title: Missing the Target for Routine Human Papillomavirus Vaccination: Consistent and Strong Physician Recommendations Are Lacking for 11- to 12-Year-Old Males.
abstract: Rates of routine human papillomavirus (HPV) vaccination of adolescent males in the United States are low. Leading health organizations advocate consistent and strong physician recommendations to improve HPV vaccine dissemination. This study describes the prevalence and correlates of consistent and strong physician recommendations for HPV vaccination of adolescent males.
  
  
  
  We surveyed pediatric and family medicine physicians in Florida about their HPV vaccine recommendations for male vaccine-eligible age groups (11-12, 13-17, 18-21 years). Descriptive statistics compared consistency and strength of HPV recommendations across age groups. Multivariable logistic regression examined factors associated with consistent and strong recommendations for 11- to 12-year-olds.
  
  
  
  We received 367 completed surveys (51% response rate). Physicians most often consistently and strongly recommended HPV vaccine to males ages 13 to 17 (39%) compared with ages 11 to 12 (31%) and 18 to 21 (31%). Consistent and strong recommendation for 11- to 12-year-old males was more likely to be delivered by Vaccine for Children providers and less likely among physicians who reported more personal barriers to vaccination, particularly concerns about vaccine safety, concerns about adding vaccines to the vaccine schedule, and difficulty in remembering to discuss HPV vaccination.
  
  
  
  Physicians' current consistency and strength of HPV vaccine recommendations do not align with national recommendations. Interventions to improve HPV vaccine recommendations must also consider the influence of physicians' personal barriers to HPV vaccine delivery.
  
  
  
  As one of the first studies to examine both consistency and strength of physicians' HPV vaccine recommendations for males, our findings can inform future interventions focused on facilitating physicians' recommendations. Cancer Epidemiol Biomarkers Prev; 25(10); 1435-46. ©2016 AACR.
authors.affiliation: Division of Population Science, Moffitt Cancer Center, Tampa, Florida. Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida. Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, Florida. Susan.Vadaparampil@Moffitt.org.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Vadaparampil
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Teri L
authors.initials: TL
authors.lastname: Malo
authors.affiliation: Division of Population Science, Moffitt Cancer Center, Tampa, Florida. Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, Florida.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Sutton
authors.affiliation: Division of Population Science, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Karla N
authors.initials: KN
authors.lastname: Ali
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohia.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Kahn
authors.affiliation: Department of Pediatrics, Orlando Health Physician Associates, Orlando, Florida.
authors.forename: Alix
authors.initials: A
authors.lastname: Casler
authors.affiliation: Department of International Health and Health Behavior Society, John Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Salmon
authors.affiliation: Klein Buendel, Boulder, Colorado.
authors.forename: Barbara
authors.initials: B
authors.lastname: Walkosz
authors.affiliation: Division of Population Science, Moffitt Cancer Center, Tampa, Florida. Department of Family Medicine, College of Medicine, University of South Florida, Tampa, Florida.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Roetzheim
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Zimet
authors.affiliation: Division of Population Science, Moffitt Cancer Center, Tampa, Florida. Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida. Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, Florida.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D053918:Papillomavirus Vaccines; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines