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Finney Rutten LJ, St Sauver JL, Beebe TJ, Wilson PM, Jacobson DJ, Fan C, Breitkopf CR, Vadaparampil ST, MacLaughlin KL, Jacobson RM. Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children. Vaccine 2017; 35:6122-6128. [PMID: 28958810 DOI: 10.1016/j.vaccine.2017.09.056] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 02/08/2023]
Abstract
PURPOSE We tested the hypotheses that consistency and strength of clinician recommendation of the human papillomavirus (HPV) vaccination would be associated with vaccine delivery rates. METHODS From October 2015 through January 2016, we conducted a survey of primary care clinicians (n=227) in Southeastern Minnesota to evaluate clinician behaviors regarding HPV vaccination. The survey response rate was 41.0% (51 clinical sites). We used the Rochester Epidemiology Project, a clinical data linkage infrastructure, to ascertain clinical site-level HPV vaccination rates. We examined associations of clinician self-reports of both the consistency and strength of their recommendations for HPV vaccination for patients aged 11-12years (n=14,406) with site-level vaccination rates. RESULTS The majority of clinicians reported consistently (always or usually) recommending the HPV vaccine to females (79.0%) and to males (62.2%); 71.9% of clinicians reported strongly recommending the vaccine to females while 58.6% reported strongly recommending to males. Consistency and strength of recommending the HPV vaccine was significantly higher among those practicing in pediatrics and board certified in pediatrics compared to family medicine. Higher rates of initiation (1 dose) [Incidence Rate Ratio (IRR)=1.05; 95% CI (1.01-1.09)] and completion (3 doses) [IRR=1.08; 95% CI (1.02-1.13)] were observed among clinical sites where, on average, clinicians more frequently reported always or usually recommending the vaccine for females compared to sites where, on average, clinicians reported recommending the vaccine less frequently. Similarly, higher rates of initiation [IRR=1.03; 95% CI (1.00-1.06)] and completion [IRR=1.04; CI (1.00, 1.08)] were observed among sites where clinicians reported strongly recommending the vaccine to females more frequently compared to sites where, on average, clinicians reported strongly recommending the HPV vaccine less frequently; similar associations were observed for male initiation [IRR=1.05; CI (1.02,1.08)] and completion [IRR=1.05; 95% CI (1.01, 1.09)]. CONCLUSIONS Consistency and strength of HPV vaccination recommendation was associated with higher vaccination rates.
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Affiliation(s)
- Lila J Finney Rutten
- Robert D. and Patricia E. Center for the Science of Health Care Delivery, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Robert D. and Patricia E. Center for the Science of Health Care Delivery, Departments of Health Sciences Research and Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
| | - Jennifer L St Sauver
- Robert D. and Patricia E. Center for the Science of Health Care Delivery, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Timothy J Beebe
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Mayo Building A302, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
| | - Patrick M Wilson
- Robert D. and Patricia E. Center for the Science of Health Care Delivery, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Debra J Jacobson
- Robert D. and Patricia E. Center for the Science of Health Care Delivery, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Chun Fan
- Robert D. and Patricia E. Center for the Science of Health Care Delivery, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Carmen Radecki Breitkopf
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
| | - Kathy L MacLaughlin
- Department of Family Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
| | - Robert M Jacobson
- Robert D. and Patricia E. Center for the Science of Health Care Delivery, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Robert D. and Patricia E. Center for the Science of Health Care Delivery, Departments of Health Sciences Research and Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
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