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.
- 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.
Theory-based development of an implementation intervention to increase HPV vaccination in pediatric primary care practices
March 13, 2018
Garbutt JM, Dodd S, Walling E, Lee AA, Kulka K, Lobb R. Theory-based development of an implementation intervention to increase HPV vaccination in pediatric primary care practices. Implement Sci. 2018 Mar 13;13(1):45. doi: 10.1186/s13012-018-0729-6. PMID: 29534761; PMCID: PMC5850961.
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
African American parents’ attitudes toward HPV vaccination
February 1, 2013
Sanders Thompson VL, Arnold LD, Notaro SR. African American parents’ HPV vaccination intent and concerns. J Health Care Poor Underserved. 2012 Feb;23(1):290-301. doi: 10.1353/hpu.2012.0007. PMID: 22643477; PMCID: PMC3601894.
African American Parents’ HPV Vaccination Intent and Concerns
July 1, 2011
Thompson VL, Arnold LD, Notaro SR. African American parents’ attitudes toward HPV vaccination. Ethn Dis. 2011 Summer;21(3):335-41. PMID: 21942167; PMCID: PMC3498955.
Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature
January 1, 2014
Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S. Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature. JAMA Pediatr. 2014 Jan;168(1):76-82. doi: 10.1001/jamapediatrics.2013.2752. PMID: 24276343; PMCID: PMC4538997.
Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls
February 25, 2015
Perkins RB, Zisblatt L, Legler A, Trucks E, Hanchate A, Gorin SS. Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls. Vaccine. 2015 Feb 25;33(9):1223-9. doi: 10.1016/j.vaccine.2014.11.021. Epub 2014 Nov 24. PMID: 25448095.
Missed opportunities for HPV vaccination in adolescent girls: a qualitative study
September 1, 2014
Perkins RB, Clark JA, Apte G, Vercruysse JL, Sumner JJ, Wall-Haas CL, Rosenquist AW, Pierre-Joseph N. Missed opportunities for HPV vaccination in adolescent girls: a qualitative study. Pediatrics. 2014 Sep;134(3):e666-74. doi: 10.1542/peds.2014-0442. PMID: 25136036.
Practice- and Community-Based Interventions to Increase Human Papillomavirus Vaccine Coverage: A Systematic Review
July 1, 2015
Niccolai LM, Hansen CE. Practice- and Community-Based Interventions to Increase Human Papillomavirus Vaccine Coverage: A Systematic Review. JAMA Pediatr. 2015 Jul;169(7):686-92. doi: 10.1001/jamapediatrics.2015.0310. PMID: 26010507; PMCID: PMC4862306.