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J Sch Health. 2017 Sep;87(9):705-714. doi: 10.1111/josh.12540.

Acceptability of School-Based Health Centers for Human Papillomavirus Vaccination Visits: A Mixed-Methods Study.

Author information

1
Department of Pediatrics, Yale School of Medicine, 333 Cedar Street, PO Box 208064, New Haven, CT 06520.
2
Yale School of Public Health, 60 College Street, New Haven, CT 06520.
3
HPV Working Group, Yale School of Public Health, 135 College Street, Suite 356, New Haven, CT 06510.
4
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, New Haven, CT 06520.

Abstract

BACKGROUND:

Countries with high human papillomavirus (HPV) vaccination rates have achieved this success largely through school-based vaccination. Using school-based health centers (SBHCs) in the United States, where HPV vaccine remains underutilized, could improve uptake. In this mixed-methods study, we examined acceptability, facilitators, and barriers of HPV vaccination visits at SBHCs from the perspectives of adolescents and parents.

METHODS:

We conducted qualitative interviews and structured surveys with adolescents and parents recruited from an urban, hospital-based clinic. Interviews with parents (N = 20) and adolescents (N = 20) were audio-recorded and transcribed for analysis using an iterative thematic approach. Quantitative measures for a survey administered to parents (N = 131) were derived from the qualitative findings. Survey results were analyzed by chi-square tests.

RESULTS:

Many participants expressed favorable opinions of HPV vaccination at SBHCs in qualitative interviews. Facilitators included convenience, ease of scheduling, and not missing work or school. However, barriers were noted including concerns about obtaining care outside the medical home, fragmentation of medical records, and negative perceptions about SBHCs. Quantitative findings revealed that a higher proportion of parents with experience using SBHCs were willing to use a middle school (59.5%) or high school (80.5%) SBHC for HPV vaccinations compared with those who had not used SBHCs (p < .05 for both comparisons).

CONCLUSIONS:

HPV vaccination visits at SBHCs were acceptable, and SBHC users expressed more favorable attitudes. Barriers to HPV vaccination at SBHCs can be addressed through more education about SBHCs' role, and improvement of systems to coordinate care.

KEYWORDS:

HPV vaccine; adolescent health; mixed-methods research; school-based health centers

PMID:
28766319
PMCID:
PMC5657244
DOI:
10.1111/josh.12540
[Indexed for MEDLINE]
Free PMC Article

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