Primary Care Providers' Perspectives on Barriers and Facilitators to Human Papillomavirus (HPV) Vaccination among Young Adults: A Qualitative Study.

Young adults (18-26 years) are at high risk of human papillomavirus (HPV) exposure. Yet, HPV vaccine uptake is suboptimal among young adults. Provider recommendation is frequently the most influential factor in HPV vaccine acceptance. Evidence-based strategies are needed to facilitate provider recommendations for young adults. To inform provider-level strategies for recommending the HPV vaccine to young adult patients, the current study aims to understand current practices and barriers and facilitators to both recommending the HPV vaccine for young adults and for young adults to receive the HPV vaccine. Primary care providers (e.g., physicians, nurses; n = 15) in the United States completed a semi-structured interview guided by the Consolidated Framework for Implementation Research (CFIR). Data were analyzed thematically using Nvivo. Most participants identified as female (80%), White (67%), and non-Hispanic (93%). Participants reported varying their HPV vaccine discussions based on visit type (acute vs. wellness) and if the patient is new or established in their practice. Participants reported barriers to HPV vaccination in young adults across several CFIR domains including outer setting (e.g., transient living situation), inner setting (e.g., lack of availability of vaccine in clinic), individual (e.g., sex differences), and process (e.g., burnout). Facilitators included considering the HPV vaccine as a high priority and scheduling future vaccine appointments at the current visit. Evidence-based interventions to increase HPV vaccine uptake among young adults are needed. Healthcare providers identified multilevel barriers to both recommending and delivering the HPV vaccine to their young adult patients.