Program Director/Principal Investigator (Last, First, Middle): Liebermann, Erica
Project Summary/Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the US; there were 43
million HPV infections in the US in 2018 and most of those infections were in teens and young adults. Though
many infections may resolve on their own, persistent infection with HPV can cause cervical cancer and other
types of cancers. The HPV vaccine is a critical tool for preventing HPV infection but has been underutilized in
the US to date. HPV Vaccine completion remains well below the Healthy People 2030 targets of 80% vaccine
completion for adolescents. The Centers for Disease Control and Prevention (CDC)'s Advisory Committee on
Immunization Practices (ACIP) recommends vaccinating children ages 11-12 with two doses of HPV vaccine
6-12 months apart; the ACIP also recommends catch-up vaccination for unvaccinated adolescents and adults
up to age 26, with three doses of vaccine. The college student population represents an important group for
catch-up vaccination as many students have insurance coverage, have access to student health services, and
are beginning to make their own health decisions. However, recent surveys indicate that only about half of
college students report they have completed HPV vaccination. College health centers are an ideal setting in
which to identify teens and young adults who have not yet completed HPV vaccination. Offering HPV vaccine
to unvaccinated or under-vaccinated students is an important public health intervention to reduce the burden of
HPV infection and its future health consequences. The aim of the proposed mixed methods study is to better
understand college healthcare providers' attitudes, beliefs and practices related to HPV vaccination and
identify their barriers and facilitators to vaccinating college students. There is limited information about college
healthcare provider practices related to HPV vaccine (assessing HPV vaccination history, recommending and
offering vaccine). We propose a sequential explanatory mixed methods study that will examine healthcare
provider attitudes and beliefs and the multi-level influences of healthcare provider practices related to HPV
vaccine. The study utilizes quantitative data regarding college healthcare providers' HPV vaccine-related
attitudes and behaviors/practices from a national study of college healthcare providers from 480 colleges
across the US. Guided by the Consolidated Framework for Implementation Research (CFIR), we will conduct
follow-up interviews with a subsample of college healthcare providers who participated in the national survey to
explore individual provider-level (e.g., knowledge, attitudes, beliefs) and multisystem-level factors (e.g., college
type, state policies, organizational climate, relative priority, change capacity) influencing HPV vaccine uptake in
the college health setting. The long-term goal of this research is to generate new knowledge regarding factors
affecting HPV vaccine uptake in college health settings and to inform future interventions to improve HPV
vaccination rates in the college student population.
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