Original article
Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes

https://doi.org/10.1016/j.jadohealth.2005.07.014Get rights and content

Abstract

Purpose

The objective of this study was to examine pediatrician characteristics and attitudes associated with intention to recommend two hypothetical human papillomavirus (HPV) vaccines.

Methods

A survey instrument mailed to a random sample of 1000 pediatricians assessed provider characteristics, HPV knowledge, and attitudes about HPV vaccination. Intention to administer each of two HPV vaccines types (a cervical cancer/genital wart vaccine and a cervical cancer vaccine) to girls and boys of three different ages (11, 14, and 17 years) was assessed. Linear mixed modeling for repeated measures and multivariable linear regression models were performed to identify variables associated with intention to recommend vaccination.

Results

The mean age of participants (n = 513) was 42 years and 57% were female. Participants were more likely to recommend vaccination to girls vs. boys and older vs. younger children, and were more likely to recommend a cervical cancer/genital wart vaccine than a cervical cancer vaccine (p < .0001). Variables independently associated with intention to recommend a cervical cancer/genital wart vaccine were: higher estimate of the percentage of sexually active adolescents in one’s practice (β .084, p = .002), number of young adolescents seen weekly (β 1.300, p = .015), higher HPV knowledge (β 1.079, p = .015), likelihood of following the recommendations of important individuals and organizations regarding immunization (β .834, p = .001), and fewer perceived barriers to immunization (β −.203, p = .001).

Conclusions

Vaccination initiatives directed toward pediatricians that focus on modifiable predictors of intention to vaccinate, such as HPV knowledge and attitudes about vaccination, may facilitate adherence to emerging national immunization guidelines.

Section snippets

Methods

The survey instrument developed for this study was based on a validated survey of physicians’ immunization knowledge, attitudes, and practices [20] and a survey previously developed by the investigators [21]. It was pretested in a sample of 20 pediatricians and family physicians, and pilot tested in a sample of American Academy of Family Physicians (AAFP) members [22]. The revised, self-administered survey instrument was then mailed twice over a two-month period in 2004 to a random sample of

Results

Of the 1000 surveys sent to providers, 603 (60%) were returned and of those, 33 reported that they did not care directly for patients. Of the remaining 570 who were eligible to participate and returned a survey, 513 (90% of those eligible, 51% of total n) completed the survey. Those who completed the survey, compared with those who did not, were more likely to be female (p = .018) and were younger (p < .0001). Participant characteristics and HPV knowledge are shown in Table 1. Most participants

Discussion

In this study, we examined pediatricians’ attitudes about HPV vaccination and intention to recommend two hypothetical HPV vaccines to children and adolescents. Intention to recommend vaccination differed according to patient gender, patient age, and vaccine type. Pediatricians’ intention to recommend both HPV vaccines was markedly higher for older vs. younger patients, as demonstrated in recent studies examining attitudes about STI vaccination among gynecologists, nurse practitioners, and

Acknowledgments

Dr. Kahn was supported by Grant #K23 AI50923-01 from the National Institute of Allergy and Infectious Diseases (NIAID). Mr. Riedesel was supported by Grant #T35 DK60444-02 from the National Institute of Diabetes and Digestive and Kidney Diseases. Dr. Zimet was supported by Grant #R01 AI49644 from NIAID. Dr. Rosenthal was supported by Grant #HD 40151 from the National Institute of Child Health and Human Development.

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