Online Program

Factors related to the diffusion of HPV vaccination in a state Medicaid program

Monday, November 4, 2013

Elizabeth Momany, PhD, Public Policy Center, University of Iowa, Iowa City, IA
Natoshia M. Askelson, MPH, PhD, Department of Community and Behavioral Health, University of Iowa, Iowa City, IA
Suzanne Bentler, PhD, Public Policy Center, University of Iowa, Iowa City, IA
The overall objective of this research is to determine who HPV vaccination rates may be improved through the determination of diffusion patterns and provider characteristics related to provision of the vaccine. Ultimately, understanding the diffusion and provision of HPV vaccine within an at risk population will lead to the development of innovative models for increasing provider compliance with HPV vaccine recommendations. Utilizing Iowa Medicaid claims and enrollment files and the Iowa Health Professions Tracking database for the period 2005-2012. We defined the diffusion pattern for adolescent females and males,identified the providers who vaccinated adolescents, and determined the vaccine intiation and completion rates.During the period 2006-2012 over 30,000 adolescents received and initial HPV vaccination, while during this same period only 10,000 completed the three dose vaccination series. OF the 20,000 that did not complete, less than 8,000 received a second dose. Nearly 500 received more than 3 doses indicating attempts to 'restart' the series. Approximately 2,300 providers were responsible for these vaccinations, with the majority having a family practice or pediatric specialty. However, there were a significant proportion who identified their specialty as "General". Though adolescent males do receive the vaccination they are far less likely to initiate and complete. We did find that adolescents with a cognitive impairment or serious mental illness were less likely intiate but more likely to complete. These adolescents were also likely to initiate at an older age. Regression to determine the factors the predict whether a provider will vaccinate are currently being completed.

Learning Areas:

Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related research

Learning Objectives:
Analyze the factors related to the diffusion of HPV vaccination taking into account provider, patient population, family and community level variables. Describe the diffusion patterns for HPV vaccination. Compare HPV vaccination diffusion patterns for adolescent females and males. Describe providers with respect to the Diffusion of Innovation categories.

Keyword(s): Adolescent Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My research spans 20 years of evaluating Medicaid programs and analyzing Medicaid data. The research includes evaluation and assessment of the Iowa Family Planning Waiver, outcomes for children and adults with IDD (including HPV vaccination rates), provider participation in the Medicaid program, dental provider service area development and diffusion of knew pharmaceuticals in the Medicaid program.
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.

Back to: 3306.0: Exploring HPV