title: Physicians', Nurses', and Medical Assistants' Perceptions of the Human Papillomavirus Vaccine in a Large Integrated Health Care System.
abstract: Vaccination against the human papillomavirus (HPV) decreases risks of cancer and genital warts and the need for gynecologic procedures, yet nationwide vaccination rates are low. Previous surveys exploring this phenomenon have not included input from nurses and medical assistants, who play integral roles in HPV vaccine delivery.
  
  
  
  To understand perceptions of HPV vaccine delivery among physicians, nurses, and medical assistants in a large integrated health care system in Southern California.
  
  
  
  Online surveys were sent to 13 nurse administrators and 75 physicians. Physicians were instructed to forward the survey to nurses and medical assistants with whom they work.
  
  
  
  A total of 76 surveys were completed, consisting of 52 physicians, 16 clinical nurses and medical assistants, and 8 nurse administrators. Physicians' perceptions of vaccine safety or strength of recommendation did not differ by specialty department. Physicians reportedly perceived the HPV vaccine as safer than did clinical nurses and medical assistants (p < 0.001), who indicated they wanted more education on the safety and efficacy of the vaccine before being comfortable strongly recommending it. Respondents advised that all clinicians could improve in their roles as HPV vaccine advocates through patient counseling and providing informational literature and that workflow standardization was needed to minimize missed vaccination opportunities.
  
  
  
  Physicians reportedly perceive the HPV vaccine as safer compared with nurses and medical assistants. Both groups think that more education of nonphysician staff is needed. Having proper systems in place is also vital to improving vaccination compliance.
authors.affiliation: Addiction Medicine Fellow in the Department of Family Medicine and Community Health at the University of Wisconsin School of Medicine and Public Health in Madison. millsdoc@gmail.com.
authors.forename: Jordan
authors.initials: J
authors.lastname: Mills
authors.affiliation: Pediatric Hospitalist at the Anaheim Medical Center and the Pediatric Area Research Chair for Kaiser Permanente Orange County in CA. patrick.j.vanwinkle@kp.org.
authors.forename: Patrick
authors.initials: P
authors.lastname: Van Winkle
authors.affiliation: Postdoctoral Scholar in the Department of Oral Biology and Medicine at the University of California Los Angeles School of Dentistry. macy.macy@gmail.com.
authors.forename: Macy
authors.initials: M
authors.lastname: Shen
authors.affiliation: Obstetrician/Gynecologist at the Orange County Medical Center in Irvine, CA. christina.x.hong@kp.org.
authors.forename: Christina
authors.initials: C
authors.lastname: Hong
authors.affiliation: Behavioral Scientist in the Department of Research and Evaluation for Kaiser Permanente Southern California in Pasadena, CA. sharon.m.hudson@kp.org.
authors.forename: Sharon
authors.initials: S
authors.lastname: Hudson
mesh_terms: D001291:Attitude of Health Personnel; D002140:California; D002983:Clinical Competence; D019033:Delivery of Health Care, Integrated; D005260:Female; D006801:Humans; D008297:Male; D009726:Nurses; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D010465:Perception; D010823:Physician Assistants; D010820:Physicians; D024382:Professional Role; D011795:Surveys and Questionnaires; D014611:Vaccination
chemical_list: D053918:Papillomavirus Vaccines