Form 9017-0036 HPV Survey

Dental Professionals & Human Papillomavirus (HPV) Prevention Survey

The purpose of this survey is to find new avenues for HPV prevention through oral health. Thank you in advance for your contribution.

Please complete sections 1 and 2 prior to the presentation. After the presentation, please complete section 3.

SECTION 1: SOCIODEMOGRAPHICS

1) What is your racial background?  American Indian/Alaskan Native  Asian  Black/African American  Native Hawaiian/Pacific Islander  White/Caucasian  Other (please specify): ____________ 2) How old are you?  18 to 30  51 to 60  31 to 40  >60  41 to 50 3) What is your sex?  Female  Male 4) What is the person's highest level of education and current job?  Secondary/high school/GED equivalent  Vocational/technical school  Bachelor's Degree  Graduate/Professional Degree  Other (please specify):

5) Current job:  Dentist  Dental Therapist  Dental Hygienist  Other (please specify):  Dental Assistant 6) Which of the following identifies your facility?  IHS/Federal  Urban  Tribal  Other  7) In which of the following IHS Areas do you work?   Alaska  Navajo  Albuquerque  Oklahoma City  Bemidji  Phoenix  Billings  Portland  California  Tucson  Great Plains  HQ  Nashville  Other (please specify): 8) Have you already participated on any educational activities on HPV prevention in the last 2 years? Select all that apply.  Yes, IHS webinar/training  No  Yes, non-HIS webinar/training

SECTION 2: PRE-QUESTIONNAIRE

1) Did you hear of human papillomavirus (HPV) before today? Yes No I don’t know 2) Is HPV infection rare? Yes No I don’t know 3) Is HPV a Sexually Transmitted Infection (STI)? Yes No I don’t know 4)Which of the following cancers may be caused by HPV? (check all that apply) Cervical cancer Breast cancer Anal cancer Penile cancer Vulvar cancer Vaginal cancer Head and neck (oropharyngeal) cancer 5)What percent of sexually active women and men are infected with HPV? 5% 20% 10% 80%

6) The HPV vaccine is recommended by the Advisory Committee on Immunization Practices for (check all that apply) 30 y.o. woman with cervical cancer Girls 9-12 years 25 y.o. woman with an abnormal pap Boys 9-12 years 7) If someone has HPV, they will develop cancer at some point. True False It depends 8) Do you think that HPV would go away on its own without treatment? Yes No I don’t know 9) Do you think that HPV can be prevented? Yes No I don’t know 10) Do you think that HPV can cause genital warts? Yes No I don’t know

11) Which of these do you think the HPV vaccine can reduce or prevent? (check all that apply) Cervical cancer Head and neck cancers Chlamydia Genital warts HIV 12) How comfortable do you feel talking to patients about the HPV vaccine? Very comfortable Not very comfortable A little comfortable Not at all comfortable 13) I currently discuss the connection between HPV and oropharyngeal cancer with my patients or their parents? No, and I do not intend to start No, but I have considered it Yes, but only with some patients  Yes, with all or most (75% or more) of my patients Other (please specify): 14) Why do you not currently discuss the connection between HPV and oropharyngeal cancer with your patients? I don’t have enough information Practice setting is not sufficiently private Discomfort discussing sexual history with my patients I cannot provide an HPV vaccine to my patients Concern with safety of vaccine Not my role as oral health provider Appointments not long enough Liability Reasons No professional policies/guidelines Other (please specify):­­­­­­­­­­ I discuss the connection between HPV and oropharyngeal cancer with my patients 15) Which of the following tools for increasing education and acceptance of HPV vaccination are most useful to you? Select all that apply. Informational flyers or brochures tailored to specific parental concerns Information for parents provided before clinic visit Discussion guide or health script for oral health professionals Information catered to cultural or ethical preferences Education for oral health professionals regarding HPV Other (please specify): None

16) What are the current policies/practices in your facility regarding the discussion of the link between HPV and oral cancer? ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ 17) At your facility have you received education/ trainings about HPV? Yes No I don’t know 18) If training could be provided, what format of training would be beneficial to your facility? Select all that apply. In person Offline self-study Webinar Other (please specify): Online self-study 19) Do you have any other suggestions for how to improve HPV vaccination and the possible role of the oral health community in this? ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________

SECTION 3: POST-QUESTIONNAIRE

1) Do you think HPV infection is rare? Yes No I don’t know 2) Do you think HPV is a Sexually Transmitted Infection (STI)? Yes No I don’t know 3)Which of the following cancers may be caused by HPV (check all that apply) Cervical cancer Breast cancer Anal cancer Penile cancer Vulvar cancer Vaginal cancer Head and neck (oropharyngeal) cancer 4)What percent of sexually active women and men are infected with HPV? 5% 20% 10% 80% 5) The HPV vaccine is recommended by the Advisory Committee on Immunization Practices for (check all that apply) 30 y.o. woman with cervical cancer Girls 9-12 years 25 y.o. woman with an abnormal pap Boys 9-12 years 6)If someone has HPV, they will develop cancer at some point. True False It depends 7) Do you think that HPV would go away on its own without treatment? Yes No I don’t know 8) Do you think that HPV can be prevented? Yes No I don’t know 9) Do you think that HPV can cause genital warts? Yes No I don’t know 10) Which of these do you think the HPV vaccine can reduce or prevent? (Check all that apply) Cervical cancer Head and neck cancers Chlamydia Genital warts HIV 11) How comfortable do you feel talking to patients about the HPV vaccine? Very comfortable Not very comfortable A little comfortable Not at all comfortable

12) How likely are you to use the information in the HPV toolkit in your clinic? not at all 1 2 3 4 5 extremely likely 13) This seminar improved my HPV knowledge. Strongly Agree Somewhat Disagree Somewhat Agree Strongly Disagree Neutral 14) I am more likely to recommend the HPV vaccine after this seminar. Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree 15) Do you have ideas/recommendations to improve HPV education/outreach in your tribal community? ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ 16) The information presented today was valuable to me not at all 1 2 3 4 5 extremely likely 17) The information presented today was new to me not at all 1 2 3 4 5 extremely likely 18) The information presented today was easy to understand not at all 1 2 3 4 5 extremely likely 19) Would you feel comfortable administering the HPV vaccine if it is within your scope of practice as a dentist? Very comfortable Not very comfortable A little comfortable Not at all comfortable

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