et al, 2018 ). In a study of physicians in Florida, many cited financial barriers such as the high cost of purchasing vaccine or inadequate reimbursement for administered vaccines from insurance companies as primary reasons for not vaccinating patients or referring patients/parents to Departments of Health (P. W. Lake et al, 2019a , 2019b ). However, providers who participated in the Vaccines for Children (VFC), which provides vaccines free of charge to children who are not insured, have Medicaid or whose private insurance does not cover the vaccine, were not only more likely to recommend the HPV vaccine to their patient and/or their parents but also more likely to provide a strong vaccine recommendation (P. W. Lake et al, 2019a , 2019b ).…”

Section: A Multilevel Framework For Factors Influencing Provider Reco...mentioning

confidence: 99%

“…One qualitative study found that lack of school entry requirements for the HPV vaccine influenced provider’s framing of the HPV vaccine as “non-urgent” (Niccolai et al, 2018 ). Another study conducted among stakeholders in Florida found a belief among stakeholders that physicians view the HPV vaccine as less important because there is no mandate in place (P. Lake et al, 2019a , 2019b ). State-level up-to-date coverage with the MenACWY vaccine (two doses by age 17 or one dose at age 16 or 17) was higher in states with either one or two-dose school entry requirements for the MenACWY vaccine.…”

Section: A Multilevel Framework For Factors Influencing Provider Reco...mentioning

confidence: 99%

See 1 more Smart Citation

Understanding the Factors Influencing Health Care Provider Recommendations about Adolescent Vaccines: A Proposed Framework

et al. 2022

View full text Add to dashboard Cite

Health care provider recommendations are among the most important factors influencing parents’ decisions to vaccinate their adolescents. However, delivery of high-quality health care provider recommendations for vaccination is not universal. There is wide variation in the strength, timeliness and consistency of the delivery of recommendations for all adolescent vaccines. The factors that influence health care providers’ recommendations are multi-level and can be conceptualized in much the same way as vaccine acceptance among parents. Health care providers are influenced by their own attitudes and beliefs about a vaccine and also by the patient they are treating and by the community in which they practice as well as state and national level vaccine policy. We propose a multi-level framework for understanding the factors that influence health care providers’ recommendations at the individual, interpersonal and community level to both develop and adapt interventions to improve providers’ recommendations.

show abstract

“…46,47 Two additional papers examine issues of risk compensation post-vaccination in the U.S. and in China, respectively. 48,49 Still other articles involve a latent-class analysis of parental worries, 50 adolescents' perspectives on vaccination, 51 college students' lack of awareness of HPV diseases and vaccination, 52 knowledge and attitudes of caregivers of childhood cancer survivors, 53 HCPs' recommendation profiles and perceptions of barriers to vaccination, 54,55 and perspectives on vaccination among boys in Sweden. 56 Finally, articles in this section apply the Precaution Adoption Process Model to a study of parental vaccine hesitancy, 57 examine preferences for a vaccine-related mobile health tool among young men who have sex with men, 58 and report on the association between vaccination history in women and the HPV vaccine status of their 11-14-y-old children.…”

Section: Hpv Vaccination Policymentioning

confidence: 99%