Characterizing safety-net providers' HPV vaccine recommendations to undecided parents: A pilot study.
L Aubree Shay, Richard L Street, Austin S Baldwin and 7 others
PMID 27401828WHAT IT FOUND
Providers almost never assumed HPV vaccination would happen; they mostly asked parents to decide.
Visits with direct recommendations and nearby cancer-prevention reasons had higher first-dose rates, but this pilot could not prove causation.
Key findings
01Only one visit used a presumptive HPV vaccine introduction; 42 visits used a participatory introduction, while all 15 TDAP and meningococcal visits used a presumptive style.
02Over half (56%) of adolescents received the first HPV dose during the visit.
03Vaccination was 72% when a rationale was adjacent to the recommendation, but 27% when providers said it was not necessary today and 38% when they emphasised parental choice.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The analytic sample was only 43 discussions, and the pilot was not powered to test whether communication patterns caused vaccination. Nurse-only visits and nurse-parent discussions outside the exam room were excluded, so the study did not describe how nurses communicated about the vaccine. The clinics were safety-net sites serving mainly low-income, publicly insured Hispanic and African American families, so findings may not apply to other populations. Providers may have qualified recommendations because of parent concerns or non-verbal cues that audio recordings did not capture. Parents completed a baseline survey before visits, which could have influenced their vaccine decisions.
Declared interests
No author conflict-of-interest declaration is included in the supplied text; the publication types note NIH extramural research support.
The easy way to misread this
Do not read the higher vaccination percentages as proof that a particular wording causes HPV vaccination. The study was a pilot with a small analytic sample and was not powered to test statistical significance; parental concerns or non-verbal cues may have prompted provider caveats.