ASPO Abstracts
HPV Vaccine Communication Styles and Challenges between Rural and Non-rural Primary Care Providers
Category: Behavioral Science & Health Communication
Conference Year: 2023
Abstract Body:
Purpose: Despite vaccine availability, HPV vaccine completion is 15 percentage points lower in rural areas compared to non-rural areas. Among a nationally representative sample of primary care providers, we identified differences in HPV vaccine communication challenges and strategies between rural and non- rural settings. Methods: Our analytic sample included 2,527 primary care providers (57% response rate) who participated in a national survey between May 2022-June 2022. We assessed provider communication challenges by asking respondents to select from a non-mutually exclusive list of challenges identified in the literature and expert opinion (i.e., believing child does not need the vaccine; concerns about safety; concerns about promoting sex; mistrust of providers; mistrust of CDC vacccine recommendations). We also asked which HPV communication strategies they used with hesitant parents (i.e., option to receive vaccine another day, prepared talking points, providing educational materials, sharing patient stories, and motivational interviewing). Using log binomial regressions, we examined unadjusted and adjusted associations between provider rurality and our specified outcomes. Results: Of the 2527 respondents, 232 (9.2%) practiced in rural areas. Providers in rural areas were more likely to be nurses (33% in rural areas vs 23% in non- rural areas), whereas pediatricians were more likely to practice in non-rural areas (13% in rural areas vs. 28% in non-rural areas). In unadjusted analyses examining communication challenges, rural providers reported that they faced concerns about vaccine safety from parents more than non-rural providers (77% vs 69%, p<0.008) but were less likely to report having long discussions with parents (22% vs 28%, p=.48). In adjusted analyses, providers practicing in rural areas had significantly higher odds of reporting challenges related to parent concerns about vaccine safety compared to non-rural providers (RR: 1.13, 95%CI:1.04-1.22). In both unadjusted and adjusted analyses, there were no differences in the HPV communication strategies by rurality. Conclusion: To increase HPV vaccination in rural areas, interventions may need to offer providers more information and strategies for how to address vaccine safety concerns of parents.
Keywords: HPV vaccine; rurality; vaccine communication; vaccine safety