Disparities in collaborative patient-provider communication about human papillomavirus (HPV) vaccination

Figures & data

Figure 1. Conceptual model of hypothesized relationships between demographic characteristics, collaborative communication (“Collab. comm”), and HPV vaccination (receipt of first of 3-dose series).

Table 1. Adolescent, parent, and household characteristics of female participants in National Immunization Survey (NIS) - Teen, Parental Attitudes Module, 2010 (n=4,124).

	N	%
	Household characteristics
Census region
South	1,461	36.1
Midwest	922	22.1
Northeast	849	18.2
West	892	23.5
Urbanicity
Rural	967	15.3
Urban/suburban	3,157	84.7
Poverty level
At or above	3,387	77.7
Below	576	17.2
	Parent characteristics
Maternal education
At least some college	2,959	63.7
High school graduate or less	1,165	36.3
Preferred language for survey
English	3,915	94.2
Spanish	172	5.8
	Adolescent characteristics
Race/ethnicity
Non-Hispanic white	2,856	61.4
Non-Hispanic black	417	15.0
Hispanic	519	15.9
Other	332	7.7
Age
13–14 y	1,719	39.1
15–17 y	2,405	60.9
Private insurance
Yes	2,802	62.4
No	1,322	37.6

Note. Frequencies are unweighted; proportions are weighted.

Table 2. Bivariate associations of demographics with collaborative communication, in National Immunization Survey (NIS) - Teen, Parental Attitudes Module, 2010 (n=4,124).

	n/N	%	OR	95% CI
Household characteristics
Census region
South	768/1,461	49.2	(ref)
Midwest	485/922	52.0	1.12	(0.88–1.43)
Northeast	505/849	57.2	1.38	(1.06–1.81)^*
West	462/892	55.3	1.28	(0.89–1.85)
Urbanicity
Rural	450/967	45.0	(ref)
Urban/suburban	1,770/3,157	54.1	1.44	(1.13–1.83)^**
Poverty level
At or above	1,853/3,387	54.6	(ref)
Below	282/576	44.1	0.66	(0.48–0.89)^**
Parent characteristics
Maternal education
At least some college	1,653/2,959	55.4	(ref)
High school graduate or less	567/1,165	48.0	0.74	(0.59–0.94)^*
Preferred language for survey
English	2,123/3,915	54.0	(ref)
Spanish	82/172	36.5	0.49	(0.26–0.93)^*
Adolescent characteristics
Race/ethnicity
Non-Hispanic white	1,595/2,856	56.8	(ref)
Non-Hispanic black	208/417	50.2	0.77	(0.55–1.07)
Hispanic	246/519	41.5	0.54	(0.37–0.79)^**
Other	171/332	47.8	0.70	(0.45–1.07)
Age
13–14 y	909/1,719	51.7	(ref)
15–17 y	1,311/2,405	53.3	1.07	(0.85–1.35)
Private insurance
Yes	1,592/2,802	57.1	(ref)
No	628/1,322	45.4	0.63	(0.49–0.79)^***

Note. OR=odds ratio; CI=confidence interval; ref=reference group. Frequencies are unweighted; proportions and odds ratios are weighted.

* p<.05;

** p<.01;

*** p<.001

Table 3. Effects of controlling for collaborative communication as a mediator of the relationship between demographics and HPV vaccine initiation, in National Immunization Survey (NIS) - Teen, Parental Attitudes Module, 2010 (n=4,124).

	c path (Total effect)	c' path (Direct effect)	Mediation
	est (SE)	est (SE)	z
Household characteristics
Census region (ref: South)
Midwest	0.14 (0.13)	0.11 (0.13)	0.89
Northeast	0.37 (0.14)^**	0.29 (0.15)^*	2.31^**
West	0.42 (0.19)^*	0.38 (0.23)	1.30
Urbanicity (ref: rural)	0.18 (0.12)	0.08 (0.12)	2.87^**
Poverty level (ref: at or above)	0.31 (0.16)	0.53 (0.18)^**	−2.59^**
Parent characteristics
Maternal education (ref: at least some college)	0.15 (0.12)	0.31 (0.14)^*	−2.38^*
Preferred language (ref: English)	0.90 (0.33)^**	1.33 (0.37)^***	−2.15^*
Adolescent characteristics
Race/ethnicity (ref: non-Hispanic white)
Non-Hispanic black	−0.13 (0.17)	−0.04 (0.19)	−1.56
Hispanic	0.26 (0.20)	0.56 (0.24)^*	−3.04^**
Other	0.03 (0.22)	0.19 (0.29)	−1.63
Age (ref: 13–14)	0.39 (0.12)^***	0.47 (0.13)^***	0.58
Private insurance (ref: yes)	0.10 (0.12)	0.30 (0.14)^*	−3.67^***

Note. est=coefficient estimate; SE=standard error; ref=reference group.

* p<.05,

** p<.01,

*** p<.001

Figure 2. Relationships between (A) urbanicity and (B) race/ethnicity and HPV vaccine initiation, depending on whether parents report collaborative communication with healthcare providers. Error bars show 95% confidence intervals.