Practice-Based Strategies to Increase HPV Vaccination Rates

Research Article| April 01 2024 Practice-Based Strategies to Increase HPV Vaccination Rates AAP Grand Rounds (2024) 51 (4): 39. https://doi.org/10.1542/gr.51-4-39 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Practice-Based Strategies to Increase HPV Vaccination Rates. AAP Grand Rounds April 2024; 51 (4): 39. https://doi.org/10.1542/gr.51-4-39 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: human papilloma virus vaccine Source: Rutten LJ, Griffin JM, St. Sauver JL, et al. Multilevel implementation strategies for adolescent human papillomavirus vaccine uptake: a cluster randomized clinical trial. JAMA Pediatr. 2024;178(1):29-36; doi: https://doi.org/10.1001/jamapediatrics.2023.4932.Google Scholar Investigators from the Mayo Clinic, Rochester, MN, and Scottsdale, AZ, and Yale University, New Haven, CT, conducted a cluster randomized clinical trial with a stepped-wedge design to assess the effectiveness of 2 practice-based interventions in increasing human papillomavirus (HPV) vaccination rates in 11- and 12-year-old adolescents. The study was conducted at 6 Mayo Clinic primary care practices providing care for children. The trial consisted of 4 12-month steps in each practice, including usual care and the 2 interventions (parent reminder/recall and provider audit and feedback), which were provided separately or in combination. During the first step, usual care was assessed in all practices, and for the fourth step, both interventions were used in all practices. During blocks 2 and 3, the intervention employed was randomly determined for each practice. Parent reminder/recall consisted of a letter to parents of patients seen at participating practices who were eligible for an HPV vaccine at the time of their 11th or 12th birthday. The letter informed the parent about all immunizations due in their child and encouraged vaccination. The audit/feedback intervention consisted of an email sent to health care providers that summarized the rate of HPV vaccination in their patients. Study data, including demographics and vaccinations, were abstracted from the electronic health record (EHR). The primary study outcome was the HPV vaccination rate during each of the 4 steps, defined as the number of 11- and 12-year-old patients in a practice who received a dose of HPV vaccine during the period divided by all eligible 11- and 12-year-old youths in the practice. Mixed effect logistic regression was used to compare the effectiveness of the interventions to usual care in increasing HPV vaccination rates. Subgroup analyses of male and female patients also were conducted. Data were analyzed on 9,242 youths. HPV vaccination rates were 21.9% with usual care, 34.6% with parent reminder/recall, 30.4% with provider audit/feedback, and 39.7% when both interventions were used in combination. Compared to usual care, HPV vaccination rates increased significantly with the parent reminder/recall intervention (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.23, 1.97) and when both interventions were used simultaneously (OR, 2.03; 95% CI, 1.44, 2.85). Provider audit/feedback alone was not associated with a significantly increased HPV vaccination rate (OR, 1.19; 95% CI, 0.94, 1.51). When males and females were analyzed separately, both individual interventions and the combination of interventions were associated with significantly increased HPV vaccination rates in males; parent reminder/recall and combined interventions were associated with increased rates in females. The authors conclude that the combination of parent recall/reminder and provider audit/feedback were effective in increasing HPV vaccination rates in adolescents. Dr Goyal has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of... You do not currently have access to this content.