Factors that Influence Healthcare Provider Recommendation of HPV Vaccination.

Purpose : This study examined factors associated with healthcare providers' (HCPs') recommendation of HPV vaccination for younger and older adolescents. Methods : This is a cross-sectional study, using web-based survey of HCPs in New Jersey in 2018. The study outcome was a dichotomous measure of HCPs' recommendation of the HPV vaccine. The study predictors included practice characteristics (i.e., proportions of race/ethnicity, age groups, insurance type, and VFC recipients) and HCP's characteristics (i.e., specialty and perceived knowledge, effectiveness, concerns, parent- and system-related barriers, and facilitators). Data analysis included logistic regression models using separate blocks for practice and provider characteristics, followed by a backward stepwise approach to determine the surviving predictors. Results: Respondents (N=390) included physicians (75%) and nurse practitioners (25%), specialized in pediatrics (62%), family medicine (20%), and women's health (18%). The HCPs' recommendation rates for HPV vaccination were 56% for younger adolescents (11-13 years old) and 73% for older adolescents (14-17 years old). For younger adolescents , the recommendation rates were significantly higher in practices with higher proportions of younger adolescent, Black and Hispanic patients; among pediatric providers; and with HCPs' higher levels of knowledge and lower levels of concern about the vaccine. For older adolescents , the rates were significantly higher in practices with higher proportions patients who are Hispanic, privately insured, and VFC recipients; among pediatric providers; and with HCPs' higher levels of knowledge and lower levels of concern about the vaccine as well as higher levels of facilitators for recommending the HPV vaccine. Conclusions: Interventions targeting HCPs need to focus on improving their knowledge regarding the vaccine, reduce their concerns around its safety, and utilize facilitators strategies, particularly among non-pediatric providers.