Association of provider HPV vaccination training with provider assessment of HPV vaccination status and recommendation of HPV vaccination

Figures & data

Table 1. Distribution of training, demographics, and practice-related factors for healthcare providers by strata of HPV vaccination status assessment and recommendation.

		Assessment of HPV vaccination status (n = 1019)			Recommendation of HPV vaccination (n = 1283)
Characteristics	Overall(n = 1283)	Often/Always (n = 482)	Never/Sometimes (n = 537)	p-value	Often/Always (n = 756)	Never/Sometimes (n = 527)	p-value
Training, n (%) No Yes	730 (57.3) 545 (42.8)	187 (31.2) 294 (71.0)	413 (68.8) 120 (29.0)	<0.001	324 (44.4) 429 (78.7)	406 (55.6) 116 (21.3)	<0.001
Recency of training, years, n (%) No Training Training received >5 years ago Training received 2–5 years ago Training received <2 years ago	730 (57.3) 168 (13.2) 211 (16.6) 164 (12.9)	187 (31.2) 81 (65.9) 101 (66.9) 110 (79.7)	413 (68.8) 42 (34.2) 50 (33.1) 28 (20.3)	<0.001	324 (44.4) 132 (78.6) 160 (75.8) 135 (82.3)	406 (55.6) 36 (21.4) 51 (24.2) 29 (17.7)	<0.001
Provider age, years, n (%) < 35 35-54 ≥ 55	160 (12.7) 783 (62.2) 316 (25.1)	42 (33.1) 278 (46.3) 156 (58.2)	85 (66.9) 323 (53.7) 112 (41.8)	<0.001	80 (50.0) 463 (59.1) 206 (65.2)	80 (50.0) 320 (40.9) 110 (34.8)	0.006
Provider sex, n (%) Female Male	966 (76.5) 297 (23.5)	362 (47.1) 113 (47.9)	406 (52.9) 123 (52.1)	0.841	569 (58.9) 174 (58.6)	397 (41.1) 123 (41.4)	0.923
Race/ethnicity, n (%) Non-Hispanic White Non-Hispanic Black Hispanic Non-Hispanic other	668 (53.3) 116 (9.3) 164 (13.1) 306 (24.4)	230 (44.2) 44 (46.8) 84 (63.6) 111 (45.1)	291 (55.9) 50 (53.2) 48 (36.4) 135 (54.9)	0.001	380 (56.9) 67 (57.8) 114 (69.5) 178 (58.2)	288 (43.1) 49 (42.2) 50 (30.5) 128 (41.8)	0.031
Practice location, n (%) Rural Urban	54 (4.2) 1228 (95.8)	25 (61.0) 456 (46.7)	16 (39.0) 521 (53.3)	0.072	38 (70.4) 717 (58.4)	16 (29.6) 511 (41.6)	0.080
Provider type, n (%) Physician Nurse Physician assistant Other	501 (39.1) 407 (31.7) 273 (21.3) 102 (8.0)	291 (74.6) 129 (40.4) 45 (20.2) 17 (19.5)	99 (25.4) 190 (59.6) 178 (79.8) 70 (80.5)	<0.001	403 (80.4) 214 (52.6) 110 (40.3) 29 (28.4)	98 (19.6) 193 (47.4) 163 (59.7) 73 (71.6)	<0.001
Type of practice, n (%) University/teaching hospital Solo practice Group practice FQHC/public facility Other	398 (31.0) 144 (11.2) 407 (31.7) 132 (10.3) 202 (15.7)	96 (29.7) 62 (54.4) 187 (59.2) 66 (62.9) 71 (44.1)	227 (70.3) 52 (45.6) 129 (40.8) 39 (37.1) 90 (55.9)	<0.001	182 (45.7) 92 (63.9) 277 (68.1) 93 (70.5) 112 (55.5)	216 (54.3) 52 (36.1) 130 (31.9) 39 (29.6) 90 (44.6)	<0.001
Years in practice, n (%) ≤ 10 years 11–20 years > 20 years	492 (38.7) 434 (34.2) 344 (27.1)	157 (41.3) 151 (44.2) 170 (59.7)	223 (58.7) 191 (55.9) 115 (40.4)	<0.001	268 (54.5) 248 (57.1) 235 (68.3)	224 (45.5) 186 (42.9) 109 (31.7)	<0.001
No of patients seen (per week), n (%) ≤ 50 51-100 > 100	608 (48.8) 486 (39.0) 153 (12.3)	149 (29.9) 246 (65.6) 73 (64.6)	349 (70.1) 129 (34.4) 40 (35.4)	<0.001	274 (45.1) 356 (73.3) 109 (71.2)	334 (54.9) 130 (26.8) 44 (28.8)	<0.001

8 observations missing for training, 10 observations missing for recency of training, 24 observations missing for age, 20 observations missing for sex, 1 observation missing for practice location, 29 observations missing for race/ethnicity, 13 observations missing for years in practice, and 36 observations missing for the number of patients seen per week.

Table 2. Bivariable and multivariable logistic regression analyses of the association between training and provider assessment of HPV vaccination status and recommendation of HPV vaccines – overall population.

	Assessment of HPV vaccination status				Recommendation of HPV vaccination
Characteristics	Crude OR (95% CI)	p-value	Adjusted OR (95% CI)	p-value	Crude OR (95% CI)	p-value	Adjusted OR (95% CI)	p-value
Training No Yes	Ref 5.41 (4.12–7.11)	Ref <0.001	Ref 4.32 (3.06–6.10)	Ref <0.001	Ref 4.63 (3.60–5.96)	Ref <0.001	Ref 3.66 (2.73–4.90)	Ref <0.001
Provider age, years < 35 35-54 ≥ 55	Ref 1.74 (1.16–2.60) 2.82 (1.81–4.39)	Ref 0.007 <0.001	Ref 1.41 (0.78–2.55) 2.07 (0.93–4.60)	Ref 0.260 0.073	Ref 1.45 (1.03–2.03) 1.87 (1.27–2.76)	Ref 0.034 0.001	Ref 1.20 (0.76–1.91) 1.19 (0.63–2.26)	Ref 0.436 0.588
Provider sex Female Male	Ref 1.03 (0.77–1.38)	Ref 0.841	Ref 0.62 (0.41–0.95)	Ref 0.029	Ref 0.99 (0.76–1.29)	Ref 0.923	Ref 0.70 (0.50–1.00)	Ref 0.047
Race/ethnicity Non-Hispanic White Non-Hispanic Black Hispanic Non-Hispanic other	Ref 1.11 (0.72–1.73) 2.21 (1.49–3.29) 1.04 (0.77–1.41)	Ref 0.633 <0.001 0.800	Ref 1.35 (0.75–2.44) 2.55 (1.52–4.29) 0.99 (0.64–1.52)	Ref 0.323 <0.001 0.959	Ref 1.04 (0.70–1.54) 1.73 (1.20–2.49) 1.05 (0.80–1.39)	Ref 0.861 0.003 0.707	Ref 1.07 (0.65–1.75) 1.87 (1.21–2.89) 1.06 (0.75–1.49)	Ref 0.792 0.005 0.752
Practice location Rural Urban	Ref 0.56 (0.30–1.06)	Ref 0.076	Ref 0.54 (0.24–1.24)	Ref 0.146	Ref 0.59 (0.33–1.07)	Ref 0.083	Ref 0.59 (0.29–1.19)	Ref 0.138
Provider type Physician Nurse Physician assistant Other	Ref 0.23 (0.17–0.32) 0.09 (0.06–0.13) 0.08 (0.05–0.15)	Ref <0.001 <0.001 <0.001	Ref 0.23 (0.16–0.35) 0.08 (0.05–0.13) 0.11 (0.06–0.23)	Ref <0.001 <0.001 <0.001	Ref 0.27 (0.20–0.36) 0.16 (0.12–0.23) 0.10 (0.06–0.16)	Ref <0.001 <0.001 <0.001	Ref 0.29 (0.20–0.41) 0.18 (0.12–0.26) 0.14 (0.08–0.24)	Ref <0.001 <0.001 <0.001
Type of practice University/teaching hospital Solo practice Group practice FQHC/public facility Other	Ref 2.82 (1.82–4.37) 3.43 (2.47–4.76) 4.00 (2.52–6.35) 1.87 (1.26–2.76)	Ref <0.001 <0.001 <0.001 0.002	Ref 2.13 (1.20–3.77) 1.69 (1.08–2.65) 2.14 (1.14–4.00) 1.03 (0.61–1.73)	Ref 0.010 0.021 0.018 0.918	Ref 2.10 (1.42–3.11) 2.53 (1.90–3.37) 2.83 (1.85–4.32) 1.48 (1.05–2.08)	Ref <0.001 <0.001 <0.001 0.025	Ref 1.43 (0.89–2.31) 1.38 (0.96–1.99) 1.78 (1.04–3.03) 0.94 (0.62–1.45)	Ref 0.139 0.082 0.035 0.792
Years in practice ≤ 10 years 11–20 years > 20 years	Ref 1.12 (0.84–1.51) 2.10 (1.54–2.87)	Ref 0.442 <0.001	Ref 0.73 (0.47–1.13) 1.04 (0.56–1.93)	Ref 0.160 0.893	Ref 1.11 (0.86–1.45) 1.80 (1.35–2.40)	Ref 0.414 <0.001	Ref 0.75 (0.53–1.07) 1.19 (0.73–1.95)	Ref 0.113 0.484
No of patients seen (per week) ≤ 50 51-100 > 100	Ref 4.47 (3.35–5.95) 4.27 (2.78–6.58)	Ref <0.001 <0.001	Ref 4.06 (2.80–5.89) 3.80 (2.13–6.78)	Ref <0.001 <0.001	Ref 3.34 (2.58–4.31) 3.02 (2.06–4.44)	Ref <0.001 <0.001	Ref 2.79 (2.05–3.80) 2.55 (1.58–4.11)	Ref <0.001 <0.001

OR: Odds Ratio; CI: Confidence Interval.

Figure 1. Multivariable logistic regression analyses of the association of recency of HPV vaccination training of HCPs with HPV vaccination status assessment and recommendation in the overall population of HCPs in Texas.

Reference category for recency of HPV vaccination training was “No training received”. AOR = Adjusted Odds Ratio. Odds ratio from logistic regression models were adjusted for HCP’s age, sex, race/ethnicity, location of practice, provider type, practice type, number of years in practice, and number of patients seen.