203068 Using the HPV vaccine schedule to promote comprehensive reproductive health counseling for adolescents: Resident physician opinions

Wednesday, November 11, 2009: 12:30 PM

Brandi Swanier, MPH , University of Pittsburgh School of Medicine, Pittsburgh, PA
Lisa K. Perriera, MD , Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Family Planning, Magee Womens Hospital, Pittsburgh, PA
Aletha Y. Akers, MD, MPH , Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, Pittsburgh, PA
Melanie A. Gold, DO , Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
BACKGROUND: Few adolescents receive recommended reproductive health services. The 3 visit HPV vaccine schedule offers a new opportunity to provide these services to adolescents.

OBJECTIVE: To explore resident physicians' opinions about providing adolescents age-appropriate reproductive health services during HPV vaccine visits.

METHODS: Between November 2008 and February 2009, residents in OB/GYN, Family Medicine and Pediatrics at the University of Pittsburgh Medical Center participated in focus groups. Three groups were conducted with each specialty. Discussions explored resident opinions about feasibility, desirability, barriers and benefits of using HPV vaccine visits to provide adolescents reproductive health counseling and education services. Discussions lasted 60 to 80 minutes, were audio-recorded, transcribed and analyzed using a grounded theory approach to content analysis.

RESULTS: 54 residents participated (18 per specialty). Residents were knowledgeable about the HPV vaccine and comfortable educating adolescents and parents about it. Universally, residents felt providing reproductive health counseling and education during HPV vaccine visits was worthwhile but impractical. Many residents were apprehensive about giving reproductive information to the target 11 to 12-year-old age group. The vaccine schedule was perceived as limiting because little time exists between visits to optimize counseling effectiveness. Lack of time and reimbursement were identified as system barriers. Parents and adolescents were believed to prefer short nurse visits for second and third vaccine administrations; compliance was speculated to decrease if other reproductive services were added.

CONCLUSIONS: Residents acknowledge and value the benefits that could arise from pairing HPV immunization with reproductive health counseling. They articulate multilevel changes necessary to implement this practice.

Learning Objectives:
Describe resident opinions about providing reproductive health counseling and education to adolescents during HPV immunization visits. Discuss barriers to the implementation of combined reproductive health counseling and education with HPV immunization in adolescents.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator for the study from which the results are abstracted. I am in my final year of medical school and plan to continue my education in a family medicine residency.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.