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Soc Sci Med. 2016 Jun;159:100-7. doi: 10.1016/j.socscimed.2016.04.030. Epub 2016 Apr 25.

Collaborative patient-provider communication and uptake of adolescent vaccines.

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Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States.
College of Medicine, The Ohio State University, Columbus, OH, United States.
Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States.



Recommendations from healthcare providers are one of the most consistent correlates of adolescent vaccination, but few studies have investigated other elements of patient-provider communication and their relevance to uptake.


We examined competing hypotheses about the relationship of patient-driven versus provider-driven communication styles with vaccination.


We gathered information about vaccine uptake from healthcare provider-verified data in the 2010 National Immunization Survey-Teen for tetanus, diphtheria, and pertussis (Tdap) booster, meningococcal vaccine, and human papillomavirus (HPV) vaccine (initiation among females) for adolescents ages 13-17. We categorized communication style in parents' conversations with healthcare providers about vaccines, based on parents' reports (of whether a provider recommended a vaccine and, if so, if conversations were informed, shared, or efficient) (N = 9021).


Most parents reported either no provider recommendation (Tdap booster: 35%; meningococcal vaccine: 46%; and HPV vaccine: 31%) or reported a provider recommendation and shared patient-provider communication (43%, 38%, and 49%, respectively). Provider recommendations were associated with increased odds of vaccination (all ps < 0.001). In addition, more provider-driven communication styles were associated with higher rates of uptake for meningococcal vaccine (efficient style: 82% vs. shared style: 77% vs. informed style: 68%; p < 0.001 for shared vs. informed) and HPV vaccine (efficient style: 90% vs. shared style: 70% vs. informed style: 33%; p < 0.05 for all comparisons).


Efficient communication styles were used rarely (≤2% across vaccines) but were highly effective for encouraging meningococcal and HPV vaccination. Intervention studies are needed to confirm that efficient communication approaches increase HPV vaccination among adolescents.


Adolescents; Human papillomavirus (HPV) vaccine; Meningococcal vaccine; Patient-provider communication; Providers; Tetanus, diphtheria, and pertussis (Tdap) booster

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