The relationship between receiving care within a medical home and HPV vaccine receipt for adolescent girls: results of the 2007 National Survey of Children's Health.

To estimate initiation of HPV vaccination among adolescent girls and examine the relationship between receiving care consistent with the medical home model in a population-based sample. We used the National Survey of Children's Health 2007, a nationally representative sample of children in the United States, to study adolescent girls 12-17 years of age. We present the results of descriptive and multivariable logistic regression analyses for the relationship between receiving care within a medical home, as defined by the American Academy of Pediatrics, and HPV vaccination initiation. Overall, 18.1% of adolescent girls had received at least one HPV vaccine injection and 54.6% received care within a medical home. The relationship between having a medical home and HPV vaccine initiation was heterogeneous across levels of household income and parent education. After adjusting for region of U.S., insurance status, and race/ethnicity, we found increased odds of HPV vaccine receipt for girls with versus without a medical home among those in low income households (<300% of the federal poverty level) whose parents have less than a high school education (OR 3.98, 95% CI 1.52-10.44). Results were not significant for other strata of household income and parent education. These findings suggest the important role of receiving care in a medical home model in HPV vaccine adoption for adolescents in households with low incomes and low parent education. Continued promotion of the medical home model at the federal and state levels, especially within vulnerable populations, may help to reduce disparities in access to preventive vaccines.