title: Urban and rural safety net health care system clinics: no disparity in HPV4 vaccine completion rates.
abstract: OBJECTIVE
  Safety net health care centers in the US serve vulnerable and underinsured females. The primary aim of this work was to determine if HPV4 dosing compliance differs between females who receive doses at rural vs. urban core safety net health care locations.
  
  
  METHODS
  Females exclusively receiving health care in the Truman Medical Center (TMC) safety net system at the urban core and rural locations were identified by their HPV4 vaccine records. Dates and number of HPV4 doses as well as age, gravidity, parity and race/ethnicity were recorded from the electronic medical record (EMR). Appropriate HPV4 dosing intervals were referenced from the literature.
  
  
  RESULTS
  1259 females, 10-26 years of age, received HPV4 vaccination at either the rural (23%) or urban core location (77%). At the rural location, 23% received three doses on time, equal to the 24% at the urban core. Females seen in the urban core were more likely to receive on-time doublet dosing than on-time triplet dosing (82% vs. 67%, p<0.001). Mistimed doses occurred equally often among females receiving only two doses, as well as those receiving three doses.
  
  
  CONCLUSIONS
  Compliance with on-time HPV4 triplet dose completion was low at rural and urban core safety net health clinics, but did not differ by location.
authors.affiliation: Department of Community and Family Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: Kelly Jo
authors.initials: KJ
authors.lastname: Sandri
authors.affiliation: Radboud University, Department of Obstetrics and Gynecology, Nijmegen, the Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Verdenius
authors.affiliation: Department of Community and Family Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Bartley
authors.affiliation: Department of Community and Family Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: Britney M
authors.initials: BM
authors.lastname: Else
authors.affiliation: Department of Community and Family Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Paynter
authors.affiliation: Department of Community and Family Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: Beth E
authors.initials: BE
authors.lastname: Rosemergey
authors.affiliation: Department of Community and Family Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: George D
authors.initials: GD
authors.lastname: Harris
authors.affiliation: Department of Obstetrics and Gynecology, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Malnar
authors.affiliation: Hampshire College, Amherst, Massachusetts, United States of America.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Harper
authors.affiliation: Department of Community and Family Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: R Stephen
authors.initials: RS
authors.lastname: Griffith
authors.affiliation: Department of Biomedical and Health Informatics, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Bonham
authors.affiliation: Department of Community and Family Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America; Department of Obstetrics and Gynecology, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America; Department of Biomedical and Health Informatics, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, United States of America.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Harper
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003695:Delivery of Health Care / Q000379:methods / Q000706:statistics & numerical data*; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008923:Missouri; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology; D010349:Patient Compliance / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D014611:Vaccination / Q000379:methods / Q000706:statistics & numerical data*; D035862:Vulnerable Populations / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines