Background. CDC awarded the American Cancer Society (ACS) a 5-year cooperative agreement to increase HPV vaccination rates. Under this award, ACS implemented an HPV Vaccination Maintenance of Certification (MOC) pilot program in collaboration with Federally Qualified Health Centers (FQHCs) to increase HPV vaccination rates among underserved adolescents, including rural, minority and immigrant populations through quality improvement and evidence-based intervention implementation including improved provider awareness, education, and system-wide processes. RTI International evaluated the HPV Pilot MOC at participating FQHCs.

Methods. RTI conducted site visits with two FQHCs implementing the HPV Pilot MOC: an urban system in New Orleans, Louisiana and a rural system in San Angelo, Texas. Site visits included interviews with clinic and local ACS staff and observational assessment of clinics. RTI conducted thematic analyses of collected qualitative data.

Results. Having an engaged ACS staff person overseeing HPV Pilot MOC implementation (e.g., organize/co-lead provider trainings, attend clinic staff meetings), in conjunction with local clinic champions, were major drivers of success. Buy-in from senior clinic leadership was critical to staff buy-in and overall success of the pilot. Parental resistance to HPV vaccination was a barrier at both sites. Initiation of HPV vaccination increased at both clinics after the HPV Pilot MOC (15.7% at the urban LA FQHC, 39.7% at the rural TX FQHC), as did vaccine series completion (12.5% at urban Louisiana FQHC, 13.3% at the rural Texas FQHC).

Conclusions. ACS successfully implemented the HPV Pilot MOC as a provider education and systems change intervention to promote cancer prevention in underserved populations. The pilot’s effectiveness is demonstrated by increases in initiation and completion rates for the HPV vaccine.