I am delighted that our intervention Give Teens Vaccines has been added to the RTIPs repository.
The HPV vaccine can prevent about 70% of all cervical cancer, 90% of all genital warts, and substantial numbers of oropharangeal cancers. In 2006, the national Advisory Committee on Immunization Practices (ACIP) recommended the HPV vaccination for all girls aged 11-12 years, and extended that recommendation to boys aged 11-12 years in 2011. These recommendations are designed to promote vaccination when the vaccine is most effective: before the initiation of sexual activity and exposure to HPV.
However, parents’ beliefs about the vaccine may also influence clinicians’ intentions to vaccinate: clinicians can be reluctant to recommend vaccination due to perceived parental concerns.
Using this information, my colleagues and I designed and tested an intervention using electronic medical record (EMR) data to improve HPV vaccination rates. The “decision support” system targeted both families and clinicians.
- The clinician-focused intervention had three components: (1) electronic alerts for routine adolescent vaccinations when a patient’s EMR was opened, (2) a one-hour online or in-person educational presentation about vaccine safety, efficacy, and strategies for overcoming barriers to vaccine receipt, with site-specific HPV vaccination rates, and (3) three quarterly feedback reports on individual, practice, and network rates.
- The family-focused intervention featured automated reminder calls about well-visit or follow-up appointments. The calls also emphasized that the vaccine was recommended by the clinician and referred families to a website containing information on adolescent vaccines.
- From May 2010-May 2011, CHOP primary care practices sites were randomized to either receive the clinician-focused intervention or no intervention. Within these practice sites, 22,486 girls (11-17 years) due for HPV vaccine dose 1, 2, or 3 were randomized to either receive the family-focused intervention or usual care. At the start, 79% of the girls had not received any doses of the vaccine.
After 12 months, the combined clinician and family-focused intervention resulted in significantly higher HPV vaccination rates compared to usual care, and reduced delays in initiating vaccination.
I would be interested in your questions about Give Teen Vaccines interventions and your experiences with low-cost interventions that support both clinicians and families with information and reminders.