Effects of an intervention promoting HPV vaccination in an urban safety-net healthcare system
OBJECTIVE: Assess effects of brochure and telephone recalls/reminders on HPV vaccine coverage in adolescent females attending safety-net clinics with a randomized trial.
SETTING: Parkland Health & Hospital System provides critical outreach to Dallas County, the 9th largest US county (34% White, 20% Black, 39% Hispanic). Over 14,000 adolescents are seen in 21 neighborhood- and school-based clinics annually.
METHODS: We randomized parents of unvaccinated females aged 11-18 who had an upcoming visit. Parents were mailed either a HPV vaccine-specific brochure (Intervention n=375) or a general adolescent vaccine brochure (Control n=365), and invited to complete a survey immediately before the visit. Intervention parents who completed the survey also received a telephone recall after two weeks if they declined the vaccine and telephone reminders if they initiated the series and failed to complete Dose 2 or 3. We ascertained by EMR review 1- and 3-dose coverage within 12 months of randomization.
RESULTS: Among survey completers (Int. n=164; Con. n=173), about half received Dose 1 at the visit (Int. 49.4%; Con. 44.5%). After 12 months, the 3-dose coverage rates were significantly higher in the Intervention vs. Control group (28.7% vs. 15.6%, p=0.004).
CONCLUSIONS: Our multi-component intervention improved 3-dose HPV coverage in urban safety-net adolescents. These parent-targeted outreach strategies complement Parkland's provider strategies that include a standing order policy and EMR alerts.
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences
Describe the design of a multi-component HPV intervention trial consisting of mailed brochure and telephone recall/reminders in an urban safety-net health care system. Discuss findings and implications of the intervention trial.
Keywords: Adolescent Health, Immunizations
Qualified on the content I am responsible for because: My work focuses on multi-level intervention research to promote the HPV vaccine specifically among underserved populations seen by urban safety-net healthcare systems.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.