Implementation of a Postpartum HPV Vaccination Program in a Southeast Texas Hospital: A Qualitative Study Evaluating Health Care Provider Acceptance
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Introduction The objective of this qualitative study was to assess healthcare providers’ acceptability of an ongoing postpartum human papillomavirus (HPV) vaccination program in Southeast Texas and its integration into everyday clinical care. Methods In 2012, the Department of Obstetrics & Gynecology at the University of Texas Medical Branch (UTMB) began offering HPV vaccination as part of standard postpartum care to increase vaccination rates among young women in Galveston County. Initial vaccine doses were offered on the postpartum unit while subsequent doses were coordinated with postpartum and well-baby visits. Thirty months after project initiation, semi-structured interviews of physicians (n = 12) and nurses (n = 6) involved in postpartum and pediatric care at UTMB were conducted. Interview transcripts were analyzed using thematic analysis in Nvivo10. Results Overall, providers demonstrated “pro-vaccine” attitudes and stated the program was an effective strategy for vaccinating hard-to-reach women. Cancer prevention was the main perceived benefit while follow-up compliance was the primary perceived patient barrier. The initial challenges with integrating postpartum HPV vaccination included miscommunication between providers regarding vaccine orders and coordination issues with well-baby visits for follow-up doses. One novel finding was providers’ beliefs that women’s personal HPV vaccine practices may positively impact their decisions about later vaccinating their children against HPV. Providers’ suggestions to improve the program included: enhancing postpartum HPV vaccine education for patients, offering more continuing education for providers, and increasing community awareness of HPV vaccination. Discussion These findings can help providers of postpartum care understand how to integrate postpartum HPV vaccination into their current practices and how to overcome perceived vaccination barriers.
KeywordsHPV vaccination, postpartum care Qualitative Women’s health
The authors would like to thank our program coordinators and staff for their work on the project as well as our colleagues at UTMB for their participation. Dr. Tyra Gross is currently an Assistant Professor in the Department of Public Health Sciences at Xavier University of Louisiana.
The Postpartum HPV Vaccination Program and this study were funded by the Cancer Prevention & Research Institute of Texas (Award ID: PP120150, PD: Dr. Abbey Berenson). Federal support for manuscript preparation was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) to Tyra Gross as a National Research Service Award postdoctoral fellow under an institutional training Grant (T32HD055163; PI/PD: Abbey Berenson). Dr. Jacqueline Hirth was supported by a research career development award (K12HD052023: Building Interdisciplinary Research Careers in Women’s Health Program-BIRCWH, PI/PD: Abbey Berenson) from NICHD and the Office of the Director (OD) at the National Institutes of Health (NIH). The study was also supported by a Clinical and Translational Science Award (UL1 TR001439) from the National Center for Advancing Translational Sciences (NCATS), NIH, through the Institute for Translational Sciences at UTMB. The content is solely the responsibility of the authors and does not necessarily represent the official views of CPRIT, NICHD, OD, NCATS, or the NIH.
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