An educational intervention to improve attitudes regarding HPV vaccination and comfort with counseling among US medical students

Figures & data

Table 1. Association between human papillomavirus vaccine-related knowledge and time of test (N = 256)

Medical student knowledge related to HPV	Pre test	Post test	% change
What is the CDC recommended dosing schedule for follow-up injections of the HPV vaccine for patients ≥15 years old? Correct (2 & 6 months) Incorrect	80 (31.3) 176 (68.7)	176 (68.8) 80 (31.2)	119.8% -54.6%
Which is/are contraindication (s) for the HPV vaccine? Correct (High fever) Incorrect	123 (48.1) 133 (51.9)	224 (87.5) 32 (12.5)	81.9% -75.9%
Sexually active women should be tested for HPV before getting the HPV vaccine. Correct (False) Incorrect	158 (61.7) 98 (38.3)	212 (82.8) 44 (17.2)	34.2% -55.1%
If a patient received the 1st dose of the HPV vaccine > 6 months ago, the CDC recommends that she/he start the series over and get 3 more doses. Correct (False) Incorrect	141 (55.1) 115 (44.9)	235 (91.8) 21 (8.2)	66.6% -81.7%

Table 2. Frequency and percentage of beliefs and attitudes changes about the human papillomavirus (HPV) vaccine after lecture (N = 256)

Beliefs and Attitudes	# of people who regressed their attitude (%)	# of people with same attitude (%)			# of people who improved their attitude (%)
		Disagree	Neutral	Agree
I believe that the HPV vaccine provides more benefit than harm. (A)	8 (3.2)	2 (0.8)	0	224 (88.9)	18 (7.1)
The HPV vaccine should not be offered to patients until they are sexually active. (D)	17 (6.8)	6 (2.4)	2 (0.8)	184 (73.0)	43 (17.0)
I think that the HPV vaccine can cause serious side effects. (D)	15 (6.1)	4 (1.6)	9 (3.6)	161 (65.2)	58 (23.5)
The HPV vaccine saves lives. (A)	6 (2.4)	0	4 (1.6)	218 (86.2)	23 (9.8)
I expect to see benefits from HPV vaccination in my patient population. (A)	6 (2.4)	0	6 (2.4)	217 (86.1)	22 (9.1)
HPV is an important public health threat. (A)	6 (2.4)	0	2 (0.8)	231 (92.0)	14 (4.8)
I believe the HPV vaccine should be required for school attendance. (A)	15 (5.9)	31 (12.2)	46 (18.1)	83 (32.7)	79 (31.1)

Parenthetical “A” or “D” following each Belief and Attitudes statement indicate whether “Agree” or “Disagree,” respectively, was the target response. Bolded values indicate improvement >15%.

Table 3. Change in comfort with HPV vaccine counseling among medical students after lecture on HPV

Survey statement	Mean score at pretest	Mean score at posttest	Mean change between pre- and post- tests (95% CI)
I am comfortable counseling eligible women 18–26 years old on HPV vaccination.	0.32	0.96	0.62 (0.48, 0.76)
I am comfortable counseling eligible men 18–26 years old on HPV vaccination.	0.25	0.95	0.70 (0.56, 0.74)
I am comfortable counseling parents of girls on the HPV vaccine for their child.	0.31	0.94	0.62 (0.48, 0.76)
I am comfortable counseling parents of boys on the HPV vaccine for their child.	0.28	0.95	0.73 (0.59, 0.86)
I am willing to discuss HPV vaccination when patients come in for other problems.	0.76	0.93	0.14 (0.04, 0.23)
I need the following to be more comfortable with counseling patients/parents:
More education on HPV vaccination	0.83	−0.04	−0.86 (−1.00, −0.71)
More safety data on HPV vaccination	0.59	−0.21	−0.85 (−1.00, −0.71)
More time on the market	0.08	−0.41	−0.49 (−0.63, −0.36)
School requirement for HPV vaccination	0.12	−0.30	−0.45 (−0.60, −0.31)
Data on vaccine not promoting sexual activity	0.08	−0.37	−0.41 (−0.56, −0.25)
I am comfortable educating vaccine hesitant patients about HPV vaccination.	0.47	0.88	0.39 (0.26, 0.52)
I am comfortable offering the HPV vaccine to patients who are:
9–10 years old	0.18	0.78	0.58 (0.45, 0.71)
11–12 years old	0.50	0.94	0.45 (0.34, 0.51)
13–17 years old	0.75	0.96	0.23 (0.15, 0.32)
I am uncomfortable recommending a vaccine against sexually transmitted infections.	−0.61	−0.66	−0.01(−0.16, 0.13)

Bolded values indicate significance at p < .05. CI = confidence interval.

Table 4. Impact of lecture on comfort with HPV vaccine counseling (N = 256)

	Comfort with HPV vaccine counseling (15 items)*
Characteristics	Pretest (mean score)	Posttest (mean score)	Mean difference (95% CI)	p-value^†
Overall	6.0	7.5	1.43 (0.75, 2.11)	0.0002
Age
<30	6.0	7.5	1.43 (0.74, 2.13)	0.0003
≥30	6.1	7.4	1.29 (−1.97, 4.54)	0.47
Gender
Female	6.2	7.5	1.32 (0.31, 2.34)	0.004
Male	5.9	7.4	1.51 (0.59, 2.43)	0.02
Race/ethnicity
White	6.0	6.8	0.79 (−0.19, 1.77)	0.15
Asian	6.0	8.9	2.85 (1.37, 4.33)	0.0002
Hispanic	5.1	7.2	2.09 (0.34, 3.85)	0.03
Black/African	7.0	6.9	−0.14 (−2.60, 2.32)	0.56
Other	7.9	8.0	0.06 (−2.28, 2.41)	0.93
HPV vaccine uptake
Yes	6.0	6.9	0.87 (−0.13, 1.87)	0.09
No	6.2	8.0	1.78 (0.62, 2.95)	0.01

CI = confidence interval.

*Mean scores calculated as an average of the total sum score (range = −15 to 15) for each participant on questions related to comfort with HPV vaccine counseling. Higher scores indicate greater readiness to counsel.

^†Wilcoxon signed rank test with two-sided test.