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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

UNITED STATES: Appalachian and Non-Appalachian Pediatricians' Encouragement of the Human Papillomavirus Vaccine: Implications for Health Disparities


Womens Health Issues Vol. 22; No. 1: P. e19-e26 (01.02.12) -

Cervical cancer incidence and mortality are higher in medically underserved regions such as Appalachia than in the general US population, the authors noted; "therefore, it is important for pediatricians to encourage parents to have their daughters vaccinated against [HPV]." Little is known, however, about the predictors of pediatricians' encouragement of HPV vaccine uptake among populations that are medically underserved. Toward the goal of identifying potential strategies to reduce health disparities, the researchers compared attitudes and behaviors of pediatricians practicing in Appalachia with those practicing in non-Appalachia.

A total of 334 pediatricians in Appalachia and non-Appalachia counties were surveyed to examine how prior behavior, perceived susceptibility, severity, self-efficacy, response- efficacy, and behavioral intentions are related to self- reported vaccine encouragement.

The results indicated that compared to pediatricians in non- Appalachia, those in Appalachia "perceived their patients to be less susceptible to HPV and reported lower rates of HPV encouragement." Self-efficacy had a significant indirect association with vaccine encouragement for pediatricians in non-Appalachia.

"This study's findings emphasize the importance of increasing Appalachian pediatricians' awareness of their patients' susceptibility to HPV," the authors concluded. "Broader efforts to increase encouragement of the HPV vaccine among pediatricians should focus on promoting self-efficacy to encourage the HPV vaccine to parents of young females."


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