Article Figures & Data
Tables
Characteristics No. (%) Gender Female 32 (86) Male 5 (14) Specialty Family practice 13 (35) Obstetrics-gynecology 12 (32) Pediatrics 5 (14) Other 7 (19) New Mexico Department of Health Public health districts District 1 (Albuquerque) 14 (38) District 2 (Santa Fe) 11 (30) District 3 (Las Cruces) 6 (16) District 4 (Roswell) 6 (16)
Additional Files
Supplemental Appendix
Supplemental Appendix. Clinician Interview Guide: Assessing HPV Vaccine Acceptability Among Adolescent Health Clinicians in New Mexico
Files in this Data Supplement:
- Supplemental data: Appendix - PDF file, 3 pages, 102 KB
The Article in Brief
HPV and Cervical Cancer Prevention Counseling with Younger Adolescents: Implications for Primary Care
Andrew L. Sussman, PhD, MCRP, and colleagues
Background Human papillomavirus (HPV), which is linked to cervical cancer, is the most common sexually transmitted infection in the United States. The first HPV vaccine, for females 9 to 26 years old, was approved in 2006. Primary care clinicians play an important role in counseling patients about preventing sexually transmitted diseases; this study looks at factors that influence their counseling of adolescent patients about HPV and cervical cancer prevention.
What This Study Found Primary care clinicians believe they should counsel adolescents about sexual risk taking, because these patients may take part in risky behaviors. Clinicians tailor their approaches to counseling, based on cues from patients and parents. In this study, clinicians did not usually discuss HPV in counseling for sexually transmitted diseases because of the complexities of the topic and because of other important tasks to be accomplished in the patient visit. They did counsel for HPV when the patient had abnormal Pap results or genital warts, but in these cases the adolescent is not a candidate for HPV vaccination. The study also found that parents accompany younger adolescents to most of their primary care visits. This is a consideration, because the HPV vaccine is most beneficial if administered before an individual is sexually active and because clinicians prefer to talk to the patient privately, without a parent present.
Implications
- This study provides a step toward better understanding factors that influence primary care clinicians in their decisions about counseling adolescent patients on HPV and cervical cancer prevention.
- Primary care clinicians need strategies that address the complexities of HPV counseling, the limitations of the HPV vaccine, the need to counsel for HPV and cervical cancer prevention at younger age
- Primary care clinicians may need to shift their counseling methods to address sexual activity and the HPV vaccine with preadolescents with their parents present.
Annals Journal Club Selection:
Jul/Aug 2007
The Annals Journal Club is designed to encourage a learning community of those seeking to improve health care and health through enhanced primary care. Additional information is available on the Journal Club home page.
The Annals of Family Medicine encourages readers to develop the learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club, and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for: Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care, and then acting on those discussions.1Article for Discussion
- Sussman AL, Helitzer D, Sanders M, Urquieta B, Salvador M, Ndiaye K. HPV and cervical cancer prevention counseling with younger adolescents: implications for primary care. Ann Fam Med. 2007;5(4):298-304.
Discussion Tips
This study considers how visits by adolescents and preadolescents may need to be modified to accommodate counseling about cervical cancer prevention in the era of a new HPV vaccine. Data were gathered from in-depth interviews of diverse clinicians. The article may serve as a useful springboard for clinicians, other practice members, adolescent patients, and parents to consider how counseling should be approached with different patient groups.Discussion Questions
- What are the research questions for this study? Why do the questions matter?
- Is the study design appropriate for the research questions? What alternative designs (and study samples) could have been used?
- Study methods�To what degree can the findings be accounted for by:
- How participants were selected?
- How the interview guide was prepared and how the interviews were conducted? (See the Clinician Interview Guide in Supplemental Appendix 1, available online at http://www.annfammed.org/cgi/content/full/5/4/298/DC1.)
- The characteristics of the analysis team?
- The analysis approach and how the data were interpreted?
- Main findings�What are the main findings? Into what broader context do the findings put HPV vaccination? How do these studies advance current knowledge? How do they fit with current approaches to promoting and paying for HPV vaccine?
- Generalizability�How transportable are the findings to other settings, particularly to my patients, practice, and community?
- Implications�How can the information from this study inform how practices approach adolescent or preadolescent patients and their families? What are the implications for adolescent patients and their parents? How can the age at which this intervention is recommended be matched to the developmental stage of the patient? How does this study inform public policy? How should public discussion around this topic be fostered? What is the role of direct-to-consumer advertising by vaccine manufacturers?
Reference
- Stange KC, Miller WL, McLellan LA, et al. Annals journal club: It�s time to get RADICAL. Ann Fam Med. 2006;4:196-197. Available at: http://annfammed.org/cgi/content/full/4/3/196.
