TABLE 4

Bivariate and Multivariate Analyses of the Association Between Pediatrician Attitudes and Being Very/Somewhat Likely to Give HPV Vaccine to 10- to 12-Year-Old Female Patients (n = 294)

FactorsUnadjusted OR (95% CI)Adjusted ORa (95% CI)
Attitudes about sexuality and adolescent patients
    Respondent feels comfortable discussing sex with his or her female adolescent patients0.50 (0.24–1.04)
    Respondent thinks that ≥10% of his or her 13- to 15-y-old patients have had sex1.64 (1.01–2.66)
Knowledge about HPV infections and vaccination
    Higher degree of knowledge regarding HPV infectionsb1.13 (0.92–1.38)
    Knowledge that HPV vaccines that are under development seem to be highly effective at preventing cervical cancer precursors2.17 (1.35–3.48)2.33 (1.37–3.97)
Attitudes about HPV vaccinationc
    Considering it necessary to discuss sexuality before recommending HPV vaccine0.36 (0.18–0.70)0.42 (0.20–0.88)
    Thinking that other new adolescent vaccine recommendations will make it easier to introduce HPV vaccine into their practice1.85 (1.13–3.03)1.86 (1.07–3.23)
    Thinking that parents of 10- to 12-y-old patients would be upset if a vaccine against a sexually transmitted infection were offered to patients this age0.23 (0.14–0.41)0.29 (0.16–0.53)
    Thinking that parents of 10- to 12-y-old patients will be more likely to refuse HPV vaccine than parents of 16- to 18-y-old patients0.22 (0.09–0.53)
    Thinking that it will be easier to discuss HPV vaccine with parents of 10- to 12-y-old patients compared with older adolescents2.30 (1.38–3.85)
Perceived barriers to vaccination
    Believing that female patients’ parents’ refusing vaccination will definitely/somewhat be a barrier0.37 (0.23–0.59)0.53 (0.31–0.91)
    Believing that the “up-front” costs to purchase the vaccine will definitely/somewhat be a barrier0.71 (0.45–1.13)
Practice characteristics
    ≥50% of respondents’ patients have public insurance1.57 (0.91–2.73)
    Respondents’ practice participates in VFC program0.92 (0.52–1.61)
  • OR indicates odds ratio; CI, confidence interval.

  • a All factors listed in this table were tested in multivariate analyses; only factors with P < .05 after adjustment for other significant factors were retained in the model presented.

  • b Represents a scale of 6 HPV-related knowledge questions (number correct/number answered).

  • c Attitudes were assessed using a 4-point scale; for analyses, responses were collapsed into dichotomous variables (strongly/somewhat agree with statement versus strongly/somewhat disagree or not sure).