title: Collaborative patient-provider communication and uptake of adolescent vaccines.
abstract: Recommendations from healthcare providers are one of the most consistent correlates of adolescent vaccination, but few studies have investigated other elements of patient-provider communication and their relevance to uptake.
  
  
  
  We examined competing hypotheses about the relationship of patient-driven versus provider-driven communication styles with vaccination.
  
  
  
  We gathered information about vaccine uptake from healthcare provider-verified data in the 2010 National Immunization Survey-Teen for tetanus, diphtheria, and pertussis (Tdap) booster, meningococcal vaccine, and human papillomavirus (HPV) vaccine (initiation among females) for adolescents ages 13-17. We categorized communication style in parents' conversations with healthcare providers about vaccines, based on parents' reports (of whether a provider recommended a vaccine and, if so, if conversations were informed, shared, or efficient) (N = 9021).
  
  
  
  Most parents reported either no provider recommendation (Tdap booster: 35%; meningococcal vaccine: 46%; and HPV vaccine: 31%) or reported a provider recommendation and shared patient-provider communication (43%, 38%, and 49%, respectively). Provider recommendations were associated with increased odds of vaccination (all ps < 0.001). In addition, more provider-driven communication styles were associated with higher rates of uptake for meningococcal vaccine (efficient style: 82% vs. shared style: 77% vs. informed style: 68%; p < 0.001 for shared vs. informed) and HPV vaccine (efficient style: 90% vs. shared style: 70% vs. informed style: 33%; p < 0.05 for all comparisons).
  
  
  
  Efficient communication styles were used rarely (≤2% across vaccines) but were highly effective for encouraging meningococcal and HPV vaccination. Intervention studies are needed to confirm that efficient communication approaches increase HPV vaccination among adolescents.
authors.affiliation: Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Moss
authors.affiliation: College of Medicine, The Ohio State University, Columbus, OH, United States.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Reiter
authors.affiliation: Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Rimer
authors.affiliation: Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D003142:Communication; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000627:therapeutic use; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D022401:Meningococcal Vaccines / Q000627:therapeutic use; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D010290:Parents / Q000193:education / Q000523:psychology*; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022401:Meningococcal Vaccines; D053918:Papillomavirus Vaccines
keywords: Adolescents; Human papillomavirus (HPV) vaccine; Meningococcal vaccine; Patient-provider communication; Providers; Tetanus, diphtheria, and pertussis (Tdap) booster