ASPO Abstracts
Using Concept Mapping to Understand Multi-State Perspectives about Barriers and Facilitators to HPV Vaccination
Category: Behavioral Science & Health Communication
Conference Year: 2020
Abstract Body:
Purpose of the Study: We conducted a multi-state concept mapping project to elicit feedback from state-level
stakeholders about reasons for low HPV vaccination rates.
Methods: Researchers in Iowa, Minnesota, Oregon, South Dakota, and Washington identified state-level
stakeholders working in the fields of adolescent health, cancer prevention, or immunization. A total of 157
individuals were invited to participate in an online concept mapping project that included two phases. First,
participants brainstormed statements in response to a prompt asking them to identify factors with the greatest
influence on HPV vaccination rates, considering both urban and rural areas. Second, participants sorted the
statements into piles. They also rated the statements on a scale of 1-5, based on importance and feasibility.
Results: Of the 157 people invited, 63 participated in the brainstorming activity, and 27 participated in sorting and
rating. Participants identified 10 clusters of factors influencing HPV vaccination which included: education, state
support, strong communication, policy, vaccines, collaboration, access, provider influence, evidence-based
interventions (EBIs), and consistent messaging. The clusters rated most important were education (4.21), provider
influence (4.1), and EBIs (4.07). Clusters identified as the least feasible were state support, access, and policy.
There was significant mismatch between ratings for importance and feasibility. For example, while education was
rated as highly important (4.21), it rated lower on feasibility (3.66). This same pattern was echoed for provider
influence, EBIs, state support, and policy.
Conclusions: These results help to contextualize what we already know about low HPV vaccination rates and
identify priority areas to address to improve them. The lower feasibility ratings for several of the most important,
and possibly most effective, clusters suggest that stakeholders perceive significant barriers (e.g. time and cost) to
their work. Our use of concept mapping allowed for easy collection of data in multiple states at the same time. This
method should be considered by other researchers looking to draw on stakeholder knowledge to design and
prioritize relevant programming for cancer prevention and control efforts.
Keywords: HPV vaccination, concept mapping