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Primary Capstone Advisor: Dr. Amy Leader

Captone Committee Member: Randee Silverman


Human Papillomavirus (HPV) vaccination rates are far below Healthy People 2020 goals and the lack of youth-friendly providers contribute to suboptimal rates. Study aims were to (1) assess accessibility of the HPV vaccine for adolescent females by evaluating providers for youth friendliness and (2) assess front-line office barriers to vaccination as would be experienced by adolescent females. Thirty-nine providers (19 city health clinics, 13 private practices and 7 university-based health centers) in Philadelphia were selected by GIS mapping to create a representative distribution of sites. Each provider was contacted via telephone utilizing a mystery-shopper format and the person who answered the call, typically the receptionist, was administered a structured telephone survey with questions of known-importance to adolescents when obtaining healthcare. At the end, each call was rated for its customer service. Each site received 2 calls, resulting in 78 completed calls. 65% of calls were answered by a receptionist, while the remainder were unanswered. Of answered calls, 76 % required that an appointment for vaccination, 83 % required that a patient be seen for a physical exam before vaccination, 90% required parental consent for vaccination, and 50% required some form of health insurance. The mean customer service rating was 3.59 (SD= 1.02). In examining the necessity of insurance coverage by provider type, results indicated that 35.7% of clinics would see patients without insurance, compared to 7.1% of private practices and 7.1% of university-based practices (Χ2= 12.761, df, 2, p = 0.002). Overall, city health clinics were determined to be the most youth-friendly, but barriers to adolescents obtaining the HPV vaccine were prevalent at all provider types. Initiatives to educate front-line office staff about interacting with youth clients, as well as decreasing barriers for adolescents to access care, could prove useful in increasing the HPV vaccination rate of adolescent females.