Background/Purpose: Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States and the cause of significant morbidity and mortality from HPV-related cancers. The HPV vaccine is recommended for 11-12 year olds for the prevention of HPV-related cancers. Although HPV is recommended at the same visit as the Tetanus, Diphtheria, and Pertussis (Tdap) vaccine and Meningococcal vaccine, HPV vaccination rates remain low and trail Tdap and Meningococcal vaccination rates. Health care providers report the need for education of HPV and strategies to address vaccine hesitancy. Literature shows that providers with high HPV vaccination rates provide strong recommendations for the vaccine and parents report that the provider recommendation has the most influence on the decision to vaccinate. The purpose of this study is to determine influential factors for parental acceptance or refusal of the HPV vaccine and to increase HPV vaccination rates by improving provider recommendation for the HPV vaccine through education and implementation of an evidence-based communication tool. Methods: The study was conducted at a pediatric primary care practice in North Carolina. Participant recruitment and consent took place on site. Participants completed a pre- and post-communication survey, online education module, and pre- and post-knowledge assessment. Providers implemented the AAP HPV Champion toolkit for the recommendation for the HPV vaccine at 11-12 year old well visits over a three-month time period. During the same period, parents of 11-12 year old patients presenting for well visits were surveyed regarding influential factors for their decision to accept or refuse the HPV vaccine for their child. Results: Provider knowledge of HPV increased after completing the education. Vaccine rates increased from baseline with the most significant improvement in HPV vaccine rates. Reasons for parental acceptance or refusal of the HPV vaccine reflect what is found in the literature. Conclusions and Implications: Provider education and implementation of an evidence-based communication tool for the recommendation of the HPV vaccine can increase HPV vaccination rates in the 11-12 year old age group. Understanding influential factors for the acceptance or refusal of the HPV vaccine can be used to strengthen HPV vaccine recommendations.