Rapid Qualitative Analysis of Dental Practitioner HPV Vaccine Promotion Barriers

Objectives: Human papillomavirus (HPV) exposure is common and is the leading cause of oropharyngeal cancer. The HPV vaccine can prevent infection if administered prior to initial exposure. Less than half of US adolescents are compliant with vaccination guidelines. Preventive dental visits may be an ideal time for promotion of these safe and effective vaccines. Unfortunately, few dental practitioners currently promote the HPV vaccine in their practice. We sought to gain a deeper understanding of the barriers of HPV vaccine promotion among dental practitioners in a large midwestern healthcare organization to guide the design of a targeted intervention to support dental practitioners in promoting the HPV vaccine.
Methods: Semi-structured interviews were conducted over Microsoft Teams with dental practitioners guided by prompts about their HPV and vaccine knowledge, self-efficacy to promote the vaccine effectively, and fear of any negative consequences. Recordings were transcribed and subjected to Rapid Qualitative Analysis.
Results: Eight dentists and three hygienists [Male (1), Female (10); Asian (2), Black/African American (1), White (5), South-Asian Indian (1), multi-racial (2)] at 6 clinics completed 30-minute interviews. Practitioners reported needing more education on HPV and the HPV vaccine, lacking confidence to recommend the vaccine, especially to hesitant patients, and perceived a potential negative impact on patient rapport. Most respondents had mixed feelings about vaccine promotion and described inter-related barriers across categories, which led to internal conflict between the importance and potential repercussions. For example, some practitioners were not willing to risk conflict with a patient by making the recommendation or would choose to forgo it due to lack of time and other competing visit priorities.
Conclusions: Interventions to support vaccine promotion in the dental office and oropharyngeal cancer prevention should carefully consider addressing practitioner gaps in HPV and vaccine knowledge, self-efficacy regarding promoting the vaccine (especially to hesitant persons), and fear of damaging patient rapport.