Emily B Walling1, Sherry Dodd2, Neil Bobenhouse2, Evelyn Cohen Reis3, Randy Sterkel2, Jane Garbutt4. 1. Division of Hematology and Oncology, Department of Pediatrics, Washington University, School of Medicine, St. Louis, Missouri; Department of Pediatrics and Communicable Diseases, Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan. Electronic address: wallinge@med.umich.edu. 2. Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri. 3. Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 4. Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
Abstract
INTRODUCTION: Human papillomavirus (HPV) vaccine coverage in the U.S. is persistently suboptimal, despite research describing barriers to vaccination and strategies to increase vaccination coverage. The objective was to assess providers' approach to the HPV vaccine and their implementation of strategies to increase HPV vaccination coverage. The hypothesis was that adoption of improvement measures to address underuse of the HPV vaccine has not occurred. METHODS: Community pediatric providers from two Midwestern practice-based research networks completed self-administered electronic surveys. Data were collected over 6 months in 2015 and organized and analyzed in 2016. RESULTS: There were 100 providers that participated. Despite agreement with national recommendations, some providers delayed their recommendation until the adolescent was older and many reported missed vaccination opportunities. Many providers experienced parental concerns including safety of the HPV vaccine, belief their child was not at risk of HPV infection, and their child's resistance to receiving multiple shots. Providers identified the following as barriers to adherence to Advisory Committee on Immunization Practices guidelines: bad publicity of the HPV vaccine, information about the HPV vaccine on the web, and a lack of a follow-up system for those who delayed HPV vaccine initiation. Approximately half of the participants had implemented strategies to address these barriers beyond offering immunization-only appointments. CONCLUSIONS: Participants were aware of barriers to HPV vaccine use, but many had not adopted a systematic approach to increase vaccine coverage. A better understanding of the challenges facing providers to adopting improvement measures and a strategy to address barriers to implementation are needed to improve HPV coverage.
INTRODUCTION:Human papillomavirus (HPV) vaccine coverage in the U.S. is persistently suboptimal, despite research describing barriers to vaccination and strategies to increase vaccination coverage. The objective was to assess providers' approach to the HPV vaccine and their implementation of strategies to increase HPV vaccination coverage. The hypothesis was that adoption of improvement measures to address underuse of the HPV vaccine has not occurred. METHODS: Community pediatric providers from two Midwestern practice-based research networks completed self-administered electronic surveys. Data were collected over 6 months in 2015 and organized and analyzed in 2016. RESULTS: There were 100 providers that participated. Despite agreement with national recommendations, some providers delayed their recommendation until the adolescent was older and many reported missed vaccination opportunities. Many providers experienced parental concerns including safety of the HPV vaccine, belief their child was not at risk of HPV infection, and their child's resistance to receiving multiple shots. Providers identified the following as barriers to adherence to Advisory Committee on Immunization Practices guidelines: bad publicity of the HPV vaccine, information about the HPV vaccine on the web, and a lack of a follow-up system for those who delayed HPV vaccine initiation. Approximately half of the participants had implemented strategies to address these barriers beyond offering immunization-only appointments. CONCLUSIONS:Participants were aware of barriers to HPV vaccine use, but many had not adopted a systematic approach to increase vaccine coverage. A better understanding of the challenges facing providers to adopting improvement measures and a strategy to address barriers to implementation are needed to improve HPV coverage.
Authors: Melissa S Stockwell; Karthik Natarajan; Rajasekhar Ramakrishnan; Stephen Holleran; Kristen Forney; Angel Aponte; David K Vawdrey Journal: Pediatrics Date: 2016-05-05 Impact factor: 7.124
Authors: Susan T Vadaparampil; Jessica A Kahn; Daniel Salmon; Ji-Hyun Lee; Gwendolyn P Quinn; Richard Roetzheim; Karen Bruder; Teri L Malo; Tina Proveaux; Xiuhua Zhao; Neal Halsey; Anna R Giuliano Journal: Vaccine Date: 2011-09-14 Impact factor: 3.641
Authors: Douglas J Opel; Rita Mangione-Smith; Jeffrey D Robinson; John Heritage; Victoria DeVere; Halle S Salas; Chuan Zhou; James A Taylor Journal: Am J Public Health Date: 2015-03-19 Impact factor: 9.308
Authors: David G Bundy; Nichole M Persing; Barry S Solomon; Tracy M King; Peter N Murakami; Richard E Thompson; Lilly D Engineer; Christoph U Lehmann; Marlene R Miller Journal: Acad Pediatr Date: 2013-03-14 Impact factor: 3.107
Authors: Tanja Y Walker; Laurie D Elam-Evans; James A Singleton; David Yankey; Lauri E Markowitz; Benjamin Fredua; Charnetta L Williams; Sarah A Meyer; Shannon Stokley Journal: MMWR Morb Mortal Wkly Rep Date: 2017-08-25 Impact factor: 17.586
Authors: Sean T O'Leary; Steven Lockhart; Juliana Barnard; Anna Furniss; Miriam Dickinson; Amanda F Dempsey; Shannon Stokley; Steven Federico; Michael Bronsert; Allison Kempe Journal: Int J Environ Res Public Health Date: 2018-01-23 Impact factor: 3.390
Authors: Natoshia M Askelson; Grace Ryan; Laura Seegmiller; Felicia Pieper; Bethany Kintigh; Donald Callaghan Journal: J Community Health Date: 2019-08
Authors: Brigid K Grabert; Rachel Kurtzman; Jennifer Heisler-MacKinnon; Jennifer Leeman; Adam Bjork; Maddy Kameny; Amy Liu; Karen Todd; Susan Alton Dailey; Kevin Smith; Noel T Brewer; Melissa B Gilkey Journal: Transl Behav Med Date: 2022-01-18 Impact factor: 3.626
Authors: Jenny K R Francis; Serena A Rodriguez; Olivia Dorsey; James-Michael Blackwell; Bijal A Balasubramanian; Neelima Kale; Philip Day; Sharice M Preston; Erika L Thompson; Sandi L Pruitt; Jasmin A Tiro Journal: Prev Med Rep Date: 2021-09-17
Authors: Mali K Schneiter; Kimberly Levinson; Anne F Rositch; Rebecca L Stone; Amanda Nickles Fader; James Stuart Ferriss; Stephanie L Wethington; Anna L Beavis Journal: Gynecol Oncol Rep Date: 2022-03-03