Human Papillomavirus (HPV) Vaccines

We will complete a single site cluster-randomized trial to evaluate the effectiveness of a multi-component implementation strategy to increase use of the HPV vaccine according to CDC guidelines. Twenty practices will be randomized into two groups, the 2-year intervention group (n=10) or a wait-list control group (n=10). The intervention includes: 1) an educational video to increase the provider’s knowledge about guideline recommendations and patient and practice benefits of vaccination by age 13; 2) audit and feedback of vaccine coverage to increase motivation to engage in practice change; 3) a communication strategy to improve providers’ communication skills and their self-efficacy to address parental hesitation; and 4) practice facilitation to support practice change to develop a sustainable HPV vaccine delivery system. The intervention will be delivered through a series of brief practice visits with the facilitator that occur every 1-4 weeks over 2-years.

The wait-list control group practices will be offered the intervention in years 3 and 4 of the project.

Current Status

• NIH R01 grant: Randomized Controlled Trial to Evaluate an Implementation Strategy to Increase Optimal Use of HPV Vaccine in Primary Care
• Pilot testing of intervention completed.

Theory-Based Intervention Development

The national guideline recommend completion of the 2-dose human papillomavirus (HPV) vaccine series before the 13th birthday; however, this recommendation is poorly implemented in primary care, and interventions to increase implementation of this guideline have had little impact. We used a theory-informed approach to identify facilitators and barriers for implementation of the HPV vaccine guideline in primary care practices, and to identify strategies to address these behaviors. The intervention targets provider behavior change and was designed to be delivered using practice facilitation, educational outreach visits, and cyclical small tests of change.

Resources

Centers for Disease Control and Prevention

• Human Papillomavirus (HPV) and Cancer
• Genital HPV Infection – CDC Fact Sheet
• 2015 Recommended Immunizations for Children from 7 Through 18 Years Old

Selected Literature