Member Research and Reports

Member Research and Reports

UAB Investigator Studies Perceived Barriers to Discussing HPV Vaccination with Patients

In a recent study, Dr. Andrzej Kulczycki, associate professor in the department of health care organization and policy at the University of Alabama at Birmingham — in collaboration with Dr. Haiyan Qu, research assistant professor, and Dr. Richard M. Shewchuk, professor emeritus, in UAB’s School of Health Professions — investigated barriers primary care physicians (PCPs) perceive exist in initiating a discussion with 11- and 12-year-old female patients about the human papillomavirus (HPV) vaccination, in addition to how those difficulties affect initiating and continuing to administer the vaccine.


[Photo: Dr. Andrzej Kulczycki]

Surveying a randomly selected sample of 301 PCPs, the researchers used latent class analysis (LCA) to model the reported perceived barriers and three iterative logistic regression models to calculate the probability a patient discussion would occur, along with the likelihood of the administration of the initial HPV vaccination and subsequent follow-up shots.

“LCA revealed three groups of PCPs who perceived major, moderately significant, and relatively minor barriers (17.9, 41.9, and 40.2 percent of respondents, respectively). Pediatricians, PCPs who are female, PCPs with minority racial/ethnic status, and PCPs who perceived only minor barriers had significantly higher odds of initiating discussion. PCPs were more likely to initiate HPV vaccination if they had initiated discussion and perceived minor or moderate communication barriers. Increased likelihood to administer follow-up HPV vaccine was associated with having initiated discussion, perceiving only minor barriers, and working outside Deep South states, but not with having initiated vaccination,” discovered Dr. Kulczycki and his colleagues.

Survey results indicate that PCPs who talk with female patients in the target age group — as well as with those patients’ mothers — have an increased likelihood of starting and continuing the full course of the vaccine. However, since PCPs identify discussion barriers differently, interventions should be tailored to address concerns in order to allow PCPs to effectively impart their recommendations to their patients.

“Recommend, but also Discuss: Different Patterns of Physician-Perceived Barriers to Discussing HPV Vaccination and Their Association with Vaccine Administration in 11–12 Year-Old Girls” was published online in July in Maternal and Child Health Journal.

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