Background: Medical assistants (MAs) and nurses are often among the first to discuss vaccination with families in primary care, yet little is known about how they communicate about HPV vaccination. Their interactions may shape parental perceptions, prime clinician conversations, and influence vaccine acceptance, but their communication practices have not been described. This study aimed to describe self-reported HPV vaccine communication practices, attitudes, and training needs among MAs and nurses working in primary care clinics.
Design/Methods: We conducted a cross-sectional survey of MAs, nurses, and other non-clinician staff (e.g., certified nursing assistants, licensed practical nurses, and other non-licensed clinical support roles) at 22 primary care clinics in Kansas and Missouri. Eligible staff interacted with families before the clinician’s visit. The survey assessed the frequency, timing, and style of HPV vaccine discussions, responses to vaccine hesitancy, and perceived role in vaccine communication.
Results: Of 247 invited staff, 185 completed surveys (75% response rate) across all 22 clinics. Most (78%) reported using a presumptive communication style; however, only 24% described a fully presumptive initiation style. Only 7% reported using motivational interviewing techniques when parents express hesitancy, and 36% accepted initial refusal and deferred to the clinician. Registered nurses (RNs) were significantly less likely than MAs, LPNs, and CNAs to initiate vaccine discussions proactively (81% vs. 93%; p=0.01). Most respondents (87%) perceived clinicians as extremely or moderately receptive to their involvement, 75% viewed their own role as important, and 82% wanted additional vaccine communication training.
Conclusions: Non-clinician staff regularly discuss HPV vaccination with families but frequently use inconsistent and non-evidence-based approaches, with a substantial gap between self-reported technique use and described practice. These findings highlight the underrecognized role of this workforce in vaccine delivery and underscore the need for structured, role-specific training interventions.
