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1 Supplemental materials for: Sussman AL, Helitzer D, Bennett A, Solares A, Lanoue M, Getrich CM. Catching up with the HPV vaccine: challenges and opportunities in primary care. Ann Fam Med. 2015;13(4):
2 Appendix 1: HPV VACCINE SURVEY In your role as a clinician, do you personally order the HPV vaccine for 9-18 year old girls? Yes No If you responded yes: Continue on to question 1 and proceed through the survey. If you responded no: You have indicated that you yourself do not directly order the HPV vaccine for patients. Therefore, the rest of our survey is not applicable to you. Please put the survey in the enclosed self-addressed stamped envelope and mail it back to us. Thank you for your willingness to assist RIOS Net. If you are interested in learning more about the HPV vaccine, please use the following link to access a free, online CME module: TargetingCervicalCancerwiththeHPVVaccines/tabid/6600/Default.aspx DEMOGRAPHICS 1. Gender: Male Female 2. How old are you today? 3. How many years of experience do you have in practice since the completion of your residency (MDs, DOs) or graduation (mid-level providers, PAs, NPs)? 4. How would you describe your practice specialty? Pediatrician Family Physician Physician Assistant Nurse Practitioner Other If you selected "Other", please specify: 5. In which of the following settings do you spend the majority of your clinical time? Community Health Center (e.g., Federally Qualified Health Center) Indian Health Service Private Practice University of New Mexico School Based Health Center Other If you selected "Other", please specify:
3 GIVING THE HPV VACCINE Please provide the answer that best applies for your 9-18 year old female patients. If you are not sure of an answer, make your best estimate. 6. At what age do you typically start offering the HPV vaccine to your female patients? 7. At what age do you feel the most comfortable first offering the HPV vaccine to your female patients? 9-10 years of age years of age years of age years of age years of age 18+ years of age 8. Does your clinic report the status of patients who have received the HPV vaccine to the New Mexico Statewide Immunization Information System (NMSIIS)? Yes, we do report to NMSIIS No, we don't report to NMSIIS I don't know if we report to NMSIIS 9. We are interested in knowing if your clinic has a way to track the status of patients who have received the HPV vaccine. Which of the following best describes the situation in your clinic? We have an electronic medical record system in place to track patient vaccination status We rely on paper charts to track patient vaccination status I don't know if we have a system in place to track patient vaccination status Other If you selected "Other", please specify: 10. Does your clinic send reminders to patients to notify them about when they are due to receive the second and third doses of the HPV vaccine? Yes No I don't know 11. Thinking about patients who have received all three doses of the HPV vaccine, which of the following best matches your experience in the timing of completing the series? My patients typically receive all three doses by six months My patients typically receive all three doses by nine months My patients typically receive all three doses by twelve months It typically takes more than twelve months for my patients to receive all three doses I don't know
4 ATTITUDES ABOUT THE HPV VACCINE Please indicate the strength of your agreement with the following statements by placing a straight line on the scale (as demonstrated below): 12. Compared to other vaccines available for 9-18 year old females, I prioritize the HPV vaccine: 13. The HPV vaccine offers the most benefit before the adolescent has started having intercourse: 14. It is worthwhile to give the HPV vaccine after the adolescent has started having intercourse: In your experience, how strongly do the following issues influence patient and/or parent decision making for the HPV vaccine: 15. Concerns about HPV vaccine side effects: No Influence on Strong Influence on
5 16. How long the HPV vaccine will offer protection: No Influence on Strong Influence on 17. Concerns the HPV vaccine will lead 9-18 year old females to feel overprotected and more likely to engage in risky sexual behavior: No Influence on Strong Influence on 18. Please share anything else that you think influences decisions about the HPV vaccine: From your perspective as a busy clinician, please review the following statements with regard to your experience offering the HPV vaccine to 9-18 year old female patients: 19. I don't have enough time to fully discuss all the relevant issues of the HPV vaccine with my patients: 20. I have sufficient information about the HPV vaccine to explain all the relevant issues to my patients:
6 21. I strongly endorse the HPV vaccine for my 9-18 year old female patients: 22. Parents typically make the decision about their 9-18 year old daughters getting the HPV vaccine without input from their daughters: 23. My 9-18 year old female patients typically get the second and third doses of the vaccine whenever they come in rather than during a visit specifically for this purpose: 24. In presenting the HPV vaccine, I emphasize its cancer prevention benefits: 25. In presenting the HPV vaccine, I see it as an opportunity to open up a discussion about adolescent sexual behavior: 26. I am concerned that my 9-18 year old female patients who receive the HPV vaccine will feel overprotected and not come back for routine cervical cancer screening (e.g., Pap smears):
7 27. Please share anything else about your experience in offering the HPV vaccine: 31. Do you think that the HPV vaccine should be mandated for school entry for all 11 to 12 year old girls? Yes No I don't know 28. Please add any comments you may have about mandating the vaccine for school entry: 29. There are now 2 HPV vaccines approved (Gardasil and Cervarix). I am prepared to provide counseling to patients about the differences between them: 30. Gardasil has also been approved for boys. I believe that parents of my 9-18 year old male patients will be receptive to the HPV vaccine: 31. Lastly, please share any other issues that you think are important with regard to the HPV vaccine: Thank you very much for completing this survey!
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