Martha J Goleman1, Millie Dolce2, Jennifer Morack2. 1. Nationwide Children's Hospital (Drs Goleman and Dolce, and Ms Morack); The Ohio State University College of Medicine (Dr Goleman), Columbus, Ohio. Electronic address: Jane.Goleman@nationwidechildrens.org. 2. Nationwide Children's Hospital (Drs Goleman and Dolce, and Ms Morack).
Abstract
OBJECTIVE: Adolescent human papillomavirus (HPV) vaccine rates remain low. Early vaccination may improve the efficacy of the vaccine and immunization rates; however, clinicians have not routinely made a strong recommendation for younger adolescents. This study assessed the feasibility of routine vaccination at 9 years of age. METHODS: Three sequential quality improvement (QI) interventions were implemented to shift the initiation of the HPV vaccine to 9 years of age in a primary care network in low-income neighborhoods in Columbus, Ohio. The first intervention changed the electronic medical record alert for the HPV vaccine from 11 to 9 years of age and focused on cancer prevention when discussing the vaccine with families. The second intervention was formation of an HPV QI team. The third intervention was a clinic incentive for HPV captured opportunity rates. Immunization rates were monitored using statistical process control charts to compare the HPV immunization rate in a sample of 9- and 10-year-old children with a sample of 11- and 12-year-old children. RESULTS: The percentage of patients receiving an HPV vaccine before 11 years increased from 4.6% to 35.7% during the 6 months after the QI initiative began and to 60.8% 18 months after the project began. In comparison, the HPV vaccination rate in the sample of 11- and 12-year-olds increased from 78.7% to 82.8% 18 months later. CONCLUSIONS: This QI project used multiple interventions to increase HPV vaccination at 9 years of age in a large primary care network serving a diverse low-income population.
OBJECTIVE: Adolescent human papillomavirus (HPV) vaccine rates remain low. Early vaccination may improve the efficacy of the vaccine and immunization rates; however, clinicians have not routinely made a strong recommendation for younger adolescents. This study assessed the feasibility of routine vaccination at 9 years of age. METHODS: Three sequential quality improvement (QI) interventions were implemented to shift the initiation of the HPV vaccine to 9 years of age in a primary care network in low-income neighborhoods in Columbus, Ohio. The first intervention changed the electronic medical record alert for the HPV vaccine from 11 to 9 years of age and focused on cancer prevention when discussing the vaccine with families. The second intervention was formation of an HPV QI team. The third intervention was a clinic incentive for HPV captured opportunity rates. Immunization rates were monitored using statistical process control charts to compare the HPV immunization rate in a sample of 9- and 10-year-old children with a sample of 11- and 12-year-old children. RESULTS: The percentage of patients receiving an HPV vaccine before 11 years increased from 4.6% to 35.7% during the 6 months after the QI initiative began and to 60.8% 18 months after the project began. In comparison, the HPV vaccination rate in the sample of 11- and 12-year-olds increased from 78.7% to 82.8% 18 months later. CONCLUSIONS: This QI project used multiple interventions to increase HPV vaccination at 9 years of age in a large primary care network serving a diverse low-income population.
Authors: Mari-Lynn Drainoni; Dea Biancarelli; Emily Jansen; Judith Bernstein; Natalie Joseph; Terresa J Eun; Anny H T R Fenton; Jack A Clark; Amresh Hanchate; Aaron Legler; Thomas J Schuch; Karin Leschly; Rebecca B Perkins Journal: J Contin Educ Health Prof Date: 2021-07-01 Impact factor: 1.355
Authors: Van C Willis; Kelly Jean Thomas Craig; Yalda Jabbarpour; Elisabeth L Scheufele; Yull E Arriaga; Monica Ajinkya; Kyu B Rhee; Andrew Bazemore Journal: JMIR Med Inform Date: 2022-01-21