title: Providers' time spent and tools used when discussing the HPV vaccine with parents of adolescents.
abstract: Little is known about HPV vaccine communication tools currently used by primary care providers of adolescents, or how such tools impact the quality of HPV vaccine recommendations, which some have defined as using a "presumptive" communication style, continuing to offer vaccines despite resistance, and strongly recommending vaccines at the appropriate ages. We surveyed primary care providers to assess their current use of HPV vaccine communication tools, and how these related to their HPV vaccine recommendation quality.
  
  
  
  Cross sectional survey of 183 pediatrics and family medicine primary care providers in the Denver metro area.
  
  
  
  Response rate was 82% (n=150). Most (59%) providers used a presumptive vaccine recommendation >75% of the time, and 76% reported continuing to offer the HPV vaccine even after parent refusal. However, less than two-thirds of providers "strongly" recommended the vaccine to 11-12year olds (60% for females, 55% for males, p=0.02). The HPV vaccine information sheet from the Centers from Disease Control and Prevention was the most frequently used communication tool during clinical visits (64% used at least 75% of the time) and directing parents to preferred websites was the most frequently used between-visit communication tool (21% used >50% of visits). Use of tools was not associated with any measure of HPV vaccine recommendation quality but was associated with longer HPV vaccine discussion times.
  
  
  
  Providers use only limited types of adolescent HPV vaccine communication tools, and frequently do not use preferred vaccine communication strategies. Better engagement with existing HPV vaccine communication tools, and/or the creation of new tools may be needed to enhance providers' ability to provide high quality HPV vaccine recommendations.
authors.affiliation: Adult and Child Consortium for Outcomes Research and Dissemination Science Program, Children's Hospital Colorado and University of Colorado, 13199 East Montview Blvd, Suite 300, Aurora, CO 80045, United States. Electronic address: Amanda.dempsey@ucdenver.edu.
authors.forename: Amanda F
authors.initials: AF
authors.lastname: Dempsey
authors.affiliation: Adult and Child Consortium for Outcomes Research and Dissemination Science Program, Children's Hospital Colorado and University of Colorado, 13199 East Montview Blvd, Suite 300, Aurora, CO 80045, United States. Electronic address: Steven.lockhart@ucdenver.edu.
authors.forename: Steven
authors.initials: S
authors.lastname: Lockhart
authors.affiliation: Adult and Child Consortium for Outcomes Research and Dissemination Science Program, Children's Hospital Colorado and University of Colorado, 13199 East Montview Blvd, Suite 300, Aurora, CO 80045, United States. Electronic address: Elizabeth.campagna@ucdenver.edu.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Campagna
authors.affiliation: Adult and Child Consortium for Outcomes Research and Dissemination Science Program, Children's Hospital Colorado and University of Colorado, 13199 East Montview Blvd, Suite 300, Aurora, CO 80045, United States. Electronic address: Jennifer.pyrzanowski@ucdenver.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pyrzanowski
authors.affiliation: Adult and Child Consortium for Outcomes Research and Dissemination Science Program, Children's Hospital Colorado and University of Colorado, 13199 East Montview Blvd, Suite 300, Aurora, CO 80045, United States. Electronic address: Juliana.barnard@ucdenver.edu.
authors.forename: Juliana
authors.initials: J
authors.lastname: Barnard
authors.affiliation: Adult and Child Consortium for Outcomes Research and Dissemination Science Program, Children's Hospital Colorado and University of Colorado, 13199 East Montview Blvd, Suite 300, Aurora, CO 80045, United States. Electronic address: Sean.O'Leary@childrenscolorado.org.
authors.forename: Sean T
authors.initials: ST
authors.lastname: O' Leary
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D006282:Health Personnel; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000150:complications* / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000276:immunology*; D010290:Parents; D011320:Primary Health Care; D013995:Time; D014481:United States
chemical_list: D053918:Papillomavirus Vaccines
keywords: Communication; Human papillomavirus; Vaccine delivery