HPV Vaccination Recommendation Practices among Adolescent Health Care Providers in 5 Countries |
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Authors: | Hillary M Topazian Debanjali Kundu Kathryn Peebles Silvina Ramos Karen Morgan Chan Joo Kim Karin L Richter Noel T Brewer Mercè Peris Jennifer S Smith |
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Affiliation: | 1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina;2. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina;3. Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina;4. Perdana University, Royal College of Surgeons in Ireland School of Medicine, Kuala Lumpur, Malaysia;5. Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland;6. Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, St. Paul''s Hospital, Seoul, Korea;7. Department of Medical Virology, University of Pretoria, National Health Laboratory Service, Pretoria, South Africa;8. Cancer Epidemiology Research Programme, Institut Català d’Oncologia, Barcelona, Spain;9. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina |
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Abstract: | Study ObjectiveTo assess adolescent health care providers’ recommendations for, and attitudes towards human papillomavirus (HPV) vaccination in 5 countries.DesignIn-depth interviews of adolescent health care providers, 2013-2014.SettingFive countries where HPV vaccination is at various stages of implementation into national programs: Argentina, Malaysia, South Africa, South Korea, and Spain.ParticipantsAdolescent health care providers (N = 151) who had administered or overseen provision of adolescent vaccinations (N = Argentina: 30, Malaysia: 30, South Africa: 31, South Korea: 30, Spain: 30).Main Outcome MeasuresFrequency of HPV vaccination recommendation, reasons providers do not always recommend the vaccine and facilitators to doing so, comfort level with recommending the vaccine, reasons for any discomfort, and positive and negative aspects of HPV vaccination.ResultsOver half of providers 82/151 (54%) recommend HPV vaccination always or most of the time (range: 20% in Malaysia to 90% in Argentina). Most providers 112/151 (74%) said they were comfortable recommending HPV vaccination, although South Korea was an outlier 10/30 (33%). Providers cited protection against cervical cancer 124/151 (83%) and genital warts 56/151 (37%) as benefits of HPV vaccination. When asked about the problems with HPV vaccination, providers mentioned high cost 75/151 (50% overall; range: 26% in South Africa to 77% in South Korea) and vaccination safety 28/151 (19%; range: 7% in South Africa to 33% in Spain). Free, low-cost, or publicly available vaccination 59/151 (39%), and additional data on vaccination safety 52/151 (34%) and efficacy 43/151 (28%) were the most commonly cited facilitators of health provider vaccination recommendation.ConclusionInterventions to increase HPV vaccination should consider a country's specific provider concerns, such as reducing cost and providing information on vaccination safety and efficacy. |
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Keywords: | Human papilloma virus HPV-associated cancers Cervical cancer Vaccination Health care provider recommendation |
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