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Associations between parents’ satisfaction with provider communication and HPV vaccination behaviors
Institution:1. Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas;2. Sealy Institute for Vaccine Sciences, University of Texas Medical Branch at Galveston, Galveston, Texas;3. Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, Texas;4. Department of Epidemiology, Emory University, Atlanta, Georgia;5. Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas;1. Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, 133 Brookline Ave., Boston, MA 02215, USA;2. Department of Health Behavior & Lineberger Comprehensive Cancer Center, University of North Carolina, Campus Box 7440, Chapel Hill, NC 27599, USA;3. Department of Pediatrics and Internal Medicine, School of Medicine, University of North Carolina, Campus Box 7220, Chapel Hill, NC 27599, USA
Abstract:BackgroundDespite increasing awareness of the importance of a provider recommendation for HPV vaccine, the U.S. has yet to achieve the Healthy people 2020 goal of 80% series completion among adolescents. This failure indicates a need for further examination of the modifiable influences on parents’ decision-making. Healthcare providers can influence parents’ HPV vaccination decision-making, but little is known about parents’ perspectives on the counseling they receive. We sought to assess U.S. parents’ satisfaction with provider communication about HPV vaccine and associations with vaccination behaviors.MethodsParents of 11-to-17-year-old adolescents who discussed HPV vaccination with a healthcare provider at least once (n = 795) completed our online survey in Fall 2016. We assessed their satisfaction with the discussion using the HPV Vaccine Communication Satisfaction Scale (α = 0.94). We examined associations between satisfaction (categorized as low, moderate, or high), and three vaccination behaviors: refusal/delay, series initiation (≥1 dose), and continuation (≥2 doses among initiators) using multivariable logistic regression.ResultsMost parents reported high (36%) or moderate (38%) satisfaction with provider communication about HPV vaccination; fewer reported low (26%) satisfaction. Moderately satisfied parents (vs. low) had lower odds of refusal/delay (aOR = 0.59, 95% CI: 0.38–0.89), and higher odds of initiation (aOR = 1.71, 95% CI:1.15–2.55) and continuation (aOR = 2.05, 95% CI: 1.24–3.40). The associations were stronger for highly satisfied parents (refusal/delay aOR = 0.45, 95% CI: 0.29–0.70, initiation aOR = 3.59, 95% CI: 2.23–5.78, and continuation aOR = 4.08, 95% CI: 2.38–7.01).ConclusionsOur study suggests that parent satisfaction with provider communication may play an important role in HPV vaccination decision-making. Yet, communication satisfaction has been largely unexamined in the HPV-vaccine literature to date. We introduce a brief, 7-item HPV Vaccine Communication Scale that can be used to assess parents’ level of satisfaction with their provider’s communication specific to HPV vaccine. We identify communication areas for providers to prioritize when discussing HPV vaccine with parents.
Keywords:Adolescent health  HPV vaccination  Cancer prevention  Parents  Patient education and counseling
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