Association of Healthcare Professionals' Characteristics and ZIP-Code-Level Income of Their Practice Location with Routine Assessment of HPV Vaccination Status.

Abstract

Background: Although the human papillomavirus (HPV) vaccine has the potential to prevent most HPV-related cancers, its uptake in Texas remains lower than the national uptake and the Healthy People 2030's goal of 80% completion among adolescents. The Centers for Disease Control and Prevention (CDC) advises healthcare professionals (HCPs) to assess immunization status at every clinical encounter and to routinely integrate these standards into their practice. Socioeconomic characteristics of individuals influence HPV vaccination; however, the role of HCPs' individual characteristics and the ZIP-code-level income of their practice location in the routine assessment of HPV vaccination is unknown.

Methods: Using data from a survey of HCPs conducted by MD Anderson in Texas in the year 2021, we examined the association between HCPs' individual characteristics and the ZIP-code-level income of their practice location in HCPs' routine assessment of HPV vaccination.

Results: This study included 1283 HCPs working in Texas. Overall, 37.6% of HCPs reported routinely assessing HPV vaccination status. Compared with HCPs whose practice was based in lower-income communities (median household income below $56,500), those who practiced in higher-income communities had 32% lower odds of routinely assessing HPV vaccination status (aOR: 0.68; 95% CI: 0.48-0.96). Compared to HCPs without prior formal training on HPV vaccination, the odds of HCPs assessing HPV vaccination status routinely were 393% higher (aOR: 4.93; 95% CI: 3.21-7.58) among HCPs who had formally trained less than two years ago, 123% higher (aOR: 2.23; 95% CI: 1.52-3.28) among HCPs formally trained between two and five years ago, and 92% (aOR: 1.92; 95% CI: 1.28-2.87) higher among HCPs formally trained more than five years ago.

Conclusions: Our findings underscore the need for targeted interventions and education to promote routine HPV vaccination communication and status assessment among HCPs in higher-income communities in Texas. These efforts should include approaches to address vaccine hesitancy and introduce reminders and system-level prompts. Future research should investigate the contextual and organizational factors that contribute to these income-related differences to better inform implementation strategies.