abstract: 'Objective: This qualitative study aimed to identify doctors'' and nurses''

  perceptions of patient-, provider-, and system-level factors associated

  with human papillomavirus (HPV) vaccine completion that may be targets

  for intervention.

  Methods: We analyzed data from 61 qualitative interviews with

  pediatricians, family medicine physicians, and immunization nurses at

  medical centers that had the highest and lowest HPV vaccine completion

  rates within the same health care system.

  Results: In both groups, almost all providers reported strong support

  for the HPV vaccine. In detailing how they talk to parents and patients

  about the vaccine, more of the providers working at higher completion

  centers described using effective communication techniques, including

  engaging parents and patients in two-way conversation and demonstrating

  awareness of cultural and practical barriers to completion that families

  may face. Providers at higher completion centers were also more likely

  to depict a local medical culture supportive of and committed to HPV

  vaccine completion, with greater levels of proactivity and teamwork. In

  contrast, providers working at lower completion medical centers

  described a lack of proactivity, and the strategies they suggested to

  improve HPV vaccine completion tended to be approaches that someone

  other than medical providers would implement. The comments made by these

  providers sometimes reflected a level of negativity and judgment absent

  from the comments of providers at higher completion centers.

  Conclusion: Interventions to improve HPV vaccination completion rates

  should address both individual and system-level factors. Improving

  communication skills, encouraging a supportive medical culture, and

  addressing resource issues is likely to improve vaccine adherence. (C)

  2016 Published by Elsevier Ltd.'
affiliation: 'Hudson, SM; Chao, C (Corresponding Author), Kaiser Permanente So Calif,
  Dept Res \& Evaluat, 100 S Los Robles,2nd Floor, Pasadena, CA 91101 USA.

  Hudson, Sharon M.; Preciado, Melissa; Chao, Chun, Kaiser Permanente So Calif, Dept
  Res \& Evaluat, 100 S Los Robles,2nd Floor, Pasadena, CA 91101 USA.

  Rondinelli, June, Kaiser Permanente So Calif, Reg Nursing Res Program, 393 E Walnut
  St, Pasadena, CA 91188 USA.

  Glenn, Beth A., Univ Calif Los Angeles, Ctr Canc Prevent \& Control Res, UCLA Kaiser
  Permanente Ctr Hlth Equ, Fielding Sch Publ Hlth, 650 Charles Young Dr South,A2-125
  CHS,Box 956900, Los Angeles, CA 90095 USA.

  Glenn, Beth A., Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, 650 Charles
  Young Dr South,A2-125 CHS,Box 956900, Los Angeles, CA 90095 USA.'
author: Hudson, Sharon M. and Rondinelli, June and Glenn, Beth A. and Preciado, Melissa
  and Chao, Chun
author-email: 'Sharon.M.Hudson@kp.org

  June.L.Rondinelli@kp.org

  bglenn@ucla.edu

  Melissa.X.Preciado@kp.org

  Chun.R.Chao@kp.org'
author_list:
- family: Hudson
  given: Sharon M.
- family: Rondinelli
  given: June
- family: Glenn
  given: Beth A.
- family: Preciado
  given: Melissa
- family: Chao
  given: Chun
da: '2023-09-28'
doi: 10.1016/j.vaccine.2016.02.066
eissn: 1873-2518
files: []
issn: 0264-410X
journal: VACCINE
keywords: Human papillomavirus; Vaccine; Adherence; Patient-provider communication
keywords-plus: 'HPV VACCINE; LOW-INCOME; PHYSICIAN COMMUNICATION; GIRLS;

  RECOMMENDATIONS; ATTITUDES'
language: English
month: JUN 24
number: '30'
number-of-cited-references: '34'
pages: 3515-3521
papis_id: bac97add6c9e39a8ace3dad78abbbede
ref: Hudson2016humanpapillomavirus
times-cited: '14'
title: 'Human papillomavirus vaccine series completion: Qualitative information from
  providers within an integrated healthcare organization'
type: article
unique-id: WOS:000378955400012
usage-count-last-180-days: '0'
usage-count-since-2013: '9'
volume: '34'
web-of-science-categories: Immunology; Medicine, Research \& Experimental
year: '2016'