Does it matter how providers frame HPV vaccination recommendations to promote uptake

Objectives: The purpose of this study was to evaluate how provider recommendations regarding HPV vaccination impact uptake among parents of children between the ages of 9 and 18 in a rural county. Methods: This was a population-based, quantitative interview study performed in a rural county in Alabama (Escambia County). Parents/guardians were interviewed between 9/2019 and 12/2019. A 16-page questionnaire was developed based on questions from the Behavioral Risk Factor Surveillance System (BRFSS) and other instruments. Questions were asked regarding type of recommendation and impression the parent/guardian had from this interaction. Participants were recruited proportionally from the nine census tract regions in the county. The questionnaire was anonymous and participation was voluntary. Inclusion criteria included: living in Escambia county and having a child between the ages of 9 and 18. Outcome variables included: child got vaccinated the day of the recommendation, HPV vaccination was scheduled, and HPV vaccination was not scheduled. Bivariate analysis and multinomial logistic regression were used. Results: A total of 147 of 368 individuals interviewed reported a provider recommended HPV vaccination for their child. Age of the parent, race, educational attainment, and health insurance coverage were similar between groups. Female parents were more likely to report HPV vaccination recommendation than male parents (44.1% vs. 23.3%; p=0.009) along with parents who had older children versus younger children (14.2 vs. 12.1 years-old; p=0.0001). The type of provider recommendation (i.e. “Provider said that the HPV vaccine is very safe” or “Provider stated he/she would vaccinate his/her own children”) was not found to significantly impact HPV vaccination uptake or scheduling (Table 1). However, the impression from the recommendation of HPV vaccination being “important” was significantly associated with the child getting vaccinated that day (OR=7.31, CI=2.20-24.3) as well as scheduling HPV vaccination as compared not vaccinating/scheduling (OR=3.17, CI= 1.01-9.92). Parents who thought their provider gave the impression “there was no hurry” were less likely to vaccinate their child as compared to the ones who vaccinated the child the day of the recommendation (OR=0.23, CI=.09-59). Conclusions: Provider recommendation for the HPV vaccine was reported by less than half of the parents interviewed in a rural county in Alabama. For those that did receive the recommendation, they were more likely to vaccinate their child that day or schedule vaccination if they got the impression from the provider that it was important. Parents were less likely to vaccinate their child if they got the impression there was no hurry. Specific recommendations were not found to influence parent's decision to vaccinate their child against HPV. Download : Download high-res image (240KB) Download : Download full-size image