The time needed to engage in conversations with patients and families may be greater

for new vaccines [62] and [90] as well as for certain populations such as those with chronic medical conditions. School nurses in the United Kingdom, for example, reported needing more time to establish a trusting relationship with these adolescents and their parents in order to persuade them that the HPV vaccine was necessary [17]. Communication about STI vaccination could be influenced by the setting in which HCPs serve their VX-809 ic50 adolescent patients. HCPs using an adolescent medical home model may have greater opportunity to develop a rapport with adolescent patients and parents and, thus, may be better able to address specific concerns about STI vaccination, leading to more effective communication. The medical home may also establish practice-based policies and procedures that incorporate evidence-based vaccination recommendations

[94]. These could facilitate adolescent vaccination by educating HCPs and enhancing the practice infrastructure. Not surprisingly, a recent study found Erlotinib ic50 that adolescents receiving preventive care within a medical home have greater HPV vaccine uptake [95]. Unfortunately, however, many countries lack necessary resources for adolescent-specific services and have little expertise in adolescent medicine [72] and [96]. HCPs often do not practice in isolation, but work within a team of individuals to promote the health of their adolescent population. Community health workers, social workers, medical assistants, teachers, religious leaders, school or clinic administrative staff, and others may serve as integral members of this team.

Limited data suggest that they could play an instrumental role in facilitating STI vaccination in both resource-poor Ribonucleotide reductase and resource-rich communities, especially for individuals at high risk of under-immunization [17], [20] and [21]. For example, community health workers in Rwanda [21] and social workers in Scotland [17] helped identify adolescents absent from schools and directed them to local health centers for HPV vaccination. Studies suggest that some team members may have misconceptions about vaccine-preventable infections, vaccine efficacy and safety, and parental beliefs [97] and [98], which could shape their conversations with adolescents and parents. However, data describing their STI vaccine communication with adolescents and parents are lacking. Thus, further examination of the role that other members of the adolescent health care team play in STI vaccine uptake, their communication with patients and families, and barriers and facilitators of appropriate communication is needed. Education of the entire adolescent health care team may be an effective way to enhance communication about STI vaccines.