Student Theses, Dissertations and Capstones

Document Type

Thesis

Degree Name

Master of Science (M.S.) in Dentistry

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Dental Medicine

First Advisor

Richard Singer

Publication Date / Copyright Date

2018

Publisher

Nova Southeastern University

Abstract

Introduction: Human Papillomavirus (HPV) is the most common sexually transmitted infection with an estimated fourteen million new cases each year in the United States alone. HPV infections generally resolve with little or no incident, but persistent infections can lead to more serious sequelae such as oral and cervical cancers. The Centers for Disease Control and Prevention recommends that all 11-12 year olds receive the HPV vaccine; yet, the prevalence of HPV vaccination in the U.S. population is far below the prevalence of routine childhood vaccinations. Clearly, there is a public health imperative to increase the HPV vaccination rate among American youth. Because orthodontists see patients of the vaccination target age monthly, for 2 or more years, they are particularly well positioned to influence vaccination rates by educating patients and their parents about HPV and the HPV vaccine. Therefore, the goals of this study were to examine the determinants of orthodontists’ willingness to provide an HPV educational intervention to adolescent patients, and orthodontists’ agreement that HPV is within the scope of orthodontic practice. Methods: A survey instrument informed by the Integrated Behavior Model of health behaviors was used to obtain cross-sectional data from a representative sample of Florida Orthodontists’ that assessed personal and practice demographics, knowledge regarding HPV and the HPV vaccine, and their willingness to provide an HPV educational intervention. Univariate, bivariate, principle component, and multivariable logistic regression analyses were used to evaluate the specific aims. Results: For each year that participants’ aged, the adjusted odds of willingness increased 12% (AOR = 1.12, 95% CI 1.02, 1.23). Additionally, those participants who agreed that HPV causes cancer in females, were four times more willing to provide an HPV educational intervention than those who disagreed (AOR = 4.07, 95% CI 1.51, 10.94). Perceived Control (AOR = 2.03, 95% CI 1.06, 3.90), and Salience (AOR = 3.09, 95% CI 1.35, 7.09) were also significant determinants of orthodontists’ willingness to provide an HPV educational intervention. The amount of office time respondents were willing to provide to deliver HPV information to patients was a significant predictor of agreement that HPV was within the scope of orthodontic practice; less than 1 minute (AOR = 7.55, 95% CI 1.09, 52.33), 1-2 minutes (AOR = 21.20, 95% CI 3.44, 130.52), and 3-4 minutes (AOR = 41.05, 95% CI 6.04, 279.12). Neither self-rated knowledge nor agreement that HPV is within the scope of orthodontic practice, were significant determinants of orthodontists’ willingness to provide an HPV educational intervention. In addition, encouragement to discuss HPV or recommend the HPV vaccine during professional education were not significant predictors of respondents’ agreement that HPV is within the scope of orthodontic practice. Conclusions: Our findings suggest an opportunity to impact orthodontists’ willingness to provide an HPV educational intervention through encouraging orthodontists to discuss HPV and the HPV vaccine effectively in professional school and continuing education, the availability and dissemination of informational pamphlets, and support and guidance from the American Association of Orthodontists (AAO). Also, support and guidance from the AAO may promote orthodontists’ understanding that HPV is within the scope of orthodontic practice.

Disciplines

Dentistry

Keywords

Childhood Vaccines, HPV, Human Papillomavirus, Orthodontists, Public Health, Scope of Practice

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