ASPO Abstracts
Parent-, Provider-, and Clinic-Level Factors Associated with Adolescent HPV Vaccination: A Multilevel Framework based on a Systematic Review of Reviews
Category: Behavioral Science & Health Communication, Cancer Health Disparities
Conference Year: 2018
Abstract Body:
Background. Multilevel models of HPV vaccination among adolescents are needed to inform interventions to increase vaccination. While current models depict factors associated with HVP vaccination among females, no models incorporate factors for males or examine factors associated with both initiation and completion. Therefore, this systematic review of reviews aimed to provide a multilevel framework of parent-, provider-, and clinic-level factors predicting and correlated with HPV vaccination among U.S. male and female adolescents. Methods. We searched Medline and PsychInfo (via Ovid), Pubmed (NLM), and CINAHL and ERIC (Ebsco) databases for reviews conducted between 2006 and February 1, 2017 that identified correlates or predictors of HPV vaccination among U.S. adolescents. We identified parental-, provider-, and clinic-level factors associated with vaccination initiation and completion. Results. Twelve eligible reviews (6=females only; 5=both genders; 1=males only) included the following individual factors: adolescent and parent socio-demographic characteristics; parental intentions, attitudes toward the vaccine, and perceptions of vaccine benefits, risk of the adolescent contracting HPV or an HPV-related disease, vaccine effectiveness, safety, and need for the vaccine. Parental behaviors associated with vaccination included interaction with the healthcare system and communication with their adolescent. Provider factors were behavior (recommending the vaccine, comfort in communicating with parents); beliefs about parent barriers, attitudes, and perceived need; and knowledge about the vaccine-HPV linkage. Clinic-level factors included provider audit and feedback systems and patient reminder systems. Factors at all three levels did not differ for boys and girls and were similar for initiation and completion. Conclusion. Our review presents a comprehensive multilevel framework that confirms the importance of several well-studied factors and others previously related only theoretically. We highlight new potential intervention targets for male and female adolescents and for initiation and completion.
Keywords: HPV vaccination; adolescent; systematic review