Implementation barriers and considerations for recommending and administering the human papillomavirus (HPV) vaccination in oncology settings

Austin R Waters; Charlene Weir; Heidi S Kramer; Karely M van Thiel Berghuijs; Yelena Wu; Deanna Kepka; Anne C Kirchhoff

doi:10.1007/s11764-023-01391-4

Implementation barriers and considerations for recommending and administering the human papillomavirus (HPV) vaccination in oncology settings

J Cancer Surviv. 2023 May 6:10.1007/s11764-023-01391-4. doi: 10.1007/s11764-023-01391-4. Online ahead of print.

Authors

Austin R Waters^{1

2}, Charlene Weir³, Heidi S Kramer³, Karely M van Thiel Berghuijs⁴, Yelena Wu^{4

5}, Deanna Kepka^{4

6}, Anne C Kirchhoff^{4

7}

Affiliations

¹ Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Dr, Salt Lake City, UT, 84112, USA. Austin.Waters@hci.utah.edu.
² Department of Health Policy & Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Austin.Waters@hci.utah.edu.
³ Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA.
⁴ Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Dr, Salt Lake City, UT, 84112, USA.
⁵ Department of Dermatology, University of Utah, Salt Lake City, UT, USA.
⁶ University of Utah College of Nursing, Salt Lake City, UT, USA.
⁷ University of Utah Department of Pediatrics, Salt Lake City, UT, USA.

PMID: 37147553
PMCID: PMC10629381 (available on 2024-11-06)
DOI: 10.1007/s11764-023-01391-4

Abstract

Background: Survivors of childhood and adolescent cancer experience low human papillomavirus (HPV) vaccination rates-a crucial form of cancer prevention. Oncology provider recommendations may increase young survivors HPV vaccine intent, but HPV vaccination is not typically provided in the oncology setting. Thus, we explored the implementation barriers of providing the HPV vaccine in oncology.

Methods: We interviewed oncology providers in a variety of specialty areas about their perceptions of the HPV vaccine and to explore barriers to recommending and administering the vaccine in their clinics. Interviews were audio recorded, quality checked, and thematically analyzed. Emergent themes were then mapped onto the Capability, Opportunity, Motivation, and Behavior (COM-B) Model and the Theoretical Domains Framework.

Results: A total of N=24 oncology providers were interviewed. Most provided direct clinical care (87.5%) and most commonly specialized in pediatric oncology (20.8%), medical oncology (16.7%), bone marrow transplant (16.7%), and nurse coordination (16.7%). Two themes emerged within each COM-B domain. Capability: 1) educational barriers to HPV vaccination and 2) complicated post treatment HPV vaccination guidelines.

Motivation: 1) perceived importance of HPV vaccine and 2) concern about blurred scope of practice.

Opportunity: 1) hospital administration and time concern barriers and 2) clinical workflow integration concerns.

Conclusion: Implementing HPV vaccination in the oncology setting has the potential to increase HPV vaccination rates among young survivors. Multi-level barriers to providing the HPV vaccine in the oncology setting were identified by participants. Leveraging existing implementation strategies may be an effective way to mitigate provider identified barriers and increase vaccination rates.

Keywords: AYA cancer survivors; HPV vaccine; Implementation science; Pediatric cancer survivors.

Abstract

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