225513 Perceived Barriers to Human Papillomavirus (HPV) Vaccination Practices among Providers in the IHS, Tribal and Urban Indian Health Facilities

Monday, November 8, 2010 : 1:35 PM - 1:50 PM

Cheyenne Jim, MS , CDC/Ncird/Isd/Pob, Indian Health Service - Immunization Program, Albuquerque, NM
Jennifer Wai Lee, BSN, RN , CDC/Cchp/Nccdphp, Center for Disease Control and Prevention, Atlanta, GA
Amy V. Groom, MPH , Immunization Services Division, Program Operations Branch, Centers for Disease Control and Prevention/Indian Health Service, Albuquerque, NM
David Espey, MD , CDC/Cchp/Nccdphp, IHS Division of Epidemiology, Albuquerque, NM
Mona Saraiya, MD, MPH , Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, GA
Steve Holve, MD , Tuba City Regional Healthcare Corporation, Indian Health Service, Tuba City, AZ
Ann Bullock, MD , Eastern Band of Cherokee, Indian Health Service, Cherokee, NC
Jean Howe, MD, MPH , Northern Navajo Medical Center, Indian Health Service, Shiprock, NM
Judith Thierry, DO, MPH , Indian Health Service, Rockville, MD
Background: American Indian/Alaska Native (AI/AN) women have high rates of cervical cancer and low rates of cervical cancer screenings. Because of this, the human papillomavirus (HPV) vaccine is of particular importance. To better understand potential barriers to HPV vaccination, we conducted a survey of providers in the Indian Health Service, Tribal and Urban (I/T/U) facilities.

Methods: During December 2009 and January 2010, we utilized existing IHS email distribution lists to distribute an on-line survey to vaccine providers working in I/T/U facilities. To further explore issues identified in the survey, we will conduct semi-structured interviews with providers.

Results: There were 270 completed surveys representing all 12 of the IHS regions. Providers reported administering HPV vaccine to the following age groups: 9-10 years 38%; 11-12 years 76%; 13-18 years 92%; and 19-26 years 61%. Potential barriers to HPV vaccination among 9 18 year olds reported include parent concerns about vaccine safety (57%), parent opposition for moral or religious reasons (48%) and parent concerns that vaccination may encourage earlier or riskier sexual behavior (47%). For women 19 26 years, financial barriers to vaccination were reported by 43% of providers.

Conclusions: For 9 18 year olds, parental concerns about the vaccine are a potential barrier reported by the majority of providers, and suggest the need for on-going patient education. Although the majority of providers are giving HPV to women 19 26 years, financial issues are the main barrier to increasing vaccination in this age group.

Learning Areas:

Learning Objectives:
Describe attitudes and practices of providers in IHS, Tribal, and Urban facilities nationwide regarding the HPV vaccine.

Keywords: American Indians, Adolescent Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee the IHS National Immunization Reporting and I led the IHS provider survey.
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.