PRACTICE-, PROVIDER-, AND PATIENT-LEVEL FACILITATORS OF AND BARRIERS TO HPV VACCINE PROMOTION AND UPTAKE IN THE STATE OF GEORGIA (ID 184)
Abstract
Introduction
The state of Georgia (U.S.) experiences higher HPV-associated cancer burden and lower HPV vaccine uptake compared to national estimates. There has been little research utilizing multilevel frameworks to study facilitators of and barriers to HPV vaccine promotion and uptake in Georgia. Guided by the P3 model that concomitantly assesses practice-, provider-, and patient-level factors influencing preventive health behaviors, we examined this question, using the perspectives of diverse healthcare providers recruited from five geographic regions in Georgia.
Methods
Between April and July 2018, we conducted six focus group discussions with a total of 55 healthcare providers. Questions focused on multilevel facilitators of and barriers to HPV vaccine promotion and uptake that healthcare providers observed in their practices. Data analysis was guided by the P3 model and a deductive coding approach based in grounded theory.
Results
At the practice level, providers discussed organizational priorities of HPV vaccinations, ability to schedule future HPV vaccine doses, use of informatics for immunization medical records, availability of HPV vaccine, and ability to coordinate with community resources. At the provider level, influential themes included time constraints, role, knowledge, self-efficacy to discuss HPV vaccine, and HPV vaccine confidence. At the patient level, providers noted issues related to patients’ trust, experiences with HPV vaccine-preventable diseases, perceived high costs, perceived side effects, and concerns with sexual activity.
Conclusions
Effective interventions should incorporate elements addressing each of the levels of the P3 model. Interventions may include incentives to boost vaccine rates and incorporating technology for vaccination appointment scheduling. Additional emphasis should be placed on improving across-practice information exchange and providing additional education for providers on HPV vaccine knowledge. Patient-provider communication and trust emerges as an important intervention target. Providers should be trained in addressing concerns about HPV vaccine, such as those related to costs, side effects, and sexual activity.
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