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. 2017 Aug;61(2):252-258.
doi: 10.1016/j.jadohealth.2017.02.019. Epub 2017 Apr 24.

Improving Human Papillomavirus Vaccine Use in an Integrated Health System: Impact of a Provider and Staff Intervention

Huong Q McLean  1 , Jeffrey J VanWormer  2 , Brian D W Chow  3 , Becky Birchmeier  4 , Elizabeth Vickers  2 , Edna DeVries  5 , James Meyer  5 , Jeffrey Moore  6 , Michael M McNeil  7 , Shannon Stokley  8 , Julianne Gee  7 , Edward A Belongia  2
Affiliations

Improving Human Papillomavirus Vaccine Use in an Integrated Health System: Impact of a Provider and Staff Intervention

Huong Q McLean et al. J Adolesc Health. 2017 Aug.

Abstract

Purpose: Acceptance and coverage of the human papillomavirus (HPV) vaccine in the United States has been suboptimal. We implemented a multifaceted provider and staff intervention over a 1-year period to promote HPV vaccination in a regional health care system.

Methods: The intervention was conducted in nine clinical departments from February 2015 to March 2016; 34 other departments served as controls. The intervention included in-person provider and staff education, quarterly feedback of vaccine coverage, and system-wide changes to patient reminder and recall notifications. Change in first-dose HPV vaccine coverage and series completion were estimated among 11- to 12-year-olds using generalized estimating equations adjusted for age and sex.

Results: HPV vaccine coverage in the intervention departments increased from 41% to 59%, and the increase was significantly greater than that seen in the control departments (32%-45%, p = .0002). The largest increase occurred in the quarter after completion of the provider and staff education and a patient reminder and recall postcard mailing (p = .004). Series completion also increased significantly system wide among adolescents aged 11-12 years following mailing of HPV vaccine reminder letters to parents of adolescents aged 12 years rather than 16 years.

Conclusions: HPV vaccine uptake can be improved through a multifaceted approach that includes provider and staff education and patient reminder/recall. System-level change to optimize reminder and recall notices can have substantial impact on HPV vaccine utilization.

Keywords: HPV; Health care providers; Health system; Human papillomavirus vaccines; Intervention; Quality improvement.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
HPV vaccine coverage among 11- to 12-year-olds and 13- to 17-year-olds by quarter and intervention and control departments, 2013—2016. Shaded area represent intervention period. ap = .03 for comparison between differences in the increase in coverage from Q1 to Q2 2015 between intervention and control departments among 13- to 17-year-olds. bp = .004 for comparison between differences in the increase in coverage from Q3 to Q4 2015 between intervention and control departments among 11- to 12-year-olds. cp = .0002 and p = .02 for comparison between differences in the increase in coverage from Q1 to Q2 2016 between intervention and control departments among 11- to 12-year-olds and 13- to 17-year-olds, respectively.
Figure 2.
Figure 2.
HPV vaccine series completion among 11- to 12-year-olds and 13- to 17-year-olds who have initiated the HPV series >7 months before the end of the measurement period by quarter and intervention and control departments, 2013—2016.
See this image and copyright information in PMC

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