title: Human Papillomavirus Vaccine Uptake in Texas Pediatric Care Settings: A Statewide Survey of Healthcare Professionals.
abstract: The purpose of this study was to identify barriers to and facilitators of human papillomavirus (HPV) vaccination in children aged 9-17 years across Texas. A literature review informed the development of a web-based survey designed for people whose work involves HPV vaccination in settings serving pediatric patients. The survey was used to examine current HPV vaccine recommendation practices among healthcare providers, barriers to HPV vaccination, reasons for parent/caregiver vaccine refusal, staff and family education practices, utilization of reminder and recall systems and status of vaccine administration (payment, ordering and stocking). 1132 responses were received representing healthcare providers, administrative and managerial staff. Respondents identified perceived barriers to HPV vaccination as parental beliefs about lack of necessity of vaccination prior to sexual debut, parental concerns regarding safety and/or side effects, parental perceptions that their child is at low risk for HPV-related disease, and parental lack of knowledge that the vaccine is a series of three shots. Of responding healthcare providers, 94 % (n = 582) reported they recommend the vaccine for 9-12 year olds; however, same-day acceptance of the vaccine is low with only 5 % (n = 31) of providers reporting the HPV vaccine is "always" accepted the same day the recommendation is made. Healthcare providers and multidisciplinary care teams in pediatric care settings must work to identify gaps between recommendation and uptake to maximize clinical opportunities. Training in methods to communicate an effective HPV recommendation and patient education tailored to address identified barriers may be helpful to reduce missed opportunities and increase on-time HPV vaccinations.
authors.affiliation: Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Mehwish
authors.initials: M
authors.lastname: Javaid
authors.affiliation: Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Ashrawi
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Landgren
authors.affiliation: Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Lori
authors.initials: L
authors.lastname: Stevens
authors.affiliation: Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Bello
authors.affiliation: Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Lewis
authors.initials: L
authors.lastname: Foxhall
authors.affiliation: Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Mims
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, Unit 1362, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA. lramonde@mdanderson.org.
authors.forename: Lois
authors.initials: L
authors.lastname: Ramondetta
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013781:Texas
chemical_list: D053918:Papillomavirus Vaccines
keywords: Barriers; HPV vaccination; Pediatrics; Survey of healthcare professionals; Vaccine uptake