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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Veröffentlicht in:Vaccine 2016-06, Vol.34 (30), p.3515-3521
Hauptverfasser: Hudson, Sharon M, Rondinelli, June, Glenn, Beth A, Preciado, Melissa, Chao, Chun
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container_end_page 3521
container_issue 30
container_start_page 3515
container_title Vaccine
container_volume 34
creator Hudson, Sharon M
Rondinelli, June
Glenn, Beth A
Preciado, Melissa
Chao, Chun
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 &amp; control ; Papillomavirus Vaccines - administration &amp; dosage ; Papillomavirus Vaccines - therapeutic use ; Parents ; Patient Acceptance of Health Care ; Patient-provider communication ; Patients ; Physician-Patient Relations ; Physicians ; Qualitative Research ; Vaccination - statistics &amp; numerical data ; Vaccine ; Vaccines ; Verbal communication</subject><ispartof>Vaccine, 2016-06, Vol.34 (30), p.3515-3521</ispartof><rights>2016</rights><rights>Copyright © 2016. 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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. 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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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