title: Primary Care Physicians' Perspectives About HPV Vaccine.
abstract: OBJECTIVE
  Because physicians' practices could be modified to reduce missed opportunities for human papillomavirus (HPV) vaccination, our goal was to: (1) describe self-reported practices regarding recommending the HPV vaccine; (2) estimate the frequency of parental deferral of HPV vaccination; and (3)identify characteristics associated with not discussing it.
  
  
  METHODS
  A national survey among pediatricians and family physicians (FP) was conducted between October 2013 and January 2014. Using multivariable analysis, characteristics associated with not discussing HPV vaccination were examined.
  
  
  RESULTS
  Response rates were 82% for pediatricians (364 of 442) and 56% for FP (218 of 387). For 11-12 year-old girls, 60% of pediatricians and 59% of FP strongly recommend HPV vaccine; for boys,52% and 41% ostrongly recommen. More than one-half reported ≥25% of parents deferred HPV vaccination. At the 11-12 year well visit, 84% of pediatricians and 75% of FP frequently/always discuss HPV vaccination. Compared with physicians who frequently/always discuss , those who occasionally/rarely discuss(18%) were more likely to be FP (adjusted odds ratio [aOR]: 2.0 [95% confidence interval (CI): 1.1-3.5), be male (aOR: 1.8 [95% CI: 1.1-3.1]), disagree that parents will accept HPV vaccine if discussed with other vaccines (aOR: 2.3 [95% CI: 1.3-4.2]), report that 25% to 49% (aOR: 2.8 [95% CI: 1.1-6.8]) or ≥50% (aOR: 7.8 [95% CI: 3.4-17.6]) of parents defer, and express concern about waning immunity (aOR: 3.4 [95% CI: 1.8-6.4]).
  
  
  CONCLUSIONS
  Addressing physicians' perceptions about parental acceptance of HPV vaccine, the possible advantages of discussing HPV vaccination with other recommended vaccines, and concerns about waning immunity could lead to increased vaccination rates.
authors.affiliation: Department of Pediatrics, Adult and Child Center for Health Outcomes Research and Delivery Science, and mandy.allison@ucdenver.edu.
authors.forename: Mandy A
authors.initials: MA
authors.lastname: Allison
authors.affiliation: Adult and Child Center for Health Outcomes Research and Delivery Science, and Division of Internal Medicine, Denver Health, Denver, Colorado;
authors.forename: Laura P
authors.initials: LP
authors.lastname: Hurley
authors.affiliation: National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention and.
authors.forename: Lauri
authors.initials: L
authors.lastname: Markowitz
authors.affiliation: Adult and Child Center for Health Outcomes Research and Delivery Science, and Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, and Children's Hospital Colorado, Aurora, Colorado;
authors.forename: Lori A
authors.initials: LA
authors.lastname: Crane
authors.affiliation: Department of Pediatrics, Adult and Child Center for Health Outcomes Research and Delivery Science, and.
authors.forename: Michaela
authors.initials: M
authors.lastname: Brtnikova
authors.affiliation: Adult and Child Center for Health Outcomes Research and Delivery Science, and.
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Beaty
authors.affiliation: Adult and Child Center for Health Outcomes Research and Delivery Science, and.
authors.forename: Megan
authors.initials: M
authors.lastname: Snow
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Janine
authors.initials: J
authors.lastname: Cory
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Shannon
authors.initials: S
authors.lastname: Stokley
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Jill
authors.initials: J
authors.lastname: Roark
authors.affiliation: Department of Pediatrics, Adult and Child Center for Health Outcomes Research and Delivery Science, and.
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D037001:Directive Counseling / Q000706:statistics & numerical data*; D005194:Family Practice; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D053918:Papillomavirus Vaccines; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010372:Pediatrics; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011368:Professional-Family Relations; D057566:Self Report; D014481:United States
chemical_list: D053918:Papillomavirus Vaccines