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
"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."