To vaccinate or not?: Using SEM to examine predictors of physicians' intentions to vaccinate against HPV

This study assessed physicians' intentions to vaccinate 9- to 15-year-old female patients against the human papillomavirus (HPV). The use of the Theory of Planned Behavior to determine the influencers of physicians' intentions is an addition to the current literature on the acceptability of the HPV vaccine. The survey was mailed to a random sample of 900 family practice and pediatric physicians in a rural, Midwest state. The survey questions focused on the constructs of the theory: subjective norms, attitudes, perceived behavioral control, and intention. Physicians were also asked about socio-demographics and practice characteristics. Structural equation modeling was used to estimate the influence of the theoretical constructs. Of the 207 physicians who responded, intentions to vaccinate were very high (86.5%). They reported intending to begin vaccination younger than the 11 to 12-year-old standard recommendation (M = 10.93 years). Physicians had positive attitudes towards the vaccine, but these attitudes did not influence intention to vaccinate. Intention to vaccinate was driven by subjective norms (â = 1.00, p < 0.05) and perceived behavioral control (â = 0.39, p < 0.05. Recommendations from professional organizations, the Advisory Committee on Immunization Practices, and influential colleagues are keys to increasing vaccine acceptability. More attention should be focused on non-physician-related vaccination issues such as cost and making it easier for girls in this age group to see a physician more often than they currently do.