Evidence map›Paper›PMID 29157686›Full record

ArticleSocial science & medicine (1982)2018

Unequal interactions: Examining the role of patient-centered care in reducing inequitable diffusion of a medical innovation, the human papillomavirus (HPV) vaccine.

Anny T Fenton, Marc N Elliott, David C Schwebel, Zahava Berkowitz, Nicole C Liddon, Susan R Tortolero, Paula M Cuccaro, Suzy L Davies, Mark A Schuster

Abstract readMulticenter Study
In one paragraph

Article in Social science & medicine (1982), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 24 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 1 country.

Anny T FentonDepartment of Sociology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA. Electronic address: afenton@fas.harvard.edu.
Marc N Elliott1776 Main Street, RAND Corporation, Santa Monica, CA 90401, USA. Electronic address: elliott@rand.org.
David C SchwebelDepartment of Psychology, University of Alabama at Birmingham, Campbell Hall 415, 1530 3rd Avenue South, Birmingham, AL 35294, USA. Electronic address: schwebel@uab.edu.
Zahava BerkowitzDivision of Cancer Prevention and Control, Epidemiology and Applied Research Branch, CDC, 1600 Clifton Road Atlanta, GA 30329, USA. Electronic address: zab3@cdc.gov.
Nicole C LiddonDivision of Adolescent and School Health, CDC, 1600 Clifton Road Atlanta, GA 30329, USA. Electronic address: nel6@cdc.gov.
Susan R TortoleroDepartment of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA. Electronic address: Susan.Tortolero@uth.tmc.edu.
Paula M CuccaroDepartment of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA. Electronic address: Paula.M.Cuccaro@uth.tmc.edu.
Suzy L DaviesDepartment of Health Behavior, UAB Center for the Study of Community Health, 1665 University Boulevard, Birmingham, AL 35294, USA. Electronic address: sdavies@ms.soph.uab.edu.
Mark A SchusterDivision of General Pediatrics, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Enders, 300 Longwood Avenue, Boston, MA 02115, USA; Kaiser Permanente School of Medicine, 100 South Los Robles Avenue, Pasadena, CA 91106, USA. Electronic address: mark.schuster@childrens.harvard.edu.
CDC Foundation · USUniversity of Alabama at Birmingham · USBoston Children's Hospital · USHarvard University · USRAND Corporation · USThe University of Texas Health Science Center at Houston · USThe University of Texas Health Science Center at Tyler · US

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

rationaleStudies of inequities in diffusion of medical innovations rarely consider the role of patient-centered care.

objectiveWe used uptake of the human papillomavirus (HPV) vaccine shortly after its licensing to explore the role of patient-centered care.

methodsUsing a longitudinal multi-site survey of US parents and adolescents, we assessed whether patient-centered care ratings might shape racial/ethnic and socioeconomic gaps at two decision points in the HPV vaccination process: (1) Whether a medical provider recommends the vaccine and (2) whether a parent decides to vaccinate.

resultsWe did not find evidence that the association of patient-centeredness with vaccination varies by parent education. In contrast, parent ratings of providers' patient-centeredness were significantly associated with racial/ethnic disparities in parents' reports of receiving a HPV vaccine recommendation from a provider: Among parents who rate patient-centered care as low, white parents' odds of receiving such a recommendation are 2.6 times higher than black parents' odds, but the racial/ethnic gap nearly disappears when parents report high patient-centeredness. Moderated mediation analyses suggest that patient-centeredness is a major contributor underlying vaccination uptake disparities: Among parents who report low patient-centeredness, white parents' odds of vaccinating their child are 8.1 times higher than black parents' odds, while both groups are equally likely to vaccinate when patient-centeredness is high.

conclusionThe results indicate that patient-centered care, which has been a relatively understudied factor in the unequal diffusion of medical innovations, deserves more attention. Efforts to raise HPV vaccination rates should explore why certain patient groups may be less likely to receive recommendations and should support providers to consistently inform all patient groups about vaccination.

Indexed as

Diffusion of InnovationPatient-Centered CarePhysician-Patient RelationsAdolescentAdultBlack or African AmericanChildFemaleHealthcare DisparitiesHealth Care SurveysHumansLongitudinal StudiesMaleMiddle AgedPapillomavirus InfectionsPapillomavirus VaccinesPapillomavirus VaccinesDiffusionHealthcare disparitiesHuman papillomavirus (HPV)Medical innovationsPatient-centered careRace/ethnicityUSVaccine

Identifiers

PMID29157686
PMCPMC6413315
OpenAlexW2762028221

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.