Evaluation of the Implementation of a Multicomponent Intervention to Improve Health Care Provider Communication About Human Papillomavirus Vaccination
Section snippets
Intervention Overview
A full description of the randomized controlled trial (RCT) can be found elsewhere14; here, we provide a brief overview. Practices recruited for the trial came from a practice-based research network in central Colorado. Eligibility criteria included having 1) a minimum of 400 active adolescent patients, 2) baseline HPV vaccination rates of <80%, and 3) HPV vaccines available at the clinic. Eight intervention and 8 control practices participated in the 12-month (February 2015–January 2016)
Results
Across the 4 study surveys, between 67% and 78% of total providers participating in the intervention completed surveys. Overall, 108 providers completed 1 or more of the surveys. Table 1 describes the respondents’ characteristics.
Discussion
Overall, results demonstrate that the fact sheet and MI were the most-used intervention components throughout the 12-month intervention period and thus likely the most impactful components of our intervention. This conclusion was further strengthened by the finding that providers also reported that the fact sheet and MI were the most useful of the intervention components. Additionally, in comparison with the other components, few providers reported that other intervention tools were sufficient
Conclusions
Overall, the current study suggests that the fact sheet and MI components of our multi-item provider HPV vaccine communication intervention were likely critical elements underlying the effectiveness of the intervention in our larger randomized trial. However, although the other intervention components were less used, when they were used, they were perceived as useful. Intervention component use overall was significantly lower in public clinics compared with private ones, likely explaining
Acknowledgments
Financial disclosure: The funding source for this study was the Centers for Disease Control and Prevention (5U01IP000801), who provided input into the main study (randomized controlled trial) design and data interpretation. The funding source had no direct involvement in the preparation of the manuscript.
References (23)
- et al.
Reasons for acceptance or refusal of human papillomavirus vaccine in a California pediatric practice
Papillomavirus Res.
(2017) - et al.
Providers’ time spent and tools used when discussing the HPV vaccine with parents of adolescents
Vaccine.
(2016) - et al.
Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children
Vaccine.
(2017) CDC Human Papillomavirus (HPV) and Cancer
(2017)- et al.
National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2016
MMWR Morb Mortal Wkly Rep.
(2017) Healthy People 2020
(2010)- et al.
Countering vaccine hesitancy
Pediatrics.
(2016) - et al.
Reasons for not vaccinating adolescents: national immunization survey of teens, 2008–2010
Pediatrics.
(2013) - et al.
Parent perception of provider interactions influences HPV vaccination status of adolescent females
Clin Pediatr (Phila).
(2016) - et al.
Factors that influence parental vaccination decisions for adolescents, 13 to 17 years old: national immunization survey teen, 2010
Clin Pediatr (Phila).
(2013)
A national study of HPV vaccination of adolescent girls: rates, predictors, and reasons for non-vaccination
Matern Child Health J.
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The authors have no conflicts of interest to disclose.