Format

Send to

Choose Destination
J Adolesc Health. 2014 Feb;54(2):190-6. doi: 10.1016/j.jadohealth.2013.08.006. Epub 2013 Sep 21.

Factors associated With Medicaid providers' recommendation of the HPV vaccine to low-income adolescent girls.

Author information

1
Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
2
Department of Health Outcomes and Policy, College of Medicine; and the Institute for Child Health Policy, University of Florida, Gainesville, Florida.
3
Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, Florida.
4
Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida; Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Science, College of Medicine, University of South Florida, Tampa, Florida.
5
Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, Florida; Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Science, College of Medicine, University of South Florida, Tampa, Florida. Electronic address: Susan.Vadaparampil@moffitt.org.

Abstract

PURPOSE:

Human papillomavirus (HPV) vaccination in the United States remains a public health challenge with vaccine rates of 50%. Although health care providers can facilitate HPV vaccination, several factors may impede their ability to universally recommend the vaccine. To maximize the potential of HPV vaccines, it is important to understand challenges providers face in the clinical environment. The study sought to identify factors associated with recommendation of the HPV vaccine for low-income adolescents in the early (9-10), target (11-12), early adolescent catch-up (13-14), and late adolescent catch-up (15-17) vaccination groups.

METHODS:

Surveys were mailed between October 2009 and April 2010 to a random sample of Florida-based physicians serving Medicaid-enrolled adolescents. Data were analyzed in 2013.

RESULTS:

Among early adolescents, discomfort discussing sexually transmitted infections (STIs) with teens (odds ratio [OR] = 1.75), difficulty ensuring vaccine completion (OR = .73), and discomfort discussing STIs with parents (OR = .44) were associated with recommendation. For target adolescents, discomfort discussing STIs with teens (OR = 2.45), time constraints (OR = .70), vaccine efficacy concerns (OR = .65), discomfort discussing STIs with parents (OR = .33), obstetrics/gynecology (OR = .25) and family medicine (OR = .24) specialty, and non-Hispanic black patient (OR = .15) were associated with recommendation. In early catch-up adolescents, concerns that teens will practice riskier behaviors (OR = .57), discomfort discussing STIs with parents (OR = .47), and family medicine specialty (OR = .20) were associated with recommendation. For late catch-up adolescents, family medicine specialty (OR = .13) was associated with recommendation.

CONCLUSIONS:

Modifiable factors that impede or influence provider recommendations of HPV vaccines can be addressed through intervention. Overall, findings suggest that efforts should focus on sexuality communication and family medicine specialty.

KEYWORDS:

Adolescent; Barriers; Human papillomavirus vaccines; Low-income population; Physicians

PMID:
24064282
PMCID:
PMC3946969
DOI:
10.1016/j.jadohealth.2013.08.006
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center