Human papillomavirus vaccine series completion: Qualitative information from providers within an integrated healthcare organization
Abstract Objective This qualitative study aimed to identify doctors’ and nurses’ perceptions of patient-, provider-, and system-level factors associated with human papillomavirus (HPV) vaccine completion that may be targets for intervention. Methods We analyzed data from 61 qualitative interviews wi...
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description | Abstract Objective This qualitative study aimed to identify doctors’ and nurses’ perceptions of patient-, provider-, and system-level factors associated with human papillomavirus (HPV) vaccine completion that may be targets for intervention. Methods We analyzed data from 61 qualitative interviews with pediatricians, family medicine physicians, and immunization nurses at medical centers that had the highest and lowest HPV vaccine completion rates within the same health care system. Results In both groups, almost all providers reported strong support for the HPV vaccine. In detailing how they talk to parents and patients about the vaccine, more of the providers working at higher completion centers described using effective communication techniques, including engaging parents and patients in two-way conversation and demonstrating awareness of cultural and practical barriers to completion that families may face. Providers at higher completion centers were also more likely to depict a local medical culture supportive of and committed to HPV vaccine completion, with greater levels of proactivity and teamwork. In contrast, providers working at lower completion medical centers described a lack of proactivity, and the strategies they suggested to improve HPV vaccine completion tended to be approaches that someone other than medical providers would implement. The comments made by these providers sometimes reflected a level of negativity and judgment absent from the comments of providers at higher completion centers. Conclusion Interventions to improve HPV vaccination completion rates should address both individual- and system-level factors. Improving communication skills, encouraging a supportive medical culture, and addressing resource issues is likely to improve vaccine adherence. |
doi_str_mv | 10.1016/j.vaccine.2016.02.066 |
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Methods We analyzed data from 61 qualitative interviews with pediatricians, family medicine physicians, and immunization nurses at medical centers that had the highest and lowest HPV vaccine completion rates within the same health care system. Results In both groups, almost all providers reported strong support for the HPV vaccine. In detailing how they talk to parents and patients about the vaccine, more of the providers working at higher completion centers described using effective communication techniques, including engaging parents and patients in two-way conversation and demonstrating awareness of cultural and practical barriers to completion that families may face. Providers at higher completion centers were also more likely to depict a local medical culture supportive of and committed to HPV vaccine completion, with greater levels of proactivity and teamwork. In contrast, providers working at lower completion medical centers described a lack of proactivity, and the strategies they suggested to improve HPV vaccine completion tended to be approaches that someone other than medical providers would implement. The comments made by these providers sometimes reflected a level of negativity and judgment absent from the comments of providers at higher completion centers. Conclusion Interventions to improve HPV vaccination completion rates should address both individual- and system-level factors. Improving communication skills, encouraging a supportive medical culture, and addressing resource issues is likely to improve vaccine adherence.</description><identifier>ISSN: 0264-410X</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2016.02.066</identifier><identifier>PMID: 26947497</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adherence ; Adult ; Allergy and Immunology ; Attitudes ; Communication ; Delivery of Health Care, Integrated ; Demographics ; Female ; Health care ; Health Knowledge, Attitudes, Practice ; Human papillomavirus ; Humans ; Immunization ; Interviews ; Interviews as Topic ; Male ; Medical personnel ; Middle Aged ; Nurses ; Organizational Culture ; Papillomaviridae ; Papillomavirus Infections - prevention & control ; Papillomavirus Vaccines - administration & dosage ; Papillomavirus Vaccines - therapeutic use ; Parents ; Patient Acceptance of Health Care ; Patient-provider communication ; Patients ; Physician-Patient Relations ; Physicians ; Qualitative Research ; Vaccination - statistics & numerical data ; Vaccine ; Vaccines ; Verbal communication</subject><ispartof>Vaccine, 2016-06, Vol.34 (30), p.3515-3521</ispartof><rights>2016</rights><rights>Copyright © 2016. Published by Elsevier Ltd.</rights><rights>Copyright Elsevier Limited Jun 24, 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-79d8af20d5b718ae2bbfd694a0c9c181f2343db02ebc1f9d38a4c4493be1e6243</citedby><cites>FETCH-LOGICAL-c481t-79d8af20d5b718ae2bbfd694a0c9c181f2343db02ebc1f9d38a4c4493be1e6243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1799650776?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26947497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hudson, Sharon M</creatorcontrib><creatorcontrib>Rondinelli, June</creatorcontrib><creatorcontrib>Glenn, Beth A</creatorcontrib><creatorcontrib>Preciado, Melissa</creatorcontrib><creatorcontrib>Chao, Chun</creatorcontrib><title>Human papillomavirus vaccine series completion: Qualitative information from providers within an integrated healthcare organization</title><title>Vaccine</title><addtitle>Vaccine</addtitle><description>Abstract Objective This qualitative study aimed to identify doctors’ and nurses’ perceptions of patient-, provider-, and system-level factors associated with human papillomavirus (HPV) vaccine completion that may be targets for intervention. Methods We analyzed data from 61 qualitative interviews with pediatricians, family medicine physicians, and immunization nurses at medical centers that had the highest and lowest HPV vaccine completion rates within the same health care system. Results In both groups, almost all providers reported strong support for the HPV vaccine. In detailing how they talk to parents and patients about the vaccine, more of the providers working at higher completion centers described using effective communication techniques, including engaging parents and patients in two-way conversation and demonstrating awareness of cultural and practical barriers to completion that families may face. Providers at higher completion centers were also more likely to depict a local medical culture supportive of and committed to HPV vaccine completion, with greater levels of proactivity and teamwork. In contrast, providers working at lower completion medical centers described a lack of proactivity, and the strategies they suggested to improve HPV vaccine completion tended to be approaches that someone other than medical providers would implement. The comments made by these providers sometimes reflected a level of negativity and judgment absent from the comments of providers at higher completion centers. Conclusion Interventions to improve HPV vaccination completion rates should address both individual- and system-level factors. Improving communication skills, encouraging a supportive medical culture, and addressing resource issues is likely to improve vaccine adherence.</description><subject>Adherence</subject><subject>Adult</subject><subject>Allergy and Immunology</subject><subject>Attitudes</subject><subject>Communication</subject><subject>Delivery of Health Care, Integrated</subject><subject>Demographics</subject><subject>Female</subject><subject>Health care</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Human papillomavirus</subject><subject>Humans</subject><subject>Immunization</subject><subject>Interviews</subject><subject>Interviews as Topic</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Middle Aged</subject><subject>Nurses</subject><subject>Organizational Culture</subject><subject>Papillomaviridae</subject><subject>Papillomavirus Infections - prevention & control</subject><subject>Papillomavirus Vaccines - administration & dosage</subject><subject>Papillomavirus Vaccines - therapeutic use</subject><subject>Parents</subject><subject>Patient Acceptance of Health Care</subject><subject>Patient-provider communication</subject><subject>Patients</subject><subject>Physician-Patient Relations</subject><subject>Physicians</subject><subject>Qualitative Research</subject><subject>Vaccination - statistics & numerical data</subject><subject>Vaccine</subject><subject>Vaccines</subject><subject>Verbal communication</subject><issn>0264-410X</issn><issn>1873-2518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk9v1DAQxSMEotvCRwBZ4sIlwXacP-YAQhVQpEoIARI3y3Em3VkSe7GdoPbKF8dhF5B66cm2_HvPnnmTZU8YLRhl9YtdsWhj0ELB07GgvKB1fS_bsLYpc16x9n62obwWuWD020l2GsKOUlqVTD7MTngtRSNks8l-XcyTtmSv9ziObtIL-jmQozUJ4BECMW7ajxDR2Zfk06xHjDriAgTt4Pyk1wsyeDeRvXcL9uAD-Ylxi5Yka7QRrryO0JMt6DFujfZAnL_SFm_-aB9lDwY9Bnh8XM-yr-_efjm_yC8_vv9w_uYyN6JlMW9k3-qB077qGtZq4F039KkQTY00rGUDL0XZd5RDZ9gg-7LVwgghyw4Y1FyUZ9nzg2_65o8ZQlQTBgPjqC24OSjW0rZmXAp-N9rIpm2oLGVCn91Cd272NhWyUrKuaNPUiaoOlPEuBA-D2nuctL9WjKo1ULVTx66rNVBFuUqBJt3To_vcTdD_U_1NMAGvDwCkzi0IXgWDYA306MFE1Tu884lXtxzMiBaNHr_DNYT_1aiQBOrzOlXrULGapi2T5W_ioMxy</recordid><startdate>20160624</startdate><enddate>20160624</enddate><creator>Hudson, Sharon M</creator><creator>Rondinelli, June</creator><creator>Glenn, Beth A</creator><creator>Preciado, Melissa</creator><creator>Chao, Chun</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T2</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7U2</scope></search><sort><creationdate>20160624</creationdate><title>Human papillomavirus vaccine series completion: Qualitative information from providers within an integrated healthcare organization</title><author>Hudson, Sharon M ; Rondinelli, June ; Glenn, Beth A ; Preciado, Melissa ; Chao, Chun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-79d8af20d5b718ae2bbfd694a0c9c181f2343db02ebc1f9d38a4c4493be1e6243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adherence</topic><topic>Adult</topic><topic>Allergy and Immunology</topic><topic>Attitudes</topic><topic>Communication</topic><topic>Delivery of Health Care, Integrated</topic><topic>Demographics</topic><topic>Female</topic><topic>Health care</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Human papillomavirus</topic><topic>Humans</topic><topic>Immunization</topic><topic>Interviews</topic><topic>Interviews as Topic</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Middle Aged</topic><topic>Nurses</topic><topic>Organizational Culture</topic><topic>Papillomaviridae</topic><topic>Papillomavirus Infections - prevention & control</topic><topic>Papillomavirus Vaccines - administration & dosage</topic><topic>Papillomavirus Vaccines - therapeutic use</topic><topic>Parents</topic><topic>Patient Acceptance of Health Care</topic><topic>Patient-provider communication</topic><topic>Patients</topic><topic>Physician-Patient Relations</topic><topic>Physicians</topic><topic>Qualitative Research</topic><topic>Vaccination - statistics & numerical data</topic><topic>Vaccine</topic><topic>Vaccines</topic><topic>Verbal communication</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hudson, Sharon M</creatorcontrib><creatorcontrib>Rondinelli, June</creatorcontrib><creatorcontrib>Glenn, Beth A</creatorcontrib><creatorcontrib>Preciado, Melissa</creatorcontrib><creatorcontrib>Chao, Chun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Safety Science and Risk</collection><jtitle>Vaccine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hudson, Sharon M</au><au>Rondinelli, June</au><au>Glenn, Beth A</au><au>Preciado, Melissa</au><au>Chao, Chun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Human papillomavirus vaccine series completion: Qualitative information from providers within an integrated healthcare organization</atitle><jtitle>Vaccine</jtitle><addtitle>Vaccine</addtitle><date>2016-06-24</date><risdate>2016</risdate><volume>34</volume><issue>30</issue><spage>3515</spage><epage>3521</epage><pages>3515-3521</pages><issn>0264-410X</issn><eissn>1873-2518</eissn><abstract>Abstract Objective This qualitative study aimed to identify doctors’ and nurses’ perceptions of patient-, provider-, and system-level factors associated with human papillomavirus (HPV) vaccine completion that may be targets for intervention. Methods We analyzed data from 61 qualitative interviews with pediatricians, family medicine physicians, and immunization nurses at medical centers that had the highest and lowest HPV vaccine completion rates within the same health care system. Results In both groups, almost all providers reported strong support for the HPV vaccine. In detailing how they talk to parents and patients about the vaccine, more of the providers working at higher completion centers described using effective communication techniques, including engaging parents and patients in two-way conversation and demonstrating awareness of cultural and practical barriers to completion that families may face. Providers at higher completion centers were also more likely to depict a local medical culture supportive of and committed to HPV vaccine completion, with greater levels of proactivity and teamwork. In contrast, providers working at lower completion medical centers described a lack of proactivity, and the strategies they suggested to improve HPV vaccine completion tended to be approaches that someone other than medical providers would implement. The comments made by these providers sometimes reflected a level of negativity and judgment absent from the comments of providers at higher completion centers. Conclusion Interventions to improve HPV vaccination completion rates should address both individual- and system-level factors. Improving communication skills, encouraging a supportive medical culture, and addressing resource issues is likely to improve vaccine adherence.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>26947497</pmid><doi>10.1016/j.vaccine.2016.02.066</doi><tpages>7</tpages></addata></record> |
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subjects | Adherence Adult Allergy and Immunology Attitudes Communication Delivery of Health Care, Integrated Demographics Female Health care Health Knowledge, Attitudes, Practice Human papillomavirus Humans Immunization Interviews Interviews as Topic Male Medical personnel Middle Aged Nurses Organizational Culture Papillomaviridae Papillomavirus Infections - prevention & control Papillomavirus Vaccines - administration & dosage Papillomavirus Vaccines - therapeutic use Parents Patient Acceptance of Health Care Patient-provider communication Patients Physician-Patient Relations Physicians Qualitative Research Vaccination - statistics & numerical data Vaccine Vaccines Verbal communication |
title | Human papillomavirus vaccine series completion: Qualitative information from providers within an integrated healthcare organization |
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