HPV vaccination rates fall short of the Healthy People 2020 goal of 80% completion. Although strategies to increase these rates exist, low rates persist. We used concept mapping with state-level stakeholders to better understand barriers and facilitators to HPV vaccination. Concept mapping is a participatory research process in which respondents brainstorm ideas to a prompt and then sort thoughts into piles. We present the results of the brainstorming phase. Researchers recruited 134 participants identified by researchers’ professional connections via e-mail invitations from five states working in adolescent health, sexual health, cancer prevention, control, or immunization. Using Concept Systems’ online software, we solicited participants’ beliefs about what factors significantly influence HPV vaccination rates in their states. From the original sample, 58.2% of participants completed the brainstorming activity and generated 372 statements. Our team removed duplicates and edited reports for clarity, which resulted in 172 views. We coded ideas using the SEM to understand what level factors affecting HPV vaccination are occurring. There were 53 statements at the individual level, 22 at the interpersonal level, 21 in community, 51 in organizational, and 25 in the policy. Our results suggest that a tiered approach utilizing multi-level interventions instead of focusing on only one level may have the most benefit. Moreover, the policy-level influences identified by participants may be difficult to modify. Thus efforts should focus on implementing evidence-based interventions to have the most meaningful impact.

Reference: https://www.tandfonline.com/doi/full/10.1080/21645515.2020.1839290