HPV vaccine knowledge, attitudes, and practices among New York State medical providers, dentists, and pharmacists

Figures & data

Table 1. Questions assessing HPV vaccine knowledge, attitudes, and recommendation practices among healthcare providers in New York State.

Questions assessing HPV vaccine knowledge Answer choices: True, False, I do not know
Vaccinating young adolescents against HPV infection increases risk of unprotected sexual activity
Oropharyngeal cancer is the most common HPV-associated cancer
HPV vaccine should be routinely administered to age-eligible males and females
Provider vaccine recommendation is associated with vaccine acceptance
Questions assessing HPV vaccine attitudes Answer choices: Strongly agree, Agree, Neutral, Disagree, Strongly disagree
I am confident in my ability to communicate with vaccine hesitant patients/families
I have a responsibility to ensure that my patients are fully vaccinated
Other providers recognize my role in vaccinating patients
HPV vaccine is effective in preventing HPV-associated cancers
Promoting HPV vaccine is within my scope of practice
Questions assessing HPV vaccine recommendation practices Answer choices: 11–12 years, 13–14 years, 15–18 years, 18+ years, Not applicable to my practice
Age at which you routinely begin strongly recommending HPV vaccine
Medical providers only: Age at which most of your patients who get immunized accept the first dose of HPV vaccine
You routinely recommend HPV vaccine to (Males, Females, Both, Not applicable to my practice)

Table 2. Demographics of NYS healthcare providers surveyed regarding HPV vaccine knowledge, attitudes, and practices.

	Total respondents	Medical providers	Dentist	Pharmacists
Total respondents	1637	864 (53)	737 (45)	36 (2)
Male	907 (55)	375 (43)	507 (69)	25 (69)
Race
American Indian/Alaskan Native	6 (<1)	4 (<1)	2 (<1)	0
Asian	146 (9)	92 (11)	52 (7)	2 (6)
Black/African American	42 (3)	32 (4)	9 (1)	1 (3)
Native Hawaiian/Pacific Islander	1 (<1)	1 (<1)	0	0
White	1401 (86)	732 (84)	646 (88)	32 (89)
Ethnicity
Hispanic/Latino	55 (3)	29 (3)	25 (3)	1 (3)
Years in practice
< 1	30 (2)	26 (3)	4 (<1)	0
1–10	271 (17)	187 (22)	74 (10)	10 (28)
11–20	265 (16)	158 (11)	96 (13)	11 (31)
21–30	371 (23)	221 (26)	144 (20)	6 (17)
31 +	700 (43)	272 (31)	419 (57)	9 (25)
Communities served
Rural	282 (17)	159 (18)	106 (14)	17 (47)
Suburban	931 (57)	451 (52)	469 (64)	11 (31)
Urban	631 (39)	384 (44)	233 (32)	14 (39)

Table 3. Vaccine knowledge, attitudes, and practices among (A) medical providers (B) dental providers and pharmacists across New York State.

	All medical providers (n = 864) N (%)				Primary care providers (n = 500) N (%)				Specialty care providers (n = 351) N (%)
Vaccine knowledge statements	Correct	Incorrect	Unsure		Correct	Incorrect		Unsure	Correct		Incorrect		Unsure
(A)
Vaccinating young adolescents against HPV infection increase risk of unprotected sexual activity	823 (95)	14 (2)	27 (3)		481 (96)	8 (2)		11 (2)	330 (94)		6 (2)		15 (4)
Oropharyngeal cancer is the most common HPV-associated cancer	273 (32)	432 (50)	158 (18)		154 (31)	265 (53)		81 (16)	113 (32)		161 (46)		77 (22)
HPV vaccine should be routinely administered to age-eligible males and females	815 (94)	24 (3)	24 (3)		482 (96)	9 (2)		9 (2)	321 (91)		15 (4)		15 (4)
Provider vaccine recommendation is associated with vaccine acceptance	796 (89)	30 (3)	26 (3)		471 (94)	14 (3)		14 (3)	313 (89)		16 (5)		22 (6)
Vaccine knowledge score above 75%	769 (89)				457 (91)				300 (85)
Vaccine attitude statements	Strong agreement N (%) [mean LOA^a]				Strong agreement N (%) [mean LOA^a]				Strong agreement N (%) [mean LOA^a]
I am confident in my ability to communicate with vaccine hesitant patients/families	323 (37) [4.11]				204 (41) [4.22]				116 (33) [3.97]
I have a responsibility to ensure that my patients are fully vaccinated	448 (52) [4.16]				340 (68) [4.55]				104 (30) [3.62]
Other providers recognize my role in vaccinating patients	321 (37) [3.71]				270 (55) [4.30]				48 (14) [2.88]
HPV vaccine is effective in preventing HPV-associated cancers	599 (69) [4.65]				381 (76) [4.73]				212 (60) [4.54]
Promoting HPV vaccine is within my scope of practice	487 (56) [4.02]				409 (82) [4.68]				70 (20) [3.08]
Vaccine attitudes score above 75%	616 (71)				457 (91)				152 (43)
Vaccine practices statements	N (%)				N (%)				N (%)
Age at which you routinely begin strongly recommending HPV vaccine	509 responses				418 responses				86 responses
11–12 years	390 (77)				329 (79)				57 (66)
13–14 years	68 (13)				52 (12)				15 (17)
15–18 years	26 (5)				17 (<1)				9 (10)
18 + years	25 (5)				20 (5)				5 (6)
Age at which most of your patients who get immunized accept the first dose of HPV vaccine	455 responses				396 responses				57 responses
11–12 years	233 (51)				207 (52)				26 (46)
13–14 years	137 (30)				122 (31)				13 (23)
15–18 years	52 (11)				39 (10)				13 (23)
18 + years	33 (7)				28 (7)				5 (9)
Provider routinely recommends HPV vaccine	612 responses				471 responses				349 responses
Males	3 (<1)				1 (<1)				2 (<1)
Females	25 (4)				16 (3)				9 (3)
Both	584 (95)				427 (91)				152 (44)
Vaccine knowledge statements	Dental providers (n = 737) N (%)								Pharmacists (n = 36) N (%)
Dental providers and Pharmacists	Correct			Incorrect			Unsure		Correct	Incorrect		Unsure
(B)
Vaccinating young adolescents against HPV infection increase risk of unprotected sexual activity	600 (81)			26 (4)			110 (15)		27 (75)	3 (8)		6 (17)
Oropharyngeal cancer is the most common HPV-associated cancer	461 (63)			101 (14)			174 (24)		8 (22)	8 (22)		20 (56)
HPV vaccine should be routinely administered to age-eligible males and females	592 (80)			39 (5)			104 (14)		28 (78)	1 (3)		7 (19)
Provider vaccine recommendation is associated with vaccine acceptance	529 (72)			54 (7)			148 (20)		33 (92)	1 (3)		2 (6)
Vaccine knowledge score above 75%				536 (73)			24 (67)
Vaccine attitude statements	Strong agreement N (%) [mean LOA^a]								Strong agreement N (%) [mean LOA^a]
I am confident in my ability to communicate with vaccine hesitant patients/families	206 (28) [3.84]								32 (89) [4.14]
I have a responsibility to ensure that my patients are fully vaccinated	126 (17) [3.33]								24 (67) [3.89]
Other providers recognize my role in vaccinating patients	57 (8) [2.73]								29 (81) [4.11]
HPV vaccine is effective in preventing HPV-associated cancers	344 (47) [4.33]								32 (89) [4.36]
Promoting HPV vaccine is within my scope of practice	153 (21) [3.22]								17 (47) [3.61]
Vaccine attitudes score above 75%	275 (37)								24 (67)
Vaccine practices statements	N (%)								N (%)
Age at which you routinely begin strongly recommending HPV vaccine	209 responses								2 responses
11–12 years	73 (35)								2 (100)
13–14 years	47 (22)								0
15–18 years	42 (20)								0
18 + years	47 (22)								0

^aLOA: level of agreement.

Table 4. Association of HPV vaccine knowledge and attitudes with the routine recommendation of HPV vaccine at ages 11–12 years among all medical providers.

Vaccine attitude statements	Routinely recommends HPV vaccine at 11–12 years Mean level of agreement (SD)	Does not routinely recommend HPV vaccine at 11–12  years Mean level of agreement (SD)	P^a
It is my responsibility to ensure that patients are fully vaccinated	4.59 (.812)	4.26 (.916)	< .001
Promoting HPV vaccine is within scope of practice	4.79 (.573)	4.41 (.906)	< .001
Other providers recognize my role in vaccinating	4.34 (.974)	3.74 (1.069)	< .001
HPV vaccine is effective in cancer prevention	4.82 (.433)	4.52 (.581)	< .001
Vaccine knowledge statements	Routinely recommends HPV vaccine at 11–12 years Correctly answered (%)	Does not routinely recommend HPV vaccine at 11–12 years Correctly answered (%)	P^b
HPV vaccination increases the risk of unprotected sexual activity	386/390 (99)	108/119 (92)	< .001
Provider vaccine recommendation is associated with vaccine acceptance	376/390 (96)	106/118 (90)	< .01
HPV vaccine is routinely recommended for females and males	385/390 (99)	114/119 (96)	< .05

^atwo-sided t-tests were used to compare the mean level agreement with each of the vaccine attitude statements.

^bChi-square testing was used to compare the number of providers who correctly answered each of the vaccine knowledge statements.

Table 5. Correlations between HPV vaccine knowledge, attitudes, and recommendation practices among (A) medical providers, (B) dental providers, and (C) pharmacy providers.

	HPV vaccine is effective in cancer prevention	Other providers recognize my role in vaccinations	It is my responsibility to ensure patients are fully vaccinated	Promoting HPV vaccine is within my scope of practice	I am confident in my ability to communicate with vaccine hesitant patients	Routinely recommends HPV vaccine at ages 11–12 years
	Pearson correlation (n)	Pearson correlation (n)	Pearson correlation (n)	Pearson correlation (n)	Pearson correlation (n)	Pearson correlation (n)
(A)
HPV vaccine knowledge scores	.331*** (863)	.160*** (862)	.174*** (862)	.230*** (862)	.111** (862)	.163*** (508)
Routinely recommends HPV vaccine at ages 11–12 years	.265*** (508)	.247*** (509)	.163*** (509)	.237*** (509)	.045 (509)
I am confident in my ability to communicate with vaccine hesitant patients	.098* (862)	.301*** (864)	.366*** (864)	.182*** (862)
Promoting HPV vaccine is within my scope of practice	.324*** (862)	.591*** (862)	.484*** (862)
It is my responsibility to ensure patients are fully vaccinated	.292*** (862)	.662*** (864)
Other providers recognize my role in vaccinations	.242*** (862)
(B)
HPV vaccine knowledge scores	.433*** (730)	.065 (730)	.255*** (731)	.328*** (729)	.093* (731)	.139* (208)
Routinely recommends HPV vaccine at ages 11–12 years	.131 (208)	.079 (209)	.128 (209)	.126 (209)	.01 (209)
I am confident in my ability to communicate with vaccine hesitant patients	.055 (734)	.370*** (733)	.455*** (734)	.149*** (733)
Promoting HPV vaccine is within my scope of practice	.321*** (733)	.186*** (732)	.272*** (732)
It is my responsibility to ensure patients are fully vaccinated	.191*** (733)	.518*** (733)
Other providers recognize my role in vaccinations	.074* (732)
(C)
HPV vaccine knowledge scores	.492** (36)	.093 (36)	.298 (36)	.237 (36)	−.02 (36)	.437 (9)
Routinely recommends HPV vaccine at ages 11–12 years	0 (1)	.449 (9)	.09 (9)	.500 (9)	0 (9)
I am confident in my ability to communicate with vaccine hesitant patients	.003 (36)	.467** (36)	.490** (36)	−.137 (36)
Promoting HPV vaccine is within my scope of practice	.346* (36)	.119 (36)	.203 (36)
It is my responsibility to ensure patients are fully vaccinated	.295 (36)	.556*** (36)
Other providers recognize my role in vaccinations	.194 (36)

*represents p < .05, **represents p < .001, ***represents p < .0001.