TY - JOUR
T1 - Catching up with the HPV vaccine
T2 - Challenges and opportunities in primary care
AU - Sussman, Andrew L.
AU - Helitzer, Deborah
AU - Bennett, Anzia
AU - Solares, Angélica
AU - Lanoue, Marianna
AU - Getrich, Christina M.
N1 - Publisher Copyright:
© 2015, Annals of Family Medicine, Inc. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - PURPOSE Data confirm that high rates of human papillomavirus (HPV) vaccination have not been achieved despite strong clinician endorsement of the vaccine. We conducted a study of primary care clinicians to assess the broad range of health care delivery, health policy, and attitudinal factors influencing vaccination uptake and opportunities for informed decision making. METHODS We implemented a mixed methods study in RIOS Net, a primary care practice–based research network in New Mexico. We first conducted qualitative, in-depth interviews with primary care clinicians, health policy makers, and immunization experts, and followed up with a confirmatory survey distributed to RIOS Net clinician members. RESULTS Health service delivery challenges emerged as the greatest barrier to HPV vaccination, specifically the lack of capacity to track and distribute reminders to eligible patients. Clinicians also reported variations in counseling approaches attributable to both age and emphasis on the cancer prevention benefits of the vaccine. There was no evidence of sociocultural influences on vaccine decision making, nor did concerns about perceived overprotection emerge. CONCLUSIONS Our findings, based on a long-term program of research, suggest that both patients’ attributes and health system delivery are most influential in HPV vaccination coverage challenges. Interventions targeting innovative communication techniques, as well as health system changes that build on efforts toward coordinated care and utilization of other venues to promote vaccination, will be necessary to address these challenges.
AB - PURPOSE Data confirm that high rates of human papillomavirus (HPV) vaccination have not been achieved despite strong clinician endorsement of the vaccine. We conducted a study of primary care clinicians to assess the broad range of health care delivery, health policy, and attitudinal factors influencing vaccination uptake and opportunities for informed decision making. METHODS We implemented a mixed methods study in RIOS Net, a primary care practice–based research network in New Mexico. We first conducted qualitative, in-depth interviews with primary care clinicians, health policy makers, and immunization experts, and followed up with a confirmatory survey distributed to RIOS Net clinician members. RESULTS Health service delivery challenges emerged as the greatest barrier to HPV vaccination, specifically the lack of capacity to track and distribute reminders to eligible patients. Clinicians also reported variations in counseling approaches attributable to both age and emphasis on the cancer prevention benefits of the vaccine. There was no evidence of sociocultural influences on vaccine decision making, nor did concerns about perceived overprotection emerge. CONCLUSIONS Our findings, based on a long-term program of research, suggest that both patients’ attributes and health system delivery are most influential in HPV vaccination coverage challenges. Interventions targeting innovative communication techniques, as well as health system changes that build on efforts toward coordinated care and utilization of other venues to promote vaccination, will be necessary to address these challenges.
KW - Adolescent health services
KW - Cervical cancer
KW - Health care delivery
KW - Health services research
KW - Mixed methods research
KW - Vaccination
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U2 - 10.1370/afm.1821
DO - 10.1370/afm.1821
M3 - Article
C2 - 26195681
AN - SCOPUS:84937949445
SN - 1544-1709
VL - 13
SP - 354
EP - 360
JO - Annals of Family Medicine
JF - Annals of Family Medicine
IS - 4
ER -