A Mixed-Methods Examination of Factors Related to HPV Vaccination Promotion in Private Dental Settings, Iowa, 2019

Abstract

IntroductionHuman papillomavirus (HPV)-associated oropharyngeal cancerrates are rising, particularly in males, although rates of other HPVrelatedcancers are decreasing. Although the HPV vaccine is safeand effective, vaccination rates remain below the Healthy People2030 goal of 80% coverage. Engaging dental providers, who haveexperience with patient education and oropharyngeal cancer, mayprove useful in efforts to increase vaccination rates. Our researchexplores dental providers’ (dentists, dental hygienists) willingness to participate in continuing education about HPV, educate parentsof adolescents, recommend the vaccine for adolescents, and referparents to medical providers.MethodsWe used a mixed-methods approach and conducted a survey withdental hygienists and semistructured interviews with dental providers.We produced frequencies and descriptive statistics for allvariables and used regression modeling to explore factors relatedto willingness to promote the HPV vaccine. We used a deductiveapproach to code interview transcripts.ResultsRegression models using survey data (n = 470) showed that aftercontrolling for demographic and practice-level characteristics,higher levels of willingness were associated with thinking that parentswould act on a recommendation and thinking that engaging inHPV promotion is within the scope of practice. Interview data reflectedwillingness of dental providers to work on HPV vaccination,but revealed barriers (eg, time, knowledge) that need to beaddressed.DiscussionOverall, dental providers expressed a willingness to participate inHPV vaccine promotion, and future efforts should focus on addressingbarriers to doing so. Engaging dental providers in HPVvaccine recommendation and referral can help prevent futureHPV-related cancers