377 - Communication Practices of Medical Assistants and Nurses About HPV Vaccination in Primary Care Clinics

Publication Number: 2366.377

David Higgins, University of Colorado School of Medicine, Centennial, CO, United States; Elisha L. Lehrhoff, University of Colorado School of Public Health, Northglenn, CO, United States; Christine Spina, University of Colorado at Anschutz Medical Campus, Denver, CO, United States; Cathryn Perreira, University of Colorado School of Medicine, Aurora, CO, United States; Laura Helmkamp, University of Colorado School of Medicine, Aurora, CO, United States; Jessica Cataldi, University of Colorado School of Medicine, Denver, CO, United States; Gretchen Homan, University of Kansas School of Medicine, Wichita, KS, United States; Delwyn Catley, San Diego State University, San Diego, CA, United States; English Evelyn, University of Colorado Anschutz, Chicago, IL, United States; Xinyu Zhang, KUMC, Wichita, KS, United States; Kathryn L. Colborn, University of Colorado Anschutz, Aurora, CO, United States; Christina Studts, University of Colorado School of Medicine, Aurora, CO, United States; Sean T. O'Leary, University of Colorado School of Medicine, Denver, CO, United States

Background: Medical assistants (MAs) and nurses are often the first to discuss vaccination with families in primary care, yet little is known about how they communicate about HPV vaccination. Their interactions may shape parental perceptions, prime clinician conversations, and influence vaccine acceptance, but their communication practices have not been well described.

Objective: To describe self-reported HPV vaccine communication practices, attitudes, and perceived roles among MAs and nurses working in primary care clinics.

Design/Methods: A cross-sectional survey was conducted among MAs and nurses (n=185, 79% response rate) across 22 primary care clinics in Kansas and Missouri affiliated with an HPV vaccination communication training trial (CCOM). Respondents were not part of the training but represented non-clinician team members working in participating clinics. Eligible participants were those who provided clinical care and reported interacting with families before the clinician entered the room. The survey assessed the frequency, timing, and style of HPV vaccine discussions, as well as communication behaviors and the perceived importance of their role. Descriptive statistics were used to summarize findings.

Results: Respondents were predominantly MAs (51%) or RNs (37%). Over 60% had six or more years of healthcare experience, and 41% reported their clinic had standing orders to administer vaccines before the clinician visit (Table 1). Most (89%) reported discussing HPV vaccination with families before the clinician entered, while 11% discussed it only if asked (Table 2). About half (53%) said they strongly recommend HPV vaccine for 11–12-year-olds. Most reported using a presumptive (72%) or bundled approach (84%), but only 7% said they use motivational interviewing when parents express hesitancy, and 36% said they accept refusal and defer to the clinician (Table 3). Most respondents (87%) perceived clinicians as extremely or moderately receptive to their involvement in discussing vaccines, 75% viewed their own role as important, and 82% said additional communication training was important (Table 4).

Conclusion(s): MAs and nurses frequently discuss HPV vaccination with families, but their approaches vary widely and often rely on optional framing or clinician deferral. These findings highlight the critical yet underrecognized role of frontline staff and underscore the need for structured, role-specific training to strengthen team-based vaccine delivery and confidence.

Tables 1 and 2: Characteristics of Respondents and HPV Vaccine Discussion and Recommendation Practices
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Table 3: Reported Use of Vaccine Communication Techniques
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Table 4: Perceived Role, Clinician Receptivity, and Training Needs in Vaccine Communication
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