One of the most powerful factors and predictors of HPV vaccine uptake is practitioner communication. The goal of this study was to use a latent class analysis to characterize pediatric practitioner HPV referral trends. Pediatric practitioners from the American Academy of Pediatrics (AAP) Pediatric Research in Office Settings (PROS) nationwide network conducted an online survey in which they were presented with 5 hypothetical vignettes of well-child visits and asked questions. Questions were asked regarding their communication techniques, assessments of the teenage patient being sexually active within the next two years for decision-making about HPV vaccine advice, and peer norms. Latent class analysis was used to categorize practitioner subgroups based on their responses to ten survey questions. Multinomial logistic regression was used to investigate the practitioner features associated with each profile. Researchers discovered three unique practitioner HPV vaccination recommendation characteristics across 470 respondents: (1) Engagers followed national age-based guidelines, strongly recommended HPV vaccination, and perceived peers to strongly recommend; (2) Protocol Followers strongly recommended HPV vaccination as well, but were less likely to engage families in a discussion about benefits; and (3) Uncertain HPV Vaccine Recommenders delayed or did not recommend HPV vaccination and were more likely to use judgment.

The findings highlight the critical necessity of continuing efforts to increase practitioner acceptance of evidence-based methods to HPV vaccination recommendation, particularly among Ambivalent Recommenders.