title: HPV vaccine hesitancy: findings from a statewide survey of health care providers.
abstract: BACKGROUND
  Health care provider recommendations are critical for human papillomavirus (HPV) vaccine uptake. We sought to describe providers' HPV vaccine recommendation practices and explore their perceptions of parental hesitancy.
  
  
  METHODS
  A statewide sample (n = 575) of Minnesota health care providers (20% pediatricians, 47% family medicine physicians, and 33% nurse practitioners) completed our online survey in April 2013.
  
  
  RESULTS
  Only 76% of health care providers reported routinely recommending HPV vaccine for girls ages 11 to 12 years, and far fewer (46%) did so for boys (p < .001). A majority of providers reported asking questions about parents' concerns (74%), but many lacked time to probe reasons (47%) or believed that they could not change parents' minds (55%). Higher levels of self-efficacy and outcome expectations were associated with routine recommendations (p < .05).
  
  
  CONCLUSIONS
  Findings suggest that providers' perceptions of hesitancy may discourage them from routinely recommending the HPV vaccine. Improving providers' self-efficacy to address hesitancy may be important for improving vaccination rates.
authors.forename: Annie-Laurie
authors.initials: AL
authors.lastname: McRee
authors.forename: Melissa B
authors.initials: MB
authors.lastname: Gilkey
authors.forename: Amanda F
authors.initials: AF
authors.lastname: Dempsey
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000523:psychology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents / Q000193:education / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccine; health care provider communication; vaccine hesitancy