What Are the Barriers and Facilitators to Improving Virginia's HPV Vaccination Rate? A Stakeholder Analysis

Background: Despite the evidence, the availability since 2006, and strong recommendations from many professional organizations, the human papillomavirus (HPV) vaccines have had low completion rate: 39.7% for girls and 21.6% for boys nationally and 35.9% for girls and 22.5% for boys in Virginia. These rates are far below the Healthy People 2020 goal of 80% and many adolescents are at risk for developing HPV-related cancers and infections.
Purpose: The purpose of this study is to identify barriers and facilitators to improving the HPV vaccination rate in central and southern Virginia.
Method: Semi-structured key informant interviews, with purposive sampling of 31 stakeholders, were conducted to identify their opinions regarding barriers and facilitators.
Results: Analysis of the interviews revealed barriers at all levels: Knowledge gaps and sexuality concerns at the parent-child dyad level, time constraint and inconsistent recommendation at the interpersonal level, lack of leadership and informational support at the organizational and community level, and an ineffective mandate at the policy level. Facilitators identified are realistic and receptive attitude at the parent-child dyad level, provider’s strong recommendation and educational support at the interpersonal level, team approach and useful data at the organizational level, educational outreach and community resources at the community level, and support from federal and professional organizations at the policy level.
Conclusion: The stakeholder analysis provided an environmental scan of the barriers and facilitators so that an effective HPV vaccination strategy can be planned and implemented in the Commonwealth of Virginia.