@article{0fcbe2bbac1b4ff7875fd5c37e6622e6,
title = "Implementation of a Postpartum HPV Vaccination Program in a Southeast Texas Hospital: A Qualitative Study Evaluating Health Care Provider Acceptance",
abstract = "Introduction The objective of this qualitative study was to assess healthcare providers{\textquoteright} acceptability of an ongoing postpartum human papillomavirus (HPV) vaccination program in Southeast Texas and its integration into everyday clinical care. Methods In 2012, the Department of Obstetrics & Gynecology at the University of Texas Medical Branch (UTMB) began offering HPV vaccination as part of standard postpartum care to increase vaccination rates among young women in Galveston County. Initial vaccine doses were offered on the postpartum unit while subsequent doses were coordinated with postpartum and well-baby visits. Thirty months after project initiation, semi-structured interviews of physicians (n = 12) and nurses (n = 6) involved in postpartum and pediatric care at UTMB were conducted. Interview transcripts were analyzed using thematic analysis in Nvivo10. Results Overall, providers demonstrated “pro-vaccine” attitudes and stated the program was an effective strategy for vaccinating hard-to-reach women. Cancer prevention was the main perceived benefit while follow-up compliance was the primary perceived patient barrier. The initial challenges with integrating postpartum HPV vaccination included miscommunication between providers regarding vaccine orders and coordination issues with well-baby visits for follow-up doses. One novel finding was providers{\textquoteright} beliefs that women{\textquoteright}s personal HPV vaccine practices may positively impact their decisions about later vaccinating their children against HPV. Providers{\textquoteright} suggestions to improve the program included: enhancing postpartum HPV vaccine education for patients, offering more continuing education for providers, and increasing community awareness of HPV vaccination. Discussion These findings can help providers of postpartum care understand how to integrate postpartum HPV vaccination into their current practices and how to overcome perceived vaccination barriers.",
keywords = "HPV vaccination, postpartum care, Qualitative, Women{\textquoteright}s health",
author = "Gross, {Tyra T.} and Mahbubur Rahman and {M. Wright}, Abigail and {M. Hirth}, Jacqueline and Sarpong, {Kwabena O.} and Rupp, {Richard E.} and {D. Barrett}, Alan and Berenson, {Abbey B.}",
note = "Funding Information: The University of Texas Medical Branch at Galveston (UTMB) serves a large population of women of diverse racial backgrounds, of which most have a family income of $30,000 or less. A large percentage of our patient population receives financial assistance through Medicaid or other public insurance programs for their prenatal, childbirth, and postpartum care. To increase HPV vaccine initiation and completion rates among low-income women from Galveston County, TX, the Department of Obstetrics & Gynecology (OB/GYN) at UTMB began offering HPV vaccination as part of standard postpartum care in 2012 with the support of a grant from the Cancer Prevention & Research Institute of Texas (CPRIT). In this program, women were counseled and offered the HPV vaccine while on the postpartum unit and follow-up doses were coordinated with the mother{\textquoteright}s checkups or her infant{\textquoteright}s checkups []. The purpose of this qualitative study was to assess provider acceptability and how well the vaccination strategy was embedded into everyday clinical work. Semi-structured interviews were conducted among 18 UTMB providers involved in the care of postpartum women or their infants. Funding Information: The Postpartum HPV Vaccination Program and this study were funded by the Cancer Prevention & Research Institute of Texas (Award ID: PP120150, PD: Dr. Abbey Berenson). Federal support for manuscript preparation was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) to Tyra Gross as a National Research Service Award postdoctoral fellow under an institutional training Grant (T32HD055163; PI/PD: Abbey Berenson). Dr. Jacqueline Hirth was supported by a research career development award (K12HD052023: Building Interdisciplinary Research Careers in Women{\textquoteright}s Health Program-BIRCWH, PI/PD: Abbey Berenson) from NICHD and the Office of the Director (OD) at the National Institutes of Health (NIH). The study was also supported by a Clinical and Translational Science Award (UL1 TR001439) from the National Center for Advancing Translational Sciences (NCATS), NIH, through the Institute for Translational Sciences at UTMB. The content is solely the responsibility of the authors and does not necessarily represent the official views of CPRIT, NICHD, OD, NCATS, or the NIH. Publisher Copyright: {\textcopyright} 2016, Springer Science+Business Media New York.",
year = "2016",
month = nov,
day = "1",
doi = "10.1007/s10995-016-2030-0",
language = "English (US)",
volume = "20",
pages = "154--163",
journal = "Maternal and Child Health Journal",
issn = "1092-7875",
publisher = "Springer GmbH & Co, Auslieferungs-Gesellschaf",
}