A brief educational intervention increases providers' human papillomavirus vaccine knowledge

Figures & data

Table 1. Characteristics of participants and impact of presentation on HPV vaccine knowledge score (n = 427)

Characteristics		Pre-test score	Post-test score	Mean difference (95% CI)	P value
Overall	427	8.44	14.72	6.29 (6.01 to 6.56)	<.001
Age categories
<30	317 (74.2)	8.15	14.95	6.80 (6.51 to 7.09)	<.001
30–49	62 (14.5)	8.89	14.24	5.35 (4.51 to 6.20)	<.001
50 and above	41 (9.6)	9.70	13.83	4.12 (3.15 to 5.09)	<.001
Unknown	7 (1.6)	10.00	14.00	4.00 (0.84–7.16)	.021
Gender
Female	286 (67.0)	8.45	14.79	6.34 (6.00 to 6.69)	<.001
Male	135 (31.6)	8.39	14.61	6.22 (5.72 to 6.70)	<.001
Unknown	6 (1.4)	8.50	13.5	5.00 (0.45–9.55)	.037
Race/ethnicity
White	199 (46.6)	8.48	15.12	6.64 (6.23 to 7.04)	<.001
African American	40 (9.4)	7.73	13.68	5.95 (4.93 to 6.97)	<.001
Hispanic	69 (16.2)	8.81	14.33	5.52 (4.78 to 6.26)	<.001
Asian American	73 (17.1)	8.58	14.68	6.11 (5.52 to 6.70)	<.001
Other	26 (6.1)	8.00	14.23	6.23 (5.07 to 7.38)	<.001
Unknown	20 (4.7)	7.75	14.00	6.25 (4.58–7.92)	<.001
Participants
MD/DO	75 (17.6)	9.48	14.51	5.03 (4.39 to 5.66)	<.001
Medical student	208 (48.7)	8.58	14.88	6.31 (5.99 to 6.62)	<.001
Other	141 (33.0)	7.63	14.57	6.93 (6.35 to 7.53)	<.001
Unknown	3 (0.7)	10.33	16.00	—

Maximum possible score = 16

^a P values were based on paired-t tests.

^b Includes 39 pediatricians, 18 Ob-Gyn physicians, 16 family physicians and 2 with unknown specialty.

^c E.g., registered nurse, nurse practitioner, nurse student, physician assistant (PA), PA student, medical assistant, certified nurse midwife.

^d Statistical analysis was not performed due to small number of observation in this category.

Table 2. Correlates of participants' HPV vaccine-related knowledge before and after the structured presentation

	Knowledge score at baseline		Changes in knowledge score after presentation
Characteristics	Regression coefficient (95% CI)	P value	Regression coefficient (95% CI)	P value
Age categories
<30	Reference		Reference
30–49	1.01 (0.29 to 1.73)	.006	−1.41 (−2.24 to −0.58)	.001
50 and above	2.41 (1.54 to 3.28)	<.001	−3.32 (−4.32 to −2.32)	<.001
Gender
Female	Reference		Reference
Male	−0.62 (−1.15 to −0.09)	.023	0.36 (−0.25 to 0.97)	.248
Race/ethnicity
White	Reference		Reference
African American	−1.35 (−2.17to −0.53)	.001	−0.19 (−1.13 to 0.76)	.698
Hispanic	0.15 (−0.50 to 0.81)	.646	−0.98 (−1.74 to −0.23)	.010
Asian American	−0.25 (−0.91 to 0.40)	.448	−0.28 (−1.04 to 0.47)	.462
Other	−0.40 (−1.40 to 0.60)	.434	0.24 (−0.91 to 1.38)	.687
Participants
MD/DO	Reference		Reference
Medical student	0.04 (−0.70 to 0.78)	.920	0.19 (−0.66 to 1.04)	.656
Other	−1.58 (−2.60 to −1.17)	<.001	1.74 (0.92 to 2.56)	<.001

^a E.g., registered nurse, nurse practitioner, nurse student, physician assistant (PA), PA student, medical assistant, certified nurse midwife.

Table 3. Proportion of correct responses to multiple choice and true-false questions administered before and after the structured presentation

	Overall (n = 427)			By Provider Type
True-False Statements and Questions	Pre-test n = 427	Post-test n = 427	P value	Pre-test			Post-test
				MD/DO n = 75	Medical Student n = 208	Other n = 141	MD/DO n = 75	Medical Student n = 208	Other n = 141
Sexually active women who want the vaccine should be tested for HPV before receiving the first dose.	71.4	98.8	<.001	85.3	72.1	63.8	98.7	98.6	99.3
Gardasil should not be administered to breastfeeding patients.	67.7	96.7	<.001	92.0	75.0	44.7	98.7	95.7	97.2
If a patient received her 1st HPV vaccination >1 y ago but never returned for follow-up, she should start the series again and get 3 additional injections.	48.1	96.7	<.001	69.3	36.1	55.3	97.3	96.2	97.2
What is the recommended age for the HPV vaccine?	67.7	98.1	<.001	74.7	67.8	63.1	97.3	97.6	99.3
What are the recommended dosing intervals for the 3 doses of Gardasil?	53.2	95.1	<.001	69.3	44.2	57.5	93.3	94.7	96.5
How many types of HPV are associated with cervical cancer?	23.7	83.8	<.001	22.7	27.9	17.0	81.3	88.9	77.3
What percent of cervical cancer in the US is caused by the 2 high-risk HPV types (16, 18) that Gardasil protects against?	56.9	91.6	<.001	62.7	57.7	52.5	88.0	89.4	96.5
Which race/ethnicity has the highest incidence of cervical cancer in the US?	18.0	94.2	<.001	18.7	14.4	22.0	81.3	97.6	95.7
What proportion of 13–17 y old females was fully vaccinated in the US in 2010?	74.7	94.4	<.001	72.0	74.5	75.9	94.7	91.8	97.9
What is the HPV immunization goal for females to ensure maximum herd immunity?	18.5	91.8	<.001	16.0	17.3	22.0	93.3	92.8	89.4
The HPV vaccine prevents cervical cancer.	99.3	99.1	.250	100.0	99.5	98.6	100.0	98.6	99.3
The HPV vaccine prevents cancer of vulva.	35.4	84.1	<.001	44.0	37.5	27.0	81.3	87.5	80.1
The HPV vaccine prevents vaginal cancer.	31.9	82.4	<.001	32.0	31.7	31.9	77.3	87.0	78.6
The HPV vaccine prevents ovarian cancer.	89.5	93.4	<.001	97.3	94.7	77.3	97.3	92.3	92.9
The HPV vaccine prevents penile cancer	40.1	85.3	<.001	49.3	47.1	24.1	85.3	87.5	81.6
The HPV vaccine prevents anal cancer.	47.1	86.7	<.001	42.7	60.1	30.5	85.3	92.3	78.7

^a Three participants whose specialty were not known were excluded from this analysis.

^b P values were based on McNemar's chi square or exact test.

^c Statistical comparisons among 3 provider groups were made using chi-square test or Fisher's exact test.

^d E.g., registered nurse, nurse practitioner, nurse student, physician assistant (PA), PA student, medical assistant, certified nurse midwife.

^e P <.017 was considered as statistically significant to adjust for multiple comparison as the comparison was made among 3 groups.

^f No Statistical difference was observed among pediatricians, family physicians and obstetricians/gynecologists.