Peter Szilagyi1, Christina Albertin2, Dennis Gurfinkel3, Brenda Beaty3, Xinkai Zhou4, Sitaram Vangala4, John Rice3,5, Jonathan D Campbell6, Melanie D Whittington6, Rebecca Valderrama7, Abigail Breck7, Heather Roth8, Megan Meldrum9, Chi-Hong Tseng4, Cynthia Rand2, Sharon G Humiston10, Stanley Schaffer2, Allison Kempe11,3. 1. Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; pszilagyi@mednet.ucla.edu. 2. Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, New York. 3. Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine and. 4. Statistics Core and. 5. Department of Biostatistics Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado. 6. Clinical Pharmacy and. 7. Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. 8. Colorado Immunization Information System, Colorado Department of Public Health and Environment, Denver, Colorado. 9. New York State Immunization Information System, New York State Department of Health, Albany, New York; and. 10. Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri. 11. Departments of Pediatrics and.
Abstract
BACKGROUND: Although autodialer centralized reminder and recall (C-R/R) from state immunization information systems (IISs) has been shown to raise childhood vaccination rates, its impact on human papillomavirus (HPV) vaccination rates is unclear. METHODS: In a 4-arm pragmatic randomized controlled trial across 2 states, we randomly selected practices representative of the specialty (pediatrics, family medicine, and health center) where children received care. Within each practice, patients 11 to 17.9 years old who had not completed their HPV vaccine series (NY: N = 30616 in 123 practices; CO: N = 31502 in 80 practices) were randomly assigned to receive 0, 1, 2, or 3 IIS C-R/R autodialer messages per vaccine dose. We assessed HPV vaccine receipt via the IIS, calculated intervention costs, and compared HPV vaccine series initiation and completion rates across study arms. RESULTS: In New York, HPV vaccine initiation rates ranged from 37.0% to 37.4%, and completion rates were between 29.1% and 30.1%, with no significant differences across study arms. In Colorado, HPV vaccine initiation rates ranged from 31.2% to 33.5% and were slightly higher for 1 reminder compared with none, but vaccine completion rates, ranging from 27.0% to 27.8%, were similar. On adjusted analyses in Colorado, vaccine initiation rates were slightly higher for 1 and 3 C-R/R messages (adjusted risk ratios 1.07 and 1.04, respectively); completion rates were slightly higher for 1 and 3 C-R/R messages (adjusted risk ratios 1.02 and 1.03, respectively). CONCLUSIONS: IIS-based C-R/R for HPV vaccination did not improve HPV vaccination rates in New York and increased vaccination rates slightly in Colorado.
RCT Entities:
BACKGROUND: Although autodialer centralized reminder and recall (C-R/R) from state immunization information systems (IISs) has been shown to raise childhood vaccination rates, its impact on human papillomavirus (HPV) vaccination rates is unclear. METHODS: In a 4-arm pragmatic randomized controlled trial across 2 states, we randomly selected practices representative of the specialty (pediatrics, family medicine, and health center) where children received care. Within each practice, patients 11 to 17.9 years old who had not completed their HPV vaccine series (NY: N = 30 616 in 123 practices; CO: N = 31 502 in 80 practices) were randomly assigned to receive 0, 1, 2, or 3 IIS C-R/R autodialer messages per vaccine dose. We assessed HPV vaccine receipt via the IIS, calculated intervention costs, and compared HPV vaccine series initiation and completion rates across study arms. RESULTS: In New York, HPV vaccine initiation rates ranged from 37.0% to 37.4%, and completion rates were between 29.1% and 30.1%, with no significant differences across study arms. In Colorado, HPV vaccine initiation rates ranged from 31.2% to 33.5% and were slightly higher for 1 reminder compared with none, but vaccine completion rates, ranging from 27.0% to 27.8%, were similar. On adjusted analyses in Colorado, vaccine initiation rates were slightly higher for 1 and 3 C-R/R messages (adjusted risk ratios 1.07 and 1.04, respectively); completion rates were slightly higher for 1 and 3 C-R/R messages (adjusted risk ratios 1.02 and 1.03, respectively). CONCLUSIONS: IIS-based C-R/R for HPV vaccination did not improve HPV vaccination rates in New York and increased vaccination rates slightly in Colorado.
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