Recent research in Vaccine identified specific areas which provider-based interventions should focus on, such as improving communication skills regarding adolescent sexuality, in order to improve HPV vaccination completion rates.
“If we don't fully vaccinate young people, they don't receive the full protection,” Sharon M. Hudson, PhD, a researcher in the department of research and evaluation at Kaiser Permanente Southern California, told Infectious Diseases in Children. “That is why it's important for health care systems and providers to do everything we can to ensure complete vaccination. Our study identified several areas where we can focus efforts to improve vaccine coverage and therefore better protect our patients against these cancers.”
Sharon M. Hudson
The researchers conducted 61 qualitative interviews with pediatricians and other health care professionals at the three Kaiser Permanente Medical Centers with the highest HPV vaccination rates and the three centers with the lowest rates. Telephone interviews with health care professionals included questions related to attitudes and behaviors toward HPV vaccination, perception of patient knowledge and attitude regarding HPV and institutional support offered at medical centers regarding HPV vaccination.
Study results showed that at both high- and low-performing medical centers, support for HPV vaccination was strong. However, clinicians at higher-performing centers were more likely to use effective communication techniques, such as engaging parents and patients in two-way conversation and acknowledging cultural and practical vaccination barriers. Clinicians from higher-performing centers also were able to recall conversations about sexuality in greater detail, were more likely to describe these conversations as difficult, and they more frequently led to successful vaccination, when compared with clinicians at lower-performing centers.
The researchers found that clinicians at lower-performing centers were more likely to describe a lack of proactivity and teamwork among center staff and were more likely to suggest improvements that involved changes from staff other than themselves. Clinicians in lower-performing centers also were more likely to respond with answers that reflected negativity and judgment compared with those at higher-performing centers.
“It is important for physicians to be prepared and comfortable engaging in conversations about sexuality, regardless of how they frame the HPV vaccination conversation with parents,” Hudson said. “It is a cancer prevention vaccine, and I agree with presenting it as such. But the fact remains that many parents associate it with sex and perceive it as condoning or promoting sexual activity. That's a real barrier to vaccination for some families. If physicians shy away from those conversations, or don't have the communication skills to negotiate those waters, then they're likely to lose some opportunities to fully vaccinate some patients.” – by David Costill
Disclosure: Hudson reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.