https://doi.org/10.3389/fdgth.2021.719138

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Successful Multi-Level HPV Vaccination Intervention at a Rural Healthcare Center in the Era of COVID-19

Deanna Kepka, Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah
Kaila Christini, Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah
Emily McGough, Telluride Regional Medical Center
Anna Wagner, College of Nursing, University of Utah
Guilherme Del Fiol, Department of Biomedical Informatics, University of Utah
Bryan Gibson, Department of Biomedical Informatics, University of Utah
Shauna Ayres, Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah
Heather M. Brandt, University of South Carolina
Sara Mann, School of Medicine, University of Utah
Amanda F. Petrik, Kaiser Permanente Center for Health Research
Gloria D. Coronado, Kaiser Permanente Center for Health Research

© 2021 Kepka, Christini, McGough, Wagner, Del Fiol, Gibson, Ayres, Brandt, Mann, Petrik and Coronado. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Abstract

To develop and test a human papillomavirus (HPV) vaccination intervention that includes healthcare team training activities and patient reminders to reduce missed opportunities and improves the rate of appointment scheduling for HPV vaccination in a rural medical clinic in the United States. The multi-level and multi-component intervention included healthcare team training activities and the distribution of patient education materials along with technology-based patient HPV vaccination reminders for parents/caregivers and young adult patients. Missed vaccination opportunities were assessed pre- and post-intervention ( = 402 and = 99, respectively) by retrospective chart review and compared using Pearson χ. The patient parent/caregiver and young adult patient population ( = 80) was surveyed following the reminder messages and penalized logistic regression quantified unadjusted odds of scheduling a visit. Missed opportunities for HPV vaccination declined significantly from the pre-intervention to the post-intervention period (21.6 vs. 8.1%, respectively, = 0.002). Participants who recalled receipt of a vaccination reminder had 7.0 (95% 2.4-22.8) times higher unadjusted odds of scheduling a visit compared with those who did not recall receiving a reminder. The unadjusted odds of confirming that they had scheduled or were intending to schedule a follow-up appointment to receive the HPV vaccine was 4.9 (95% 1.51-20.59) times greater among those who had not received the vaccine for themselves or for their child. Results from this intervention are promising and suggest that vaccination interventions consisting of provider and support staff education and parent/caregiver and patient education materials, and reminders can reduce missed opportunities for vaccinations in rural settings.