Peer-reviewed article
A Scoping Review of Influences on HPV Vaccine Uptake in the Rural US.
Sheinfeld Gorin S, Hyman R, Olson C, Fournier EA, Yang K et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined factors affecting HPV vaccine uptake among rural US adolescents, analysing 101 studies published between 2010-2023. Rural populations receive HPV vaccinations at lower rates than urban populations, despite vaccines preventing over 90% of HPV-related cancers. The review identified barriers including limited vaccine awareness, poor access to vaccination sites, and weak healthcare provider recommendations. The authors recommend tailored interventions targeting parents and caregivers, training for healthcare providers including school nurses and pharmacists, and better coordination between primary care and public health.
Key points
- Rural adolescents initiate and complete HPV vaccinations at lower rates than urban populations
- Key barriers identified: limited vaccine awareness, limited access to vaccination sites, and insufficient primary care provider recommendations
- Adolescents themselves were the most common focus of interventions studied
- Provider training increases HPV vaccine recommendations
- Tailored interventions targeting rural parents/caregivers and multiple healthcare provider types are needed
Limitations
This is a scoping review that identifies influences and barriers but does not evaluate the effectiveness of specific interventions to address them. The review cannot provide evidence of what works best to improve HPV vaccine uptake in rural US settings.
Abstract
The human papillomavirus (HPV) is the leading cause of cervical and oropharyngeal cancers. Vaccination can prevent over 90% of HPV-attributed cancers. Rural populations are less likely to initiate and complete HPV vaccinations than urban. The primary objective of this paper is to systematically examine the multilevel (child/youth, parent/caregiver, physician/team, healthcare organization, community, and policy) influences on HPV vaccine uptake in the rural US population. As a secondary aim, we seek to identify gaps in the research that could contribute to the development of more precise intervention approaches in this population. The study adds to the limited number of recent reviews on rural HPV vaccine uptake in the US. Method We conducted a systematic search of published empirical studies over 13 years (2010-2023), resulting in 1657 publications. The following databases were searched: Medline (OVID), Embase, CINAHL, PsychInfo, Cochrane, Sociological Abstracts, and Scopus using pre-specified inclusion criteria. Two reviewers independently coded 101 full texts; discrepancies were resolved by a third reviewer. The primary outcome was HPV vaccine uptake. Results Adolescents themselves were the most common foci of change. Barriers to rural HPV uptake included limited; vaccine awareness, access to vaccines for children vaccination sites, and primary care recommendations. Conclusions Tailored interventions to rural parents/caregivers could increase uptake of the vaccine. Provider training increases HPV vaccine recommendations; programs should also be targeted to rural school nurses, pharmacists, and dental care providers. Linking primary care practices and public health dissemination strategies are key.