Program Director/Principal Investigator (Last, First, Middle): Liebermann, Erica Project Summary/Abstract Human papillomavirus (HPV) is the most common sexually transmitted infection in the US; there were 43 million HPV infections in the US in 2018 and most of those infections were in teens and young adults. Though many infections may resolve on their own, persistent infection with HPV can cause cervical cancer and other types of cancers. The HPV vaccine is a critical tool for preventing HPV infection but has been underutilized in the US to date. HPV Vaccine completion remains well below the Healthy People 2030 targets of 80% vaccine completion for adolescents. The Centers for Disease Control and Prevention (CDC)'s Advisory Committee on Immunization Practices (ACIP) recommends vaccinating children ages 11-12 with two doses of HPV vaccine 6-12 months apart; the ACIP also recommends catch-up vaccination for unvaccinated adolescents and adults up to age 26, with three doses of vaccine. The college student population represents an important group for catch-up vaccination as many students have insurance coverage, have access to student health services, and are beginning to make their own health decisions. However, recent surveys indicate that only about half of college students report they have completed HPV vaccination. College health centers are an ideal setting in which to identify teens and young adults who have not yet completed HPV vaccination. Offering HPV vaccine to unvaccinated or under-vaccinated students is an important public health intervention to reduce the burden of HPV infection and its future health consequences. The aim of the proposed mixed methods study is to better understand college healthcare providers' attitudes, beliefs and practices related to HPV vaccination and identify their barriers and facilitators to vaccinating college students. There is limited information about college healthcare provider practices related to HPV vaccine (assessing HPV vaccination history, recommending and offering vaccine). We propose a sequential explanatory mixed methods study that will examine healthcare provider attitudes and beliefs and the multi-level influences of healthcare provider practices related to HPV vaccine. The study utilizes quantitative data regarding college healthcare providers' HPV vaccine-related attitudes and behaviors/practices from a national study of college healthcare providers from 480 colleges across the US. Guided by the Consolidated Framework for Implementation Research (CFIR), we will conduct follow-up interviews with a subsample of college healthcare providers who participated in the national survey to explore individual provider-level (e.g., knowledge, attitudes, beliefs) and multisystem-level factors (e.g., college type, state policies, organizational climate, relative priority, change capacity) influencing HPV vaccine uptake in the college health setting. The long-term goal of this research is to generate new kno...