Table 2.
Logistic bivariate and multivariable modelling of factors influencing strength and frequency of HPV vaccine recommendations.
| Bivariate OR (95% CI) | Multivariable aOR (95% CI) | Backwards Stepwise aOR (95% CI)1 | |
|---|---|---|---|
| Provider Characteristics | |||
| N/A | |||
| Clinic Characteristics | |||
| Geographic location: | |||
| Rural | ref | ref | ref |
| Urban | 2.92 (1.08–7.89) | 3.03 (0.88–10.36) | 3.54 (1.07–11.76) |
| Suburban | 3.49 (1.37–8.89) | 3.38 (1.04–11.04) | 3.31 (1.07–10.19) |
| Is the HPV vaccine stocked in your clinic: Yes |
3.07 (1.54–6.13)* | 2.62 (0.92–7.43) | 2.66 (1.02–6.93) |
| Systems-level barriers to HPV vaccination | 0.75 (0.61–0.91)* | 0.95 (0.82–1.09) | |
| Provider Knowledge, Attitudes, and Beliefs | |||
| Believe HPV vaccine should be incorporated into regular clinic care for non-pregnant patients: Yes |
3.41 (1.14–10.22) | 1.62 (0.34–7.68) | |
| Benefits of HPV vaccine to patients | 2.53 (1.47–4.33)* | 1.56 (0.78–3.11) | |
| perception of other OB/GYN recommendation frequency: | |||
| Some or none/almost none (<39% of the time) | ref* | ref | ref* |
| About half (40–59% of the time) | 1.29 (0.54–3.07) | 1.15 (0.39–3.40) | 1.01 (0.36–2.86) |
| Most (60–90% of the time) | 4.30 (1.79–10.29)* | 2.47 (0.84–7.27) (0.84–7.27) | 2.81 (0.98–8.07) |
| All/almost all (>90% of the time) | 42.00 (4.98–354.36)* | 28.74 (2.79–296.07)* | 24.33 (2.56–231.14)* |
| Number of HPV-related cancers mentioned | 1.22 (1.05–1.41) | 1.11 (0.91–1.34) | |
| Knowledge Score | 1.45 (1.12–1.87)* | 1.21 (0.86–1.70) | 1.35 (0.98–1.86) |
| Provider's beliefs about vaccine safety or efficacy as barriers to vaccination | 1.50 (1.13–1.98)* | 1.26 (0.84–1.88) | |
| Provider Perception of Patient Attitudes and Beliefs | |||
| Perception of patient interest in receiving HPV vaccine: 50% or more |
4.63 (2.45–8.77)* | 2.81 (1.02–7.73) | 2.77 (1.25–6.13) |
| If you recommended HPV vaccination to patients: Patients would accept |
2.17 (1.19–3.94) | 0.66 (0.24–1.61) | |
1. The multivariable logistic regression model refined with a likelihood ratio-based backwards stepwise process using a factor elimination cutoff of p < 0.1. N = 175.
Odds ratios and adjusted odds ratios are statistically significant at α = 0.05 (bold), or α = 0.01 (*).