Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls |
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| Institution: | 1. Boston University School of Medicine/Boston Medical Center, Department of Obstetrics and Gynecology, 85 E. Concord St 6th Floor Boston MA 02118, USA;2. Boston University School of Medicine Continuing Medical Education, Boston MA, USA;3. Veterans Affairs Boston Healthcare System, USA;4. Veterans Affairs Boston Healthcare System/Boston University School of Medicine, Boston MA, USA;5. Leidos Biomedical Research Inc. [SAIC], Division of Cancer Control and Population Sciences, NCI, NIH, Bethesda, MD, USA;6. New York Physicians against Cancer (NYPAC), Herbert Irving Comprehensive Cancer Center, New York, NY, USA;1. Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building Phase 2, City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK;2. Leicester City Council, Public Health Directorate, New Walk Centre, Leicester, LE1 6ZG, UK;1. Planned Parenthood Federation of America, 434 West 33rd Street, New York, NY 10001, United States;2. Division of Family Planning, Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, 1900 West Polk Street, 5th Floor, Chicago, IL 60612, United States;3. Westport Compass, 3011 S. Plateau, Salt Lake City, UT 84109, United States;1. Clinical Research Institute and Goldberg Center for Community Pediatric Health, Children''s National Health System, 111 Michigan Ave, NW Washington, DC, WA 20010, United States;2. Western Sydney Sexual Health Centre, The University of Sydney, Level 4 Jeffery House, 162 Marsden Street, Parramatta 2150, NSW, Australia;3. Betty Irene Moore School of Nursing, University of California, Davis, CA, 4610 “X” Street, Sacramento, CA 95817 United States;4. Department of Pediatrics, Indiana University, 410 W. 10th Street, HS 1001, Indianapolis, IN 46202, United States |
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| Abstract: | BackgroundHPV vaccination is universally recommended for boys and girls, yet vaccination rates remain low nationwide.MethodsWe conducted a provider-focused intervention that included repeated contacts, education, individualized feedback, and strong quality improvement incentives to raise HPV vaccination rates at two federally qualified community health centers. To estimate the effectiveness of the intervention, rates of initiation of vaccination, and completion of the next needed HPV vaccination (dose 1, 2 or 3) among boys and girls ages 11–21 were compared at baseline and two follow-up periods in two intervention health centers (n  4093 patients) and six control health centers (n 9025 patients). We conducted multivariable logistic regression accounting for clustering by practice.ResultsGirls and boys in intervention practices significantly increased HPV vaccine initiation during the active intervention period relative to control practices (girls OR 1.6, boys OR 11; p < 0.001 for both). Boys at intervention practices were also more likely to continue to initiate vaccination during the post-intervention/maintenance period (OR 8.5; p < 0.01). Girls and boys at intervention practices were more also likely to complete their next needed HPV vaccination (dose 1, 2 or 3) than those at control practices (girls OR 1.4, boys OR 23; p < 0.05 for both). These improvements were sustained for both boys and girls in the post-intervention/maintenance period (girls OR 1.6, boys OR 25; p < 0.05 for both).ConclusionsProvider-focused interventions including repeated contacts, education, individualized feedback, and strong quality improvement incentives have the potential to produce sustained improvements in HPV vaccination rates. |
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| Keywords: | HPV vaccination Provider education Intervention Quality improvement |
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