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Parth
Shah
Author
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children.
Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents.
Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts.
Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
Spring 2017
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Health Behavior
Noel
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine
uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal,
provider, and structural factors related to pharmacies as vaccination settings that
might motivate parents to obtain pharmacist-provided HPV vaccinations for their children.
Methods. Aim One: I conducted structural equation modeling to evaluate how the type of
pharmacy parents (n=1,504) use to get medications for their adolescent children was
associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I
conducted analysis of variance and multiple regression models to examine how parents
(n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared
to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether
community pharmacists can improve access to HPV vaccination services in primary health
care shortage areas in Texas, which allows pharmacists to immunize adolescents.
Results. Aim One: Compared to parents who used chain pharmacies, parents who used
independent pharmacies were less willing to get their adolescent children HPV vaccine from
pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this
relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a
pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies
(β=.29; p<.001), and if they believed vaccine delivery features related to patient
accessibility were more important than features related to the health care environment
(β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine
providers along with primary care physicians, census tracts shifted towards adequate
coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts.
Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception
of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations
should capitalize on their relative advantages in patient accessibility over
doctors’ offices, while also improving on vaccine delivery features related to the health
care environment which parents believed to be superior in doctors’ offices. Pharmacists
could potentially increase access to HPV vaccination for parents and adolescents in states
that allow pharmacists to immunize adolescents.
Spring 2017
2017
Public health
alternative vaccination setting, HPV vaccine, human
papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting
institution
Health Behavior
Noel
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
Spring 2017
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Health Behavior
Noel
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017-05
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Health Behavior
Noel
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Health Behavior
Noel
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
2017-05
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Health Behavior
Noel
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
2017-05
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Health Behavior
Noel
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
2017-05
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
Health Behavior
Noel T.
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol E.
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
2017-05
University of North Carolina at Chapel Hill
Degree granting institution
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017
Public health
alternative vaccination setting; HPV vaccine; human papillomavirus; pharmacists; pharmacy; preventive care delivery
eng
Doctor of Philosophy
Dissertation
Health Behavior
Noel T.
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol E.
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
2017-05
University of North Carolina at Chapel Hill
Degree granting institution
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Health Behavior
Noel T.
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol E.
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
2017-05
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017
Public health
alternative vaccination setting, HPV vaccine, human papillomavirus, pharmacists, pharmacy, preventive care delivery
eng
Doctor of Philosophy
Dissertation
Health Behavior
Noel T.
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol E.
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
2017-05
University of North Carolina at Chapel Hill
Degree granting institution
Parth
Shah
Creator
Department of Health Behavior
Gillings School of Global Public Health
The role of pharmacy in HPV vaccination of U.S. adolescents
Purpose. Pharmacies could play a meaningful role in improving HPV vaccine uptake in US adolescents. This dissertation aimed to evaluate the intrapersonal, provider, and structural factors related to pharmacies as vaccination settings that might motivate parents to obtain pharmacist-provided HPV vaccinations for their children. Methods. Aim One: I conducted structural equation modeling to evaluate how the type of pharmacy parents (n=1,504) use to get medications for their adolescent children was associated with willingness to get these children HPV vaccine from pharmacists. Aim Two: I conducted analysis of variance and multiple regression models to examine how parents (n=1,500) perceived relative advantages of vaccine delivery in pharmacies compared to doctors’ offices. Aim Three: I conducted geospatial analyses to assess whether community pharmacists can improve access to HPV vaccination services in primary health care shortage areas in Texas, which allows pharmacists to immunize adolescents. Results. Aim One: Compared to parents who used chain pharmacies, parents who used independent pharmacies were less willing to get their adolescent children HPV vaccine from pharmacists (β=-.094; p=.001). Service quality and satisfaction suppressed this relationship. Aim Two: Parents were more willing to get their children HPV vaccine from a pharmacist if they indicated more relative advantages in vaccine delivery in pharmacies (β=.29; p<.001), and if they believed vaccine delivery features related to patient accessibility were more important than features related to the health care environment (β=.20; p<.001). Aim Three: When pharmacists were included as adolescent vaccine providers along with primary care physicians, census tracts shifted towards adequate coverage in 35% (1,055/3013) of urban tracts and in 18% (92/521) of rural tracts. Conclusion. Pharmacies could increase HPV vaccine uptake by improving parents’ perception of service quality at pharmacies they use. Pharmacies that provide adolescent vaccinations should capitalize on their relative advantages in patient accessibility over doctors’ offices, while also improving on vaccine delivery features related to the health care environment which parents believed to be superior in doctors’ offices. Pharmacists could potentially increase access to HPV vaccination for parents and adolescents in states that allow pharmacists to immunize adolescents.
2017
Public health
alternative vaccination setting; HPV vaccine; human papillomavirus; pharmacists; pharmacy; preventive care delivery
eng
Doctor of Philosophy
Dissertation
Noel T.
Brewer
Thesis advisor
Shelley
Golden
Thesis advisor
Carol E.
Golin
Thesis advisor
Macary
Marciniak
Thesis advisor
Justin
Trogdon
Thesis advisor
text
2017-05
University of North Carolina at Chapel Hill
Degree granting institution
Shah_unc_0153D_17153.pdf
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2017-06-19T15:13:34Z
2019-08-15T00:00:00
proquest
application/pdf
3060156
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