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Provider factors associated with disparities in human papillomavirus vaccination among low-income 9- to 17-year-old girls†
Article first published online: 1 AUG 2012
Copyright © 2012 American Cancer Society
Volume 119, Issue 3, pages 621–628, 1 February 2013
How to Cite
Vadaparampil, S. T., Staras, S. A. S., Malo, T. L., Eddleton, K. Z., Christie, J., Rodriguez, M., Giuliano, A. R. and Shenkman, E. A. (2013), Provider factors associated with disparities in human papillomavirus vaccination among low-income 9- to 17-year-old girls. Cancer, 119: 621–628. doi: 10.1002/cncr.27735
The authors would like to thank Deepa Ranka, MS, and the Medicaid programming team at the Institute for Child Health Policy for sample selection and data management. The work contained within this publication was supported in part by the Survey Methods Core Facility at the Moffitt Cancer Center.
- Issue published online: 22 JAN 2013
- Article first published online: 1 AUG 2012
- Manuscript Accepted: 4 JUN 2012
- Manuscript Revised: 24 APR 2012
- Manuscript Received: 8 MAR 2012
- human papillomavirus;
- HPV vaccine;
- cancer vaccine;
- cervix cancer;
- low-income population;
Many women who develop cervical cancer are eligible for or are participants of Medicaid. Providing human papillomavirus (HPV) vaccination to girls enrolled in Medicaid may reduce cervical cancer disparities in low-income and minority women. This study evaluated provider characteristics associated with HPV vaccination among 9- to 17-year-old female Medicaid enrollees.
A random sample of 800 providers from the Florida Medicaid Master Provider File was mailed a survey in October 2009 that evaluated demographic and practice characteristics, HPV information and knowledge, barriers to HPV vaccination, vaccine practices, and vaccine recommendation practices. To measure HPV vaccination, Medicaid claims data were used to calculate the proportion of eligible patients who received at least 1 dose of the vaccine from participating providers within the study period. Provider factors associated with vaccination at the bivariate level were evaluated in a multiple linear regression model.
The response rate was 68.3% (N = 485). After excluding ineligible respondents, the current analysis included 433 providers. HPV vaccination prevalence ranged from 0% to 61.9% (M = 20.4, standard deviation = 14.5). HPV vaccination rates were higher among providers who were pediatricians, had a private practice, practiced in a single specialty setting, were providers under the Vaccines for Children program, saw primarily non-Hispanic white patients, used 2 or more strategies for vaccine series completion, and did not refer out for HPV vaccination.
Despite financial coverage for Medicaid-eligible girls, HPV vaccination rates are low. Study findings can be used to target health services interventions to providers least likely to administer HPV vaccine to female Medicaid enrollees. Cancer 2013. © 2012 American Cancer Society.