Healthcare providers’ practice protocols, strategies, and needed tools to address parental HPV vaccine hesitancy: An exploratory study

Figures & data

Table 1. Provider characteristics, n = 15.

Race (n, %)
African American	2 (13.3)
White	10 (66.7)
Other	3 (20.0)
Sex (n, %)
Male	4 (26.7)
Female	11 (73.3)
Practice Type (n, %)
Pediatrics	13 (86.6)
Family Medicine	1 (6.7)
Adolescent Medicine	1 (6.7)
Practice Area (n, %)
Urban	10 (66.7)
Suburban	`4 (26.7)
Rural/Mostly Rural	1 (6.6)
Geographical Region (n, %)
South	8 (53.3%)
Northeast	5 (33.3%)
West	1 (6.7%)
Midwest	1 (6.7%)
Years Practicing (μ, yrs)	14.3
Residency year training (range, year of completion)	1982–2021

Figure 1. Example protocol to engage HPV vaccine hesitant parents in a clinical encounter(s).

Note: This protocol can be used in more than one encounter with parents. Also, parents may still need education after child initiates and/or completes the HPV vaccine series.

Table 2. Recommendations for HealthCare providers to engage HPV vaccine hesitant parents.

Provide pre-visit recommendation and/or information on HPV vaccination before clinic visit or prior to actual patient-provider encounter at a clinic visit. Develop a standard protocol to engage HPV vaccine hesitant parents which can be tailored for use by clinic (See Figure 3 for example). The following components should be included: Use of a strong recommendation and continued discussion Recommendation for HPV vaccination at 9 years of age Allotment of time for Parent-Provider discussion, and possibly adolescent involvement Linkage of parents to credible information sources which could be available internally (e.g., one-pager or pamphlet) or externally (e.g., webpage or parents) (if necessary) Continued Follow-up if Delays or Refusals. Use of EMR-based reminders and EMR-linked clinical decision support to assist with follow-up. Development of or linkage to training opportunities for providers and clinic staff to ensure consistency in engagement and messaging from the front to the back of the clinic. Ongoing education on vaccines including HPV vaccines if needed regardless of vaccine status. Identify strategies with preference for evidence-based approaches to be used in training opportunities for providers that can be applied in patient-parent-provider encounters. Evidence-based strategies include use of the presumptive approach, motivational interviewing, and persistence. Additional strategies for consideration are tailored messaging, persuasive messaging, personal experience, altruism, and family-centered engagement. Use consistent messaging in patient-parent-provider encounters to address parental concerns of vaccines. (Note. Messaging may vary by adolescent subgroups such as age and gender.) Be trustworthy while applying plain language in communication. Trustworthiness can be established being transparent, empathetic, culturally-sensitive, promoting dialogue for informed decision-making (humility), and listening actively. It is built over-time. Allow parents time for decision-making if necessary. Direct parents to credible resources and patient advocates or parent champions if available for “outside research” purposes. If necessary, develop a patient advocacy program to direct HPV vaccine parents and their adolescents.