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

Lila J Rutten, Jennifer St. Sauver, Timothy J. Beebe, Patrick M. Wilson, Debra J. Jacobson, Chun Fan, Carmen Radecki Breitkopf, Susan T. Vadaparampil, Kathy Mac Laughlin, Robert M Jacobson

Research output: Contribution to journalArticle

8 Citations (Scopus)

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 11-12. years (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.

Original languageEnglish (US)
JournalVaccine
DOIs
StateAccepted/In press - 2017

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Papillomavirus Vaccines
Papillomaviridae
Vaccination
vaccination
vaccines
uptake mechanisms
Vaccines
incidence
Incidence
Pediatrics
Information Storage and Retrieval
human behavior
Self Report
dosage
infrastructure
Primary Health Care
Epidemiology
linkage (genetics)
epidemiology
Medicine

Keywords

  • Guideline adherence
  • Papillomavirus vaccines health knowledge, attitudes, practice
  • Patient acceptance of health care
  • Professional practice
  • Vaccination
  • Vaccination refusal

ASJC Scopus subject areas

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

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. / Rutten, Lila J; St. Sauver, Jennifer; Beebe, Timothy J.; Wilson, Patrick M.; Jacobson, Debra J.; Fan, Chun; Radecki Breitkopf, Carmen; Vadaparampil, Susan T.; Mac Laughlin, Kathy; Jacobson, Robert M.

In: Vaccine, 2017.

Research output: Contribution to journalArticle

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title = "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",
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 11-12. years (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.",
keywords = "Guideline adherence, Papillomavirus vaccines health knowledge, attitudes, practice, Patient acceptance of health care, Professional practice, Vaccination, Vaccination refusal",
author = "Rutten, {Lila J} and {St. Sauver}, Jennifer and Beebe, {Timothy J.} and Wilson, {Patrick M.} and Jacobson, {Debra J.} and Chun Fan and {Radecki Breitkopf}, Carmen and Vadaparampil, {Susan T.} and {Mac Laughlin}, Kathy and Jacobson, {Robert M}",
year = "2017",
doi = "10.1016/j.vaccine.2017.09.056",
language = "English (US)",
journal = "Vaccine",
issn = "0264-410X",
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T1 - 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

AU - Rutten, Lila J

AU - St. Sauver, Jennifer

AU - Beebe, Timothy J.

AU - Wilson, Patrick M.

AU - Jacobson, Debra J.

AU - Fan, Chun

AU - Radecki Breitkopf, Carmen

AU - Vadaparampil, Susan T.

AU - Mac Laughlin, Kathy

AU - Jacobson, Robert M

PY - 2017

Y1 - 2017

N2 - 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 11-12. years (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.

AB - 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 11-12. years (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.

KW - Guideline adherence

KW - Papillomavirus vaccines health knowledge, attitudes, practice

KW - Patient acceptance of health care

KW - Professional practice

KW - Vaccination

KW - Vaccination refusal

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