# Knowledge, Attitudes, and Practices Associated with Human Papillomavirus Vaccine Recommendation Among Healthcare Professionals: A Cross-Sectional Study

## TL;DR

This study explores how healthcare professionals in Jordan recommend the HPV vaccine, finding that attitudes and active practice matter more than knowledge.

## Contribution

The study reveals that higher knowledge unexpectedly correlates with lower vaccine recommendation rates among healthcare professionals.

## Key findings

- Positive attitudes and active clinical practice strongly predict HPV vaccine recommendation.
- Higher knowledge scores were associated with a reduced likelihood of recommending the vaccine.
- Physicians and academic staff showed higher engagement in HPV vaccine recommendation.

## Abstract

Background: Cervical cancer remains a significant global public health concern, with human papillomavirus (HPV) vaccination serving as an effective preventive measure. Despite its proven efficacy, HPV vaccine uptake in Jordan remains low. This study aimed to assess the knowledge, attitudes, and practices (KAP) influencing HPV vaccine recommendation among healthcare professionals. Methods: A cross-sectional survey was conducted between August 2023 and February 2024 among 304 healthcare professionals and trainees in Amman, Jordan, using a pre-validated questionnaire. Descriptive statistics, correlational analyses, and Firth’s penalized logistic regression were employed to examine predictors of vaccine recommendation behavior. Results: Positive attitudes (OR = 3.89; p < 0.001) and active clinical practice (OR = 5.02; p < 0.001) were strong predictors of HPV vaccine recommendation. Unexpectedly, higher knowledge scores were associated with reduced likelihood of recommending the vaccine (OR = 0.44; p = 0.032). Significant variation in KAP scores was observed across professional groups, with physicians and academic staff demonstrating higher levels of engagement. Conclusions: Attitudes and practical engagement were more influential than knowledge alone in shaping HPV vaccine recommendation behavior among healthcare professionals. These findings underscore the need for interventions that not only enhance knowledge but also foster supportive attitudes and strengthen clinical advocacy skills. The results provide actionable evidence to inform targeted strategies for increasing HPV vaccine uptake and reducing cervical cancer incidence in Jordan.