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Communication Interactions, Needs, and Preferences During Clinical Encounters of African American Parent–Child Dyads

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A Correction to this article was published on 30 October 2023

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Abstract

Human papillomavirus (HPV) vaccination rates remain suboptimal among African American adolescents. Although provider recommendations during clinical encounters are believed to be highly effective in increasing uptake and series completion, little has been reported about parent–child perspectives on the counseling received during these encounters. Among African American parent–child dyads, we sought to explore and compare interactions, needs, and preferences during clinical encounters by child’s HPV vaccination status. We applied a qualitative, phenomenological study design to conduct semi-structured interviews with African American parent–child dyads representing children who were unvaccinated (n = 10), had initiated but not completed (n = 11), or had completed the HPV vaccine series (n = 9). Using iterative, inductive-deductive thematic analysis, five themes were generated: (1) parents’ attitudes varied about the HPV vaccine but were mostly positive for vaccines in general; (2) patient-parent-provider clinical encounters from the parent perspective; (3) patient-parent-provider clinical encounters from the child perspective; (4) methods of distribution of supplemental HPV information; and (5) communication desired on HPV vaccination by parents and children. Parents stating they received a provider’s recommendation increased by vaccination status (unvaccinated: 6 out of 10; initiated: 7 out of 11; completed: 9 out of 9). Most parents and children were not satisfied with provider communication on the HPV vaccine and used supplemental materials to inform decision-making. Ongoing communication on the HPV vaccine was requested even post-vaccination of the child. During clinical encounters, children and parental messaging needs are similar yet dissimilar. We offer communication strategies and messaging that can be used for African American parent–child dyads by child HPV vaccination status during a clinical encounter.

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Acknowledgements

The authors would like to acknowledge members of the Meharry-Vanderbilt-Tennessee State University Cancer Partnership Community Advisory Board (CAB) for being actively engaged throughout this research process. Their input was essential for the success of this project. The authors would also like to thank the African American parents and children for their valuable insights on communication needs for the HPV vaccine.

Funding

This work was supported by the Vanderbilt Patient Centered Outcomes Research Career Knowledge, Education, and Training (K12) Program by a grant from the Agency for Healthcare Research and Quality under grant number 5K12HS022990-05, National Cancer Institute under grant numbers K01CA237748 and U54CA163072.

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Authors and Affiliations

  1. Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN, 37208-3599, USA

    Jennifer Cunningham-Erves & Elizabeth C. Stewart

  2. Meharry Vanderbilt Alliance, 1005 Dr. D.B. Todd Jr. Blvd., Biomedical Building, Nashville, TN, 37208, USA

    Meredith Smalls

  3. Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, 2200 Children’s Way, Suite 2404, Nashville, TN, 37232, USA

    Kathryn Edwards

  4. Department of Behavioral Science, College of Medicine, Markey Cancer Center, University of Kentucky, Lexington, KY, 40506, USA

    Pamela C. Hull

  5. Adult & Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, 80045, USA

    Amanda F. Dempsey

  6. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, 80045, USA

    Amanda F. Dempsey

  7. Merck and Company, Wales, PA, 19454, USA

    Amanda F. Dempsey

  8. Office of Health Equity, Vanderbilt University Medical Center, 1121 Medical Center Drive, Nashville, TN, 37232, USA

    Consuelo H. Wilkins

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Contributions

Jennifer Cunningham-Erves, Amanda Dempsey, Pamela Hull, and Consuelo H Wilkins were responsible for conceptualization, methodology, validation, resources, and funding acquisition. Jennifer Cunningham-Erves, Meredith Smalls, and Elizabeth Stewart were responsible data curation and writing—original draft. Jennifer Cunningham-Erves were responsible for data collection and management and survey data analysis. Kathryn Edwards assisted in data interpretation. The first draft of the manuscript was written by Jennifer Cunningham-Erves and all authors were responsible for the review and editing of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jennifer Cunningham-Erves.

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Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Meharry Medical College Institutional Review Board (Date: 7.30.2020; Protocol Number: 16–06-569).

Consent to Participate

Informed consent was obtained parents and assent from children after being explained the study procedures including purpose, risks, and benefits.

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The authors affirm that human research participants provided informed consent for publication of aggregate data.

Competing Interests

KME: Consultant to Bionet and IBM: Member Data Safety and Monitoring Board for Sanofi, X-4 Pharma, Seqirus, Moderna, Pfizer, Merck, and Roche. JCE: Education Consultant and Advisory Board Member for MERCK. All other authors declare no conflicts of interest.

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The original version of this article was revised: The abstract has been updated to accurately report data concerning numbers of study participants.

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Cunningham-Erves, J., Smalls, M., Stewart, E.C. et al. Communication Interactions, Needs, and Preferences During Clinical Encounters of African American Parent–Child Dyads. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01754-8

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