Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents

dc.creatorFrancis, Jenny K.R.
dc.creatorRodriguez, Serena A.
dc.creatorDorsey, Olivia
dc.creatorBlackwell, James-Michael
dc.creatorBalasubramanian, Bijal A.
dc.creatorKale, Neelima
dc.creatorDay, Philip
dc.creatorPreston, Sharice M.
dc.creatorThompson, Erika L.
dc.creatorPruitt, Sandi L.
dc.creatorTiro, Jasmin A.
dc.creator.orcid0000-0002-7115-0001 (Thompson, Erika L.)
dc.description.abstractParental vaccine hesitancy is a growing concern. Less is known about provider or practice characteristics that encounter HPV-specific vaccine-hesitant parents, the providers' confidence in responding to HPV vaccine concerns, and the attitudes and use of vaccine dismissal policies (i.e., removing patients from the practice). North Texas providers completed an online survey. Dependent variables assessed: (1) percentage of HPV vaccine-hesitant parents encountered in practice defined as substantive, or high (≥11%, or among more than one out of ten adolescent patient encounters) versus low (≤10%) levels; (2) confidence in responding to 11 HPV vaccine concerns; (3) attitudes and use of vaccine dismissal policies. Chi-square and Fisher's exact tests were conducted. Among 156 providers, 29% reported high HPV vaccine hesitancy (≥11% of patient population). Overall, providers reported being "very confident" in addressing vaccine concerns (mean: 3.37 out of 4, SD: 0.57). Mean confidence scores were significantly higher for white (vs. non-white) providers and for pediatricians (vs. family practitioners). Providers were least confident in responding to parents' religious/personal beliefs (69%). Some providers (25%) agreed with policies that dismissed vaccine-hesitant parents after repeated counseling attempts. More providers used dismissal policies for childhood (19%) than adolescent (10%) immunizations. Provider communication training should include parental religious/personal beliefs to effectively address HPV vaccine hesitancy. Other regions should examine their HPV-specific vaccine hesitancy levels to understand how the use of dismissal policies might vary between adolescent and childhood immunizations.
dc.description.sponsorshipThis work was funded by the National Cancer Institute (No. P30 CA142543-08S1), Lyda Hill Philanthropies, Dallas TX; and the National Institutes of Health (No. K23 HD097291). The content is solely the responsibility of the authors and does not necessarily represent the official views of the study sponsors. The sponsors did not have a role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
dc.identifier.citationFrancis, J., Rodriguez, S. A., Dorsey, O., Blackwell, J. M., Balasubramanian, B. A., Kale, N., Day, P., Preston, S. M., Thompson, E. L., Pruitt, S. L., & Tiro, J. A. (2021). Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents. Preventive medicine reports, 24, 101562.
dc.publisherElsevier Inc.
dc.rights.holder© 2021 The Author(s).
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
dc.sourcePreventive Medicine Reports
dc.subjectdismissal policies
dc.subjectHPV vaccine
dc.subject.meshPapillomavirus Vaccines
dc.subject.meshVaccination Hesitancy
dc.titleProvider perspectives on communication and dismissal policies with HPV vaccine hesitant parents


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