Online Program

Least important and last on the list: Physicians' communication about HPV vaccination

Monday, November 2, 2015 : 9:30 a.m. - 9:45 a.m.

Melissa Gilkey, PhD, Population Medicine, Harvard Medical School, Boston, MA
Jennifer Moss, PhD, MSPH, Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
Megan Hall, MPH, Health Behavior, University of North Carolina, Chapel Hill, NC
Parth Shah, PharmD, Health Behavior, University of North Carolina, Chapel Hill, NC
Noel Brewer, PhD, Department of Health Behavior, University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC
Background. Human papillomavirus (HPV) vaccine uptake remains far below the Healthy People 2020 goal of 80% coverage, and stands in stark contrast to our success in delivering other adolescent vaccines. Because improving physicians' communication about HPV vaccine is critical to raising coverage, we sought to understand how the communication context surrounding adolescent vaccination varies by vaccine type.

Methods. Pediatricians and family physicians (n=776) completed our national online survey in 2014. We assessed physicians' perceptions and communication practices related to recommending adolescent vaccines for 11- to 12-year-old patients.

Results. Most physicians reported recommending tetanus, diphtheria, and acellular pertussis (Tdap) (95%) and meningococcal vaccines (87%) as highly important for adolescents, but fewer strongly endorsed HPV vaccine (73%, both p<0.001). Only 13% of physicians perceived HPV vaccine as being highly important to parents, which was far fewer than for Tdap (74%) or meningococcal vaccines (62%, both p<0.001). Physicians reported that, on average, discussing HPV vaccine took 3.7 minutes (SE=0.12), which was almost twice as long as their estimates for Tdap. Among physicians with a preferred order for discussing adolescent vaccines, most (70%) discussed HPV vaccine last.

Conclusions. Our findings suggest that physicians perceive HPV vaccine discussions to be burdensome, requiring more time and engendering less parental support than other adolescent vaccines. Perhaps for this reason, physicians in our national study endorsed HPV vaccine less strongly than other adolescent vaccines, and often chose to discuss it last. Communication strategies are needed to support physicians in recommending HPV vaccine with greater confidence and efficiency.

Learning Areas:

Clinical medicine applied in public health
Communication and informatics
Other professions or practice related to public health
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related education

Learning Objectives:
Describe differences in vaccination coverage for vaccines in the adolescent platform. Assess physicians' perceptions and communication practices related to adolescent vaccination by vaccine type. Discuss the implications of study findings for intervening to improve physicians' communication about HPV vaccination.

Keyword(s): Immunizations, Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator for a federally funded grant focusing on HPV vaccination in primary care settings. I have published over a dozen peer-reviewed papers on this topic.
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.