243099 HPV vaccine and oral cancer: Barriers to prevention among oral health providers

Sunday, October 30, 2011

Ellen Daley, PhD , Center for Transdisciplinary Research on Women's Health, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Rita DeBate, PhD, MPH, CHES , Center for Transdisciplinary Research on Women's Health, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Christopher Wheldon, MSPH, MEd , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Virginia J. Dodd, PhD, MPH , Dept. of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL
Sarah A. Smith, MPH , Center for Transdisciplinary Research on Women's Health, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Hannah L. Helmy, MA, MPH , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Hollie Jo Fuhrmann, MA , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Cheryl Vamos, MPH , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Karen Dyer, MA, MPH , Department of Anthropology, University of South Florida, Tampa, FL
Background: While the overall incidence of oral cancers (OC) has decreased over the past thirty years due to reductions in tobacco exposure, the incidence of HPV-related OC is increasing. Oral health providers (OHP) can play a critical role in the prevention of HPV-related OC by discussing the HPV-OC link as well as HPV vaccines. Methods: Utilizing the Transtheoretical and Health Belief Models, a web-based likert-type survey was completed by 210 dentists practicing in Florida. Logistic regression was used to identify barriers associated with discussing the HPV vaccine with patients. Results: Knowledge of HPV was high and nearly all (98%) of the respondents were aware of the HPV vaccine prior to completing the survey. In addition, they expressed beliefs that the vaccine is safe (92%) and prevents transmission of certain types of HPV (86%). However, most dentists (92%) reported not discussing the HPV vaccine with female patients or not considering doing so (59%). Statistically significant (p<.05) barriers to discussing the vaccine were perceived liability (OR=3.03), lack of policies/guidelines (OR=2.15), discomfort discussing sexual history/topics (OR=3.70), and the belief that it is not the role of an oral health provider to recommend this vaccine (OR=6.57). Neither lack of information about the vaccine nor beliefs about the vaccine's safety were significantly associated with stage of readiness.Conclusions: Although dentists may play a fundamental role in the prevention of HPV-related OC, the majority surveyed were in the precontemplation/contemplation stage of this behavior. Implications for practice should focus on role perceptions and professional policies/guidelines.

Learning Areas:
Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Describe barriers reported by dentists that prevent them from discussing HPV vaccine with female patients. 2. Identify which barriers are predictive of stage of readiness to discuss HPV vaccine with female patients. 3. Discuss how dentists and other oral health providers can play a critical role in the prevention of HPV-related oral cancer.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed and implemented the study being reported in this abstract.
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.

See more of: Oral-Systemic Health Linkages and the Impact of Behavior
See more of: Oral Health