Health care provider attitudes and practices regarding adolescent immunizations: a qualitative study
Sharon G. Humiston1, Christina Albertin1, Stanley Schaffer1, Cynthia Rand1, Laura Shone1, Peter G. Szilagyi2, and Shannon Stokley3. (1) Emergency Medicine, Univ. of Rochester, Strong Memorial Hospital, 601 Elmwood Ave, Rochester, NY, USA, (2) Department of Pediatrics, University of Rochester, 601 Elmwood Ave, Box 777, Rochester, NY, USA, (3) National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention
Learning Objectives for this Presentation: By the end of the presentation participants will be able to 1- Name 3 overarching themes noted by study participants to be critical for adolescent immunizations, 2-For each of the following, name 2 factors noted by study participants to be critical for adolescent immunizations: professional buy-in, parent/adolescent buy-in, delivery factors
Background: Recent studies explored factors that influenced provider perceptions, focusing on HPV vaccine rather than assessing provider perceptions about adolescent vaccinations in the context of comprehensive adolescent healthcare.
Objectives: This qualitative study assessed the attitudes and practices of primary care providers regarding adolescent immunizations.
Methods: We performed 3 focus groups with 21 primary care practitioners from Monroe County, NY followed by key informant interviews (KIIs) with 24 primary care practitioners throughout the U.S. The studies were performed in 2005, soon after the recommendation for adolescent vaccination with Menactra (MCV4), and with the expectation of an upcoming recommendation for Tdap. The audiotaped focus group discussions were transcribed verbatim and analyzed with the use of Atlas.ti. The resulting themes were reviewed and revised by the team of investigators. Results for each KII question were listed and reviewed by the authors; resulting themes were added to those from the focus groups.
Results: 3 overarching themes were noted to be critical for adolescent immunizations: professional buy-in (e.g., reimbursement, professional organization recommendations, disease and vaccine characteristics, office consensus); parent/adolescent buy-in (e.g., school requirements, perception of MD recommendations, cost and insurance coverage, media reports, disease and vaccine characteristics, “vaccine fatigue”), and delivery factors (e.g., vaccine supply, ordering, timing and scheduling, consent, tracking and reaching teens for vaccinations).
Conclusions: The success of the new adolescent vaccination effort depends upon buy-in from multiple parties and the quality of intertwined systems.