Annals Journal Club: Challenges in Counseling Adolescents about HPV Vaccine
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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.1

## HOW IT WORKS

In each issue, the *Annals* selects an article or articles and provides discussion tips and questions. We encourage you to take a RADICAL approach to these materials, and to post a summary of your conversation in our online discussion. (Open the article online and click on “TRACK Comments: Submit a response.”) You can find discussion questions and more information online at: [http://www.AnnFamMed.org/AJC](http://www.AnnFamMed.org/AJC).

## CURRENT SELECTION

### Article 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.[Abstract/FREE Full Text](http://www.annfammed.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoiYW5uYWxzZm0iO3M6NToicmVzaWQiO3M6NzoiNS80LzI5OCI7czo0OiJhdG9tIjtzOjIyOiIvYW5uYWxzZm0vNS80L2lpaS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

### 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:
    
    1.  How participants were selected?
    
    2.  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](http://www.annfammed.org/cgi/content/full/5/4/298/DC1).)
    
    3.  The characteristics of the analysis team?
    
    4.  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?

*   © 2007 Annals of Family Medicine, Inc.

## REFERENCE

1.  Stange KC, Miller WL, McLellan LA, et al. *Annals* Journal Club: It’s time to get RADICAL. Ann Fam Med. 2006;4(3):196–197. [http://annfammed.org/cgi/content/full/4/3/196](http://annfammed.org/cgi/content/full/4/3/196).
    
    [FREE Full Text](http://www.annfammed.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6ODoiYW5uYWxzZm0iO3M6NToicmVzaWQiO3M6NzoiNC8zLzE5NiI7czo0OiJhdG9tIjtzOjIyOiIvYW5uYWxzZm0vNS80L2lpaS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=)