title: Provider factors associated with disparities in human papillomavirus vaccination among low-income 9- to 17-year-old girls.
abstract: BACKGROUND
  Many women who develop cervical cancer are eligible for or are participants of Medicaid. Providing human papillomavirus (HPV) vaccination to girls enrolled in Medicaid may reduce cervical cancer disparities in low-income and minority women. This study evaluated provider characteristics associated with HPV vaccination among 9- to 17-year-old female Medicaid enrollees.
  
  
  METHODS
  A random sample of 800 providers from the Florida Medicaid Master Provider File was mailed a survey in October 2009 that evaluated demographic and practice characteristics, HPV information and knowledge, barriers to HPV vaccination, vaccine practices, and vaccine recommendation practices. To measure HPV vaccination, Medicaid claims data were used to calculate the proportion of eligible patients who received at least 1 dose of the vaccine from participating providers within the study period. Provider factors associated with vaccination at the bivariate level were evaluated in a multiple linear regression model.
  
  
  RESULTS
  The response rate was 68.3% (N = 485). After excluding ineligible respondents, the current analysis included 433 providers. HPV vaccination prevalence ranged from 0% to 61.9% (M = 20.4, standard deviation = 14.5). HPV vaccination rates were higher among providers who were pediatricians, had a private practice, practiced in a single specialty setting, were providers under the Vaccines for Children program, saw primarily non-Hispanic white patients, used 2 or more strategies for vaccine series completion, and did not refer out for HPV vaccination.
  
  
  CONCLUSIONS
  Despite financial coverage for Medicaid-eligible girls, HPV vaccination rates are low. Study findings can be used to target health services interventions to providers least likely to administer HPV vaccine to female Medicaid enrollees.
authors: Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL 33612, USA. Vadaparampil@moffitt.org
authors: Susan T
authors: ST
authors: Vadaparampil
authors: Stephanie A S
authors: SA
authors: Staras
authors: Teri L
authors: TL
authors: Malo
authors: Katie Z
authors: KZ
authors: Eddleton
authors: Juliette
authors: J
authors: Christie
authors: Maria
authors: M
authors: Rodriguez
authors: Anna R
authors: AR
authors: Giuliano
authors: Elizabeth A
authors: EA
authors: Shenkman
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000276:immunology*; D015984:Causality; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D008297:Male; D032541:Mass Vaccination / Q000706:statistics & numerical data*; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000191:economics; D010819:Physician's Role; D011203:Poverty / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines