Pediatric oncology providers’ knowledge, attitude, self-efficacy and practice towards the HPV vaccine after communication training: A comparison to a national survey
Introduction
Human papillomavirus (HPV) vaccinations have been proven effective in preventing HPV infection and HPV-related malignancies. However, despite having an increased risk of developing secondary cancers linked to HPV, childhood cancer survivors (CCS) are not receiving adequate vaccination. Research suggests that promoting HPV vaccination in the oncology setting and receiving a recommendation from their oncology care team can significantly increase vaccination rates in this demographic, particularly among minorities. We developed a multi-level HPV Vaccine educational intervention to address this disparity.
Methods
We assessed providers’ vaccination practices and knowledge about CCS being at a higher risk for HPV-related malignancies, as well as their attitude towards the HPV vaccine and self-efficacy in recommending the vaccine to CCS after participating in our intervention on the recommendation of HPV vaccination to eligible CCS in pediatric oncology clinics. Between February and March 2023, 88 providers from five pediatric oncology clinics in Texas were invited to complete surveys online. Thirty-nine (39) responses were received (44% participation rate). The survey was hosted online through Research Electronic Data Capture (REDCap). Data from a national sample of providers who completed a Survey of Vaccination Practices among Pediatric Oncology Providers in 2019 (n=195) was used for comparison.
Results
In comparison to the national provider sample, the majority of clinicians who participated in our program showed knowledge of CCS being at a higher risk for secondary malignancies associated with HPV (95.8% vs. 38.1%, respectively; p= 0.000). Furthermore, they reported to feel that they knew enough about the HPV vaccine (87.5% vs. 52.7%, p=0.001) and demonstrated higher self-efficacy in discussing and recommending the HPV vaccine in a way that leads to vaccination (100% vs. 65.6%, p=0.000) as well as in addressing parental concerns (100% vs. 69.3%, p= 0.000). Additionally, they appeared to have a more positive attitude toward oncology providers, rather than general pediatricians, recommending (95.8% vs.71%, respectively; p=0.006) and administering the HPV vaccine to CCS (95.8% vs. 53%, p=0.000), and were significantly more likely to discuss and recommend the HPV vaccine vs. flu and meningococcal vaccines (62.5% vs. 34.9%, respectively; p= 0.013).
Conclusion
Addressing the disparity in HPV vaccination uptake among CCS is critical to ensuring that patients receive the necessary protection against HPV-related malignancies. Effective strategies to accomplish this goal include educating oncology providers on the greater risk of CCS, improving their self-efficacy to recommend the HPV vaccine, and promoting vaccination in the oncology setting.