2015 APHA Annual Meeting & Expo

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Online Program

336292
Impact of Targeted Human Papillomavirus (HPV) Clinician Education on Intended HPV Vaccine Recommendation Practices


Sunday, November 1, 2015

Kristen Feemster, MD MPH MSHP, Department of Pediatrics, Division of Infectious Diseases, The Children's Hospital of Philadelphia; University of Pennsylvania School of Medicine, Philadelphia, PA
Caitlin Fasano, M.P.H., Vaccine Education Center, The Children's Hospital of Philadelphia, Philadelphia, PA
Charlotte Moser, BS, Vaccine Education Center, The Children's Hospital of Philadelphia, Philadelphia, PA
Healthcare provider recommendation is the strongest predictor of human papillomavirus (HPV) vaccine acceptance yet strength of recommendation varies.  This may be related to limited knowledge about HPV vaccinology and epidemiology among providers leading to discomfort responding to HPV vaccine-related questions and decreased enthusiasm for following recommendations. This study measured the impact of receiving information regarding HPV epidemiology and vaccinology on HPV vaccine recommendation practices among family practitioners, obstetrician-gynecologists and pediatricians.

 In this cross-sectional study of PA physicians, participants were randomly selected from an American Medical Association (AMA) mailing list (n=3,126) and received one of two versions of an anonymous 24- item survey instrument with 5 clinical vignettes. To measure associations between scientific knowledge and vaccine recommendation behavior, responses to Survey A (no additional information) and Survey B (additional scientific information) were compared using Chi Square and multivariable logistic regression while accounting for effect modification by provider type.

Among 781 (25%) respondents, the majority (80%) self-identified as pediatricians or family practitioners.  Information about HPV vaccine immunogenicity was significantly associated with likelihood of recommending HPV vaccines according to the recommended schedule (61.5% vs. 50.4%, p .002); whereas, information about HPV disease risk was not (52.3% vs. 47.9%, p.22).  Preliminary analysis shows a stronger information effect among family practitioners compared to other provider types. 

Results suggest that HPV-related information can influence recommendation practices but is used by clinicians differently when discussing recommendations and counseling parents.  Results can guide development of curricula and communication tools to most effectively promote endorsement of HPV vaccine recommendations.

Learning Areas:

Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Assess influence of targeted clinician education about HPV epidemiology and vaccinology on intended recommendation and counseling practices Identify differences in the association between clinician education and recommendation behaviors across clinical specialties

Keyword(s): Immunizations, Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Research Director for the Vaccine Education Center and have led or collaborated on multiple studies focusing upon vaccine acceptance and implementation of immunization recommendations, including HPV vaccines. I have formal training in infectious diseases, public health and health services research.
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.

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