title: Factors influencing the recommendation of the human papillomavirus vaccine by Serbian pediatricians.
abstract: OBJECTIVE
  This research was undertaken to investigate the knowledge and attitudes regarding Human Papillomavirus infection and the Human Papillomavirus (HPV) vaccine among pediatricians who work in primary health care and to determine their intention to recommend the HPV vaccine as an important measure for the primary prevention of cervical cancer. We assessed the factors associated with the intention to recommend the vaccine.
  
  
  METHODS
  This cross-sectional study was conducted in March and April 2012. This research included all pediatricians who worked with school children in public primary health care institutions in Belgrade. A research instrument questionnaire had been designed for this study.
  
  
  RESULTS
  The response rate was 78.7%. The knowledge of pediatricians related to HPV infection and the HPV vaccine was estimated as poor. However, pediatricians recognized the need for additional education in this field. The most-frequently reported barrier to HPV vaccination was the financial concern (68.2%). Alternatively, according to the pediatricians, the most common parental barrier to vaccination was the lack of information on the vaccine (67.2%). Nearly two-thirds of the pediatricians were willing to recommend the vaccine (60.2%). The factors associated with the pediatricians' intention to recommend the vaccine included the parents' attitudes.
  
  
  CONCLUSIONS
  The majority of pediatricians accept the HPV vaccine and recommend it to their patients. It is necessary to improve cooperation between parents and pediatricians to increase immunization coverage and develop national consulting strategies with a focus on the prevention of HPV infection.
authors.affiliation: Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Serbia. Electronic address: zeljka.nikolic@mfub.bg.ac.rs.
authors.forename: Zeljka
authors.initials: Z
authors.lastname: Nikolic
authors.affiliation: Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Bojana
authors.initials: B
authors.lastname: Matejic
authors.affiliation: Department of Obstetrics and Gynecology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Kesic
authors.affiliation: Institute for Statistics and Informatics, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Eric Marinkovic
authors.affiliation: Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Jovic Vranes
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000523:psychology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents / Q000523:psychology; D010372:Pediatrics; D011320:Primary Health Care; D055771:Serbia; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000523:psychology; D014611:Vaccination / Q000523:psychology*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Attitudes; HPV vaccination; Intention; Knowledge; Pediatricians