Background
Although incidence of cervical cancer has been decreasing in the United States over the last decade, Hispanic and African American women have substantially higher rates compared to Caucasian women. The human papillomavirus (HPV) is a necessary, although insufficient, cause of cervical cancer. In the U.S. in 2013, only 37.6% of girls 13–17 years old received the recommended three doses of a vaccine that is almost 100% efficacious for preventing infection with viruses that are responsible for 70% of cervical cancers.
Implementation research has been underutilized in interventions for increasing vaccine uptake. The Consolidated Framework for Implementation Research (CFIR), an approach for designing effective implementation strategies, integrates five domains that may include barriers and facilitators of HPV vaccination. These include the innovative practice (Intervention), communities where youth and parents live (Outer Setting), agencies offering vaccination (Inner Setting), healthcare staff (Providers), and planned execution and evaluation of intervention delivery (Implementation Process).
Methods
Secondary qualitative analysis of transcripts of interviews with 30 community healthcare providers was conducted using the CFIR to code potential barriers and facilitators of HPV vaccination implementation.
Results
All CFIR domains except Implementation Process were well-represented in providers’ statements about challenges and supports for HPV vaccination.
Conclusion
A comprehensive implementation framework for promoting HPV vaccination may increase vaccination rates in ethnically diverse communities. Further research is needed to determine if identifying implementation barriers and facilitators in all five CFIR domains as part of developing an intervention contributes to improved HPV vaccination rates.