Missed Opportunities for Adolescent HPV Vaccination in the United States: Parents' Perceptions of a Range of Healthcare Providers and Settings.

Non-traditional providers and healthcare settings (e.g., dental offices, pharmacies) provide an opportunity to increase human papillomavirus (HPV) vaccine accessibility; however, they remain underutilized. The purpose of this study was to examine United States (U.S.) parents' perceptions of healthcare provider recommendations for the HPV vaccine and perceived convenience and likelihood of vaccination across healthcare settings. Parents' perceptions were assessed and compared according to the Transtheoretical Model stages of change (action: adolescent already vaccinated; preparation: intend-to-vaccinate; contemplation: unsure of intention). Parents of adolescents ages 11-12 from across the U.S. were recruited to participate in an online survey via Qualtrics that measured their perceptions of HPV vaccination by healthcare provider type and setting. The convenience and likelihood of vaccinating in different settings and the importance of provider recommendation were evaluated for those in the preparation and contemplations groups using one-way repeated measures ANOVAs. Participants across all stages of change were similar in their perceptions of vaccination across healthcare settings, rating family practice and pediatric offices as the most convenient and most likely settings for vaccination. Dental offices were perceived as the least convenient and least likely settings, and dental provider recommendations were rated as the least important. Among those in the contemplation stage, pharmacies were also rated lower in convenience and likelihood. There is a missed opportunity for HPV vaccination in non-traditional settings, including dental offices and pharmacies. Increasing education on HPV and availability of the vaccine in alternative settings can encourage vaccine uptake and move parents towards preparation and action.