Advertisement

Journal of Community Health

, Volume 35, Issue 6, pp 645–652 | Cite as

Influential Factors in HPV Vaccination Uptake Among Providers in Four States

  • Emily L. McCave
Original Paper

Abstract

To examine health providers’ perceived barriers, supports, and vaccination actions in delivering the HPV vaccine to females ages 9–17 in four states. Differences in providers’ HPV vaccination of pre-adolescents compared with older adolescents were explored. A random sample of 1,500 pediatricians, family physicians, gynecologists, nurse practitioners, and physician assistants from four states were asked to complete a mail survey. Providers were recruited through state medical and nursing boards. The final sample included 227 respondents. Among those participants, health providers vaccinated older females (ages 13–17) at significantly higher rates than pre-adolescents (ages 9–12) in all four states. Providers who reported increased barriers to HPV vaccination were significantly less likely to vaccinate girls in either age group. The most frequent barriers reported by providers included the financial burden of the HPV vaccine and encountering patients (more often patients’ parents) who have negative perceptions of vaccine. Most common supports included a personal belief in the positive impact of the HPV vaccine, followed by providers feeling comfortable talking with parents about the sexual nature of the vaccine, and the importance of adhering to the CDC’s recommendations on HPV vaccination. Age of patient will likely influence providers’ HPV vaccination behaviors, particularly if parents have concerns about vaccinating their pre-adolescents. Providers can best serve their patients when they are aware of the potential barriers and supports that may influence their HPV vaccination behaviors.

Keywords

HPV Vaccination Barriers Supports Adolescents 

Notes

Acknowledgments

This author would like to thank Dr. Marianne Berry and Dr. Mark Ezell, University of Kansas, School of Social Welfare for their guidance and support with the completion of this study. The author would also like to thank Dr. Catherine Crisp, University of Arkansas at Little Rock, School of Social Work, for her guidance and support during the development of this study.

Sources and Funding

This study was supported in part by a University of Kansas Graduate Summer Research Fellowship.

References

  1. 1.
    Markowitz, L. E., Dunne, E. F., Saraiya, M., et al. (2007). Quadrivalent human papillomavirus vaccine: Recommendations of the advisory committee on immunization practices (ACIP). MMWR, 56, 1–24.PubMedGoogle Scholar
  2. 2.
    Marlow, L. A. V., Forster, A. S., Wardle, J., et al. (2009). Mothers’ and adolescents’ beliefs about risk compensation following HPV vaccination. Journal of Adolescent Health, 44, 446–451.CrossRefPubMedGoogle Scholar
  3. 3.
    Herzog, T. J., Huh, W. K., Downs, L. S., et al. (2008). Initial lessons learned in HPV vaccination. Gynecologic Oncology, 109, S4–S11.CrossRefPubMedGoogle Scholar
  4. 4.
    Hopenhayn, C., Christian, A., Christian, W. J., et al. (2007). Human papillomavirus vaccine: Knowledge and attitudes in two appalachian Kentucky counties. Cancer Causes and Control, 18, 627–634.CrossRefPubMedGoogle Scholar
  5. 5.
    Adams, M., Jasani, B., & Fiander, A. (2007). Human papillomavirus (HPV) prophylactic vaccination: Challenges for public health and implications for screening. Vaccine, 25, 3007–3013.CrossRefPubMedGoogle Scholar
  6. 6.
    Chan, S. S. C., Cheung, T. H., Lo, W. K., et al. (2007). Women’s attitudes on human papillomavirus vaccination to their daughters. Journal of Adolescent Health, 41, 204–207.CrossRefPubMedGoogle Scholar
  7. 7.
    Gerend, M. A., Lee, S. C., & Shepherd, J. E. (2007). Predictors of human papillomavirus vaccination acceptability among underserved women. Sexually Transmitted Diseases, 34, 468–471.PubMedGoogle Scholar
  8. 8.
    Kahn, J., Rosenthal, S. L., Jin, Y., et al. (2008). Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women. Obstetrics and Gynecology, 111, 1103–1110.PubMedGoogle Scholar
  9. 9.
    Korfage, I. J., Essink-Bot, M., Daamen, R., et al. (2008). Women show mixed intentions regarding the uptake of HPV vaccinations in pre-adolescents: A questionnaire study. European Journal of Cancer, 44, 1186–1192.CrossRefPubMedGoogle Scholar
  10. 10.
    Lazcano-Ponce, E., Rivera, L., Arillo-Santillan, E., et al. (2001). Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico. Archives of Medical Research, 32, 243–247.CrossRefPubMedGoogle Scholar
  11. 11.
    Marshall, H., Ryan, P., Roberton, D., et al. (2007). A cross-sectional survey to assess community attitudes to introduction of human papillomavirus vaccine. Australian and New Zealand Journal of Public Health, 31, 235–242.CrossRefPubMedGoogle Scholar
  12. 12.
    McIntosh, J., Sturpe, D. A., & Khanna, N. (2008). Human papillomavirus vaccine and cervical cancer prevention: Practice and policy implications for pharmacists. Journal of the American Pharmaceutical Association, 48, e1–e13.CrossRefGoogle Scholar
  13. 13.
    Olshen, E., Woods, E. R., Austin, S. B., et al. (2005). Parental acceptance of the human papillomavirus vaccine. Journal of Adolescent Health, 37, 248–251.CrossRefPubMedGoogle Scholar
  14. 14.
    Sussman, A. L., Helitzer, D., Sanders, M., et al. (2007). HPV and cervical cancer prevention counseling with younger adolescents: Implications for primary care. Annals of Family Medicine, 5, 298–304.CrossRefPubMedGoogle Scholar
  15. 15.
    Tissot, A. M., Zimet, G. D., Rosenthal, S. L., et al. (2007). Effective strategies for HPV vaccine delivery: The views of pediatricians. Journal of Adolescent Health, 41, 119–125.CrossRefPubMedGoogle Scholar
  16. 16.
    Vanslyke, J., Baum, J., Plaza, V., et al. (2008). HPV and cervical dancer testing and prevention: Knowledge, beliefs, and attitudes among Hispanic women. Qualitative Health Research, 18, 584–596.CrossRefPubMedGoogle Scholar
  17. 17.
    Woodhall, S. C., Lehtinen, M., Verho, T., et al. (2007). Anticipated acceptance of HPV vaccination at the baseline of implementation: A survey of parental and adolescent knowledge and attitudes in Finland. Journal of Adolescent Health, 40, 466–469.CrossRefPubMedGoogle Scholar
  18. 18.
    Brabin, L., Roberts, S. A., Stretch, R., et al. (2008). Uptake of first doses of human papillomavirus vaccine by adolescent schoolgirls in Manchester: Prospective Cohort Study. British Medical Journal, 336, 1056–1058.CrossRefPubMedGoogle Scholar
  19. 19.
    Fazekas, K. I., Brewer, N. T., & Smith, J. (2008). HPV vaccine acceptability in a Rural Southern Area. Journal of Women’s Health, 17, 539–548.CrossRefPubMedGoogle Scholar
  20. 20.
    Feemster, K., Winters, S., Fiks, A., et al. (2008). Pediatricians’ intention to recommend HPV vaccines post-licensing. Journal of Adolescent Health, 42, S1.CrossRefGoogle Scholar
  21. 21.
    Hoover, D. R., Carfioli, B., & Moench, E. A. (2000). Attitudes of adolescent/young adult women toward human papillomavirus vaccination and clinical trials. Health Care for Women International, 21, 375–391.CrossRefPubMedGoogle Scholar
  22. 22.
    Kahn, J. A., Zimet, G. D., Bernstein, D. I., et al. (2005). Pediatricians’ intention to administer human papillomavirus vaccine: The role of practice characteristics, knowledge, and attitudes. Journal of Adolescent Health, 37, 502–510.CrossRefPubMedGoogle Scholar
  23. 23.
    Lenselink, C. H., Gerrits, M., Melchers, W., et al. (2008). Parental acceptance of human papillomavirus vaccines. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 137, 103–107.CrossRefPubMedGoogle Scholar
  24. 24.
    Mays, R. M., Sturm, L. A., & Zimet, G. D. (2004). Parental perspectives on vaccinating children against sexually transmitted infections. Social Science and Medicine, 58, 1405–1413.CrossRefPubMedGoogle Scholar
  25. 25.
    Ogilvie, G. S., Remple, V. P., Marra, F., et al. (2008). Parental intention to have daughters receive the human papillomavirus vaccine. Canadian Medical Association Journal, 177, 1506–1512.CrossRefGoogle Scholar
  26. 26.
    Tedeschi, S. K., Lally, M. A., Parekh, M. J., et al. (2006). Attitudes of at-risk adolescents and their parents toward anticipated HPV and HIV vaccines. Journal of Adolescent Health, 38, 128.CrossRefGoogle Scholar
  27. 27.
    Zimet, G. D., Mays, R. M., Winston, Y., et al. (2000). Acceptability of human papillomavirus immunization. Journal of Women’s Health & Gender-Based Medicine, 9, 47–50.CrossRefGoogle Scholar
  28. 28.
    Rosenthal, S. L., Rupp, R., Zimet, G. D., et al. (2008). Uptake of HPV vaccine: Demographics, sexual history and values, parenting style, and vaccine attitudes. Journal of Adolescent Health, 43, 239–245.CrossRefPubMedGoogle Scholar
  29. 29.
    Patel, M., Zandieh, S., & Chang, J. (2009). Are our adolescent females becoming “One Less”? HPV vaccination rates and barriers to vaccination. Journal of Adolescent Health, 44, S28.CrossRefGoogle Scholar
  30. 30.
    National Conference of State Legislatures. (2008). HPV vaccine [Online]. Available at: http://www.ncsl.org/programs/health/HPVvaccine.htm. Accessed November 15, 2008.
  31. 31.
    US Census Bureau. (2007). State and county quick facts [Online]. Available at: http://quickfacts.census.gov/gfd. Accessed June 1, 2007.
  32. 32.
    United States Cancer Statistics: 2003. (2006). Incidence and mortality. Atlanta, GA: US Department of Health and Human Services and Centers for Disease Control.Google Scholar
  33. 33.
    Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.CrossRefGoogle Scholar
  34. 34.
    Kellerman, S. E., & Herold, J. (2001). Physician response to surveys: A review of the literature. American Journal of Preventive Medicine, 20, 61–67.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Social WorkWest Virginia UniversityMorgantownUSA

Personalised recommendations