Health Care Providers' Perspectives on Low HPV Vaccine Uptake and Adherence in Appalachian Kentucky

Overview

Journal Public Health Nurs

Date 2013 Jul 2

PMID 23808860

Citations 20

Authors

Katharine J Head

Robin C Vanderpool

Laurel A Mills

Affiliations

Soon will be listed here.

Abstract

Objective: Previous intervention research conducted in Appalachian Kentucky resulted in extremely low uptake and adherence to the human papillomavirus (HPV) vaccine among women ages 18-26, despite provision of free vaccine. Because of these findings, the purpose of this qualitative, follow-up study was to elicit health care providers' perspectives on barriers and facilitators to HPV vaccination and suggested strategies for improving vaccination rates.

Design And Sample: Researchers conducted semi-structured qualitative interviews with a purposive sample of eight health care providers (seven nursing professionals, one physician) at the health clinic where the original HPV vaccination intervention took place. Interviews were audio-recorded and transcribed and authors used a constant-comparative method to analyze the data.

Results: Significant themes emerged from the interviews, centering around two primary issues: vaccine uptake and vaccine adherence. Related to uptake, health care providers identified perceived patient barriers and inadequate HPV vaccine education. They also identified the vaccine schedule and clinic-centered communication deficiencies as adherence-related barriers.

Conclusion: These Appalachian Kentucky health care providers provided important insights into barriers and facilitators to HPV vaccine uptake and adherence that need to be readily addressed in this community. As informed by these providers, several suggestions for improving HPV vaccination, such as more targeted education efforts and patient-centered reminder systems, may be applicable to other nursing professionals working in rural and medically underserved communities.

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References

Brewer N, Chapman G, Gibbons F, Gerrard M, McCaul K, Weinstein N . Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Health Psychol. 2007; 26(2):136-45. DOI: 10.1037/0278-6133.26.2.136. View

. Cancer death rates--Appalachia, 1994-1998. MMWR Morb Mortal Wkly Rep. 2002; 51(24):527-9. View

Hopenhayn C, King J, Christian A, Huang B, Christian W . Variability of cervical cancer rates across 5 Appalachian states, 1998-2003. Cancer. 2008; 113(10 Suppl):2974-80. DOI: 10.1002/cncr.23749. View

Duval B, Gilca V, Boulianne N, Pielak K, Halperin B, Simpson M . Cervical cancer prevention by vaccination: nurses' knowledge, attitudes and intentions. J Adv Nurs. 2009; 65(3):499-508. DOI: 10.1111/j.1365-2648.2008.04900.x. View

Rosenthal S, Weiss T, Zimet G, Ma L, Good M, Vichnin M . Predictors of HPV vaccine uptake among women aged 19-26: importance of a physician's recommendation. Vaccine. 2010; 29(5):890-5. DOI: 10.1016/j.vaccine.2009.12.063. View

Katz M, Reiter P, Heaner S, Ruffin M, Post D, Paskett E . Acceptance of the HPV vaccine among women, parents, community leaders, and healthcare providers in Ohio Appalachia. Vaccine. 2009; 27(30):3945-52. PMC: 2700122. DOI: 10.1016/j.vaccine.2009.04.040. View

Hall B, Howard K, McCaffery K . Do cervical cancer screening patient information leaflets meet the HPV information needs of women?. Patient Educ Couns. 2008; 72(1):78-87. DOI: 10.1016/j.pec.2008.01.024. View

Behringer B, Friedell G . Appalachia: where place matters in health. Prev Chronic Dis. 2006; 3(4):A113. PMC: 1779277. View

Krieger J, Katz M, Kam J, Roberto A . Appalachian and non-Appalachian pediatricians' encouragement of the human papillomavirus vaccine: implications for health disparities. Womens Health Issues. 2011; 22(1):e19-26. PMC: 3790263. DOI: 10.1016/j.whi.2011.07.005. View

10.

Schoenberg N, Hatcher J, Dignan M . Appalachian women's perceptions of their community's health threats. J Rural Health. 2008; 24(1):75-83. PMC: 3025859. DOI: 10.1111/j.1748-0361.2008.00140.x. View

11.

Katz M, Reiter P, Kluhsman B, Kennedy S, Dwyer S, Schoenberg N . Human papillomavirus (HPV) vaccine availability, recommendations, cost, and policies among health departments in seven Appalachian states. Vaccine. 2009; 27(24):3195-200. PMC: 2689551. DOI: 10.1016/j.vaccine.2009.03.042. View

12.

Cook R, Zhang J, Mullins J, Kauf T, Brumback B, Steingraber H . Factors associated with initiation and completion of human papillomavirus vaccine series among young women enrolled in Medicaid. J Adolesc Health. 2010; 47(6):596-9. DOI: 10.1016/j.jadohealth.2010.09.015. View

13.

. Adult vaccination coverage--United States, 2010. MMWR Morb Mortal Wkly Rep. 2012; 61(4):66-72. View

14.

Tan W, Viera A, Rowe-West B, Grimshaw A, Quinn B, Walter E . The HPV vaccine: are dosing recommendations being followed?. Vaccine. 2011; 29(14):2548-54. DOI: 10.1016/j.vaccine.2011.01.066. View

15.

Markowitz L, Dunne E, Saraiya M, Lawson H, Chesson H, Unger E . Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007; 56(RR-2):1-24. View

16.

Wingo P, Tucker T, Jamison P, Martin H, McLaughlin C, Bayakly R . Cancer in Appalachia, 2001-2003. Cancer. 2007; 112(1):181-92. DOI: 10.1002/cncr.23132. View

17.

Keating K, Brewer N, Gottlieb S, Liddon N, Ludema C, Smith J . Potential barriers to HPV vaccine provision among medical practices in an area with high rates of cervical cancer. J Adolesc Health. 2008; 43(4 Suppl):S61-7. DOI: 10.1016/j.jadohealth.2008.06.015. View

18.

Short M, Rosenthal S, Sturm L, Black L, Loza M, Breitkopf D . Adult women's attitudes toward the HPV vaccine. J Womens Health (Larchmt). 2010; 19(7):1305-11. DOI: 10.1089/jwh.2009.1471. View

19.

Yabroff K, Lawrence W, King J, Mangan P, Washington K, Yi B . Geographic disparities in cervical cancer mortality: what are the roles of risk factor prevalence, screening, and use of recommended treatment?. J Rural Health. 2005; 21(2):149-57. DOI: 10.1111/j.1748-0361.2005.tb00075.x. View

20.

Reiter P, Katz M, Paskett E . HPV vaccination among adolescent females from Appalachia: implications for cervical cancer disparities. Cancer Epidemiol Biomarkers Prev. 2012; 21(12):2220-30. PMC: 3518634. DOI: 10.1158/1055-9965.EPI-12-0850. View