ASPO Abstracts
Which healthcare professionals need interventions to improve their HPV vaccine recommendations? A systematic review
Category: Behavioral Science & Health Communication
Conference Year: 2023
Abstract Body:
Purpose: More than one-third (38%) of U.S. adolescents fail to complete the multi-dose human papillomavirus (HPV) vaccine series, placing them at risk of developing future HPV-related cancers. Though receiving a healthcare professional's (HCP) recommendation is a key reason for vaccine uptake, not all HCPs deliver HPV vaccine recommendations. We sought to identify which subgroups of HCPs most need to improve their recommendation practices so as to guide future intervention efforts to strengthen HCP communication about HPV vaccination. Methods: We followed PRISMA guidelines in conducting a systematic review of quantitative studies published in 2012-2022 on the frequency of HPV vaccine recommendation among HCPs for U.S. adolescents aged 9-17. Two researchers independently reviewed each study title and abstract for eligibility, before screening eligible studies in full text. We abstracted relevant findings from eligible studies and assessed study quality using an existing 24-point index. We excluded qualitative studies, reviews, and non-peer-reviewed literature. Results: Out of 10,751 initial records, we identified 29 studies that met eligibility criteria (mean quality score=21.6, standard deviation=2.4). Most studies (8 of 11) found that a lower proportion of HCPs in family medicine than pediatrics recommended HPV vaccine to adolescents (difference: -2 to -60 percentage points, all p<.05), while the remaining 3 studies observed no difference between these specialties. Some studies also suggested recommendations were less common among HCPs with low versus high HPV vaccine-related knowledge (4 of 6 studies), with versus without vaccine safety concerns (2 of 4 studies), or in rural versus non-rural clinics (3 of 6 studies). Studies consistently observed no association between recommendations and perceptions of vaccine efficacy (4 of 4 studies). Conclusion: Our review suggests that future interventions to improve HPV recommendation should target HCPs in family medicine and rural areas. Given less frequent recommendations among some HCPs with vaccine concerns and low vaccine-related knowledge, interventions should also emphasize enhancing HCPs' beliefs and knowledge about vaccinating adolescents against HPV.
Keywords: HPV vaccine communication; recommendation disparities