Marjorie A Margolis1, Noel T Brewer1, Marcella H Boynton2, Jennifer Elston Lafata3, Brian G Southwell4, Melissa B Gilkey5. 1. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599 USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA. 2. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599 USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill, NC, USA. 3. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; Division of Pharmaceutical Outcomes and Policy, University of North Carolina, Chapel Hill, NC, USA. 4. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599 USA; Science in the Public Sphere, RTI International, Research Triangle Park, NC, USA; Duke Forge, School of Medicine, Duke University, Durham, NC, USA. 5. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599 USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA. Electronic address: gilkey@email.unc.edu.
Abstract
OBJECTIVE: Parents often decline HPV vaccination, but little is known about how healthcare providers should promote vaccination at a later visit for secondary acceptance. We examined the associations of two factors, providers' response to declination during the visit and follow-up after the visit, with secondary acceptance. METHODS: We conducted a cross-sectional survey of US parents whose 9- to 17-year-old child had not yet completed the HPV vaccination series. Parents who declined HPV vaccination during an initial discussion with a provider (n = 447) reported whether their provider engaged in any active response during the visit (e.g., giving information, trying to change their mind) or any follow-up after the visit (e.g., scheduling another visit). We conducted multivariable logistic regression to determine whether an active response or follow-up was associated with secondary acceptance of HPV vaccination. RESULTS: Only about one-third of parents reported an active response during the visit (35%) or follow-up after the visit (39%) following HPV vaccination declination. Parents had higher odds of secondary acceptance of HPV vaccine if they received any provider follow-up after the visit (43% vs. 20%, aOR:3.19; 95% CI:2.00:5.07). Receipt of an active provider response was not associated with secondary acceptance. More parents thought a provider should actively respond and follow-up (61% and 68% respectively), compared with those who received such a response (both p < .01). CONCLUSIONS: Providers' follow-up after the visit may be important for promoting secondary acceptance of HPV vaccination. Parents who decline HPV vaccination often prefer to receive an active response or follow-up from a provider.
OBJECTIVE: Parents often decline HPV vaccination, but little is known about how healthcare providers should promote vaccination at a later visit for secondary acceptance. We examined the associations of two factors, providers' response to declination during the visit and follow-up after the visit, with secondary acceptance. METHODS: We conducted a cross-sectional survey of US parents whose 9- to 17-year-old child had not yet completed the HPV vaccination series. Parents who declined HPV vaccination during an initial discussion with a provider (n = 447) reported whether their provider engaged in any active response during the visit (e.g., giving information, trying to change their mind) or any follow-up after the visit (e.g., scheduling another visit). We conducted multivariable logistic regression to determine whether an active response or follow-up was associated with secondary acceptance of HPV vaccination. RESULTS: Only about one-third of parents reported an active response during the visit (35%) or follow-up after the visit (39%) following HPV vaccination declination. Parents had higher odds of secondary acceptance of HPV vaccine if they received any provider follow-up after the visit (43% vs. 20%, aOR:3.19; 95% CI:2.00:5.07). Receipt of an active provider response was not associated with secondary acceptance. More parents thought a provider should actively respond and follow-up (61% and 68% respectively), compared with those who received such a response (both p < .01). CONCLUSIONS: Providers' follow-up after the visit may be important for promoting secondary acceptance of HPV vaccination. Parents who decline HPV vaccination often prefer to receive an active response or follow-up from a provider.
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