Table 3.

Correlates of HPV vaccine recommendation quality

Physicians with high recommendation quality scores/total physicians in category (%)Bivariate OR (95% CI)Multivariable OR (95% CI)
Physician characteristics
 Medical specialty
  Pediatrics220/410 (54)11
  Family practice137/366 (37)0.52 (0.39–0.69)a0.72 (0.50–1.04)
 Sex
  Male221/526 (42)11
  Female136/250 (54)1.65 (1.22–2.23)a1.39 (0.97–2.00)
 Years in practice
  ≤19168/352 (48)1
  ≥20189/424 (45)0.88 (0.66–1.17)
 Adolescent patients seen in typical wk
  ≤958/129 (45)1
  10–24156/351 (44)0.98 (0.65–1.47)
  ≥25143/296 (48)1.14 (0.76–1.73)
 Vaccine doses through VFC program
  ≤9%117/290 (40)11
  10%-49%131/274 (48)1.35 (0.97–1.89)1.13 (0.76–1.69)
  ≥50%85/152 (56)1.88 (1.26–2.79)a1.50 (0.94–2.39)
  Not sure24/60 (40)0.99 (0.56–1.74)1.32 (0.68–2.56)
Clinic or practice characteristics
 Type
  Private practice (solo, group, HMO)301/660 (46)1
  Other56/116 (48)1.11 (0.75–1.65)
 Total physicians
  1–4174/398 (44)1
  5–9103/217 (47)1.16 (0.83–1.62)
  ≥1080/161 (50)1.27 (0.88–1.84)
 Stock HPV vaccine
  Yes335/703 (48)11
  No22/73 (30)0.47 (0.28–0.80)a0.97 (0.53–1.78)
 Region
  Northeast78/184 (42)1
  Midwest82/165 (50)1.34 (0.88–2.05)
  South121/275 (44)1.07 (0.73–1.56)
  West76/152 (50)1.36 (0.88–2.09)
HPV vaccine communication context
 Believe parents feel HPV vaccine is
  Moderately/very/extremely important208/409 (51)11
  Not/slightly important149/367 (41)0.66 (0.50–0.88)a0.60 (0.43–0.84)a
 Anticipate uncomfortable conversations
  Strongly/somewhat disagree161/307 (52)11
  Strongly/somewhat agree/neither196/469 (42)0.65 (0.49–0.87)a0.89 (0.60–1.30)
 Perceive STI discussion as uncomfortable
  Strongly/somewhat disagree222/390 (57)11
  Strongly/somewhat agree/neither135/386 (35)0.41 (0.30–0.54)a0.45 (0.31–0.65)a
 Perceive tone of discussions to be
  Less important than what is said53/127 (42)1
  As important as what is said278/577 (48)1.30 (0.88–1.91)
  More important than what is said26/72 (36)0.79 (0.43–1.43)
Communication practices
 Begin discussions byb
  Saying child is due178/236 (75)11
  Giving information68/261 (26)0.11 (0.08–0.17)a0.12 (0.08–0.18)a
  Suggesting HPV vaccine95/227 (42)0.23 (0.16–0.35)a0.26 (0.17–0.40)a
  Eliciting questions10/41 (24)0.11 (0.05–0.23)a0.13 (0.06–0.29)a
 Say HPV vaccine prevents cervical cancer andc
  Other cancers and genital warts220/400 (55)11
  Other cancers11/24 (46)0.69 (0.30–1.58)0.70 (0.27–1.81)
  Genital warts93/248 (38)0.49 (0.36–0.68)a0.56 (0.38–0.82)a
  Nothing else26/93 (28)0.32 (0.19–0.52)a0.36 (0.20–0.64)a

NOTE: Dashes (—) indicate the variable was not included in the multivariable model because it was not statistically significant in bivariate analyses.

Abbreviations: HMO, health maintenance organization; STI, sexually transmitted infection.

  • aP < 0.01.

  • bExcludes respondents (n = 11) who indicated “say we'll give it at the end of the visit.”

  • cExcludes respondents (n = 11) who indicated “none of these.”