Patient and healthcare provider factors influencing shared clinical decision-making for HPV (human papillomavirus) vaccination among adults aged 27–45 years old in the United States: a systematic review

  • Tanjila Taskin
  • , Idara N. Akpan
  • , Grace Maynard
  • , Sarah A. Alkhatib
  • , Christopher W. Wheldon
  • , Jessica Grace
  • , Erika L. Thompson

Research output: Contribution to journalReview articlepeer-review

Abstract

Aim: The United States Advisory Committee on Immunization Practices (ACIP) recommended shared clinical decision-making for mid-adult HPV vaccination. However, healthcare practitioners and patients struggle with shared clinical decision-making (SCDM) due to unclear guidelines. The purpose of this systematic review was to identify factors contributing to decision-making for HPV vaccination among US mid-adults aged 27 - 45 and factors that influence healthcare providers implementing this guideline. Methods: Following PRISMA guidelines, PubMed, PsycINFO, SCOPUS, and the Web of Science were searched for peer-reviewed articles published in English between 2006 and 2022. Fourteen articles were included in this review. The Anderson’s healthcare utilization model was used to synthesize the results into predisposing, enabling, and need-based factors. Results: The predisposing factors that positively influenced HPV vaccination were being male, having a graduate degree, and having HPV knowledge. Enabling factors that positively influenced HPV vaccination were having health insurance, healthcare provider recommendations, access to health care services, a trusted source for information, financial support, and emotional support. Need-based factors that positively influenced HPV vaccination were perceived cancer risk, prior HPV infection, reducing HPV-related morbidities, and improving physical health. Healthcare providers were more likely to recommend the vaccine if they were aware of the ACIP guideline, and for patients who were younger, in a relationship, or had more than one sexual partner, had health insurance, and had a history of high-grade HPV infection. Conclusion: The review suggests routine provider training and developing patient decision-aid tools to facilitate the shared clinical decision-making process for increasing HPV vaccination in this age group.

Original languageEnglish (US)
JournalJournal of Public Health (Germany)
DOIs
StateAccepted/In press - 2025
Externally publishedYes

Keywords

  • Guidelines
  • HPV vaccination
  • Mid-adults
  • Providers
  • Shared clinical decision-making

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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