Recommending the HPV Vaccine: New Skills for a New Recommendation in Oral Health

Background: In 2018, the American Dental Association (ADA) adopted the policy urging dentists to support the use and administration of the human papillomavirus vaccine (HPV). Research has shown a need for and support for professional development in recommending the vaccine. In this pilot project, entire clinic staff from two urban dental clinics in Minnesota were trained on the importance of HPV vaccination recommendations using both traditional lecture and youth actors to simulate patient conversations.

Objective: To review the results of offering the 3-hour in-clinic training, which included simulated patient interviewing skills using trained youth actors.

Methods: Two urban clinics, with diverse patients and staff, were recruited to provide training to all staff members during the educational forum. Participants were offered continuing education credits, and clinic participation was incentivized. Following 90-minutes of provider instruction, youth actors from the University of Minnesota’s Department of Pediatrics Program, YouthCHAT, role-played an individual in need of an HPV vaccine. Participants volunteered to practice the demonstrated interviewing skills while their colleagues observed. A qualitative evaluation study was conducted post-training. This study was deemed exempt from the University of Minnesota IRB (Ethos Study ID STUDY00008406). Zoom-based, In-depth, open-ended interviews lasting approximately 30 minutes were offered to all participants one year after the training.

Results: Of the 61 staff who were trained, three dentists and nine dental assistants or dental hygienists participated in the interviews. Saturation was reached at 12. All participants answered questions related to their HPV knowledge and comfort with recommending the HPV vaccine. Answers documented providers’ knowledge, skill change and increased comfort addressing the topic. Basic information on HPV as an oral health-related disease was deemed new and vital by most participants. Most participants mentioned training using the simulated patient interviews as important in learning the skills necessary to provide HPV recommendations. Dental assistants provided evidence of a greater learning curve than dental hygienists and dentists, although all noted the necessity of learning both the didactic and the skill-based information.

Conclusion: Results from this evaluation reinforce earlier research. Oral health professionals need additional training to understand the link between HPV and head and neck cancers. Additionally, oral health professionals want and need opportunities to practice recommending the HPV vaccine to parents, youth, and young adult patients. Youth actors are highly recommended as an effective teaching modality. Future trainings in the oral health setting, utilizing a multi-modal approach to HPV vaccine counseling, should be widely adopted.