title: Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls.
abstract: BACKGROUND
  HPV vaccination is universally recommended for boys and girls, yet vaccination rates remain low nationwide.
  
  
  METHODS
  We conducted a provider-focused intervention that included repeated contacts, education, individualized feedback, and strong quality improvement incentives to raise HPV vaccination rates at two federally qualified community health centers. To estimate the effectiveness of the intervention, rates of initiation of vaccination, and completion of the next needed HPV vaccination (dose 1, 2 or 3) among boys and girls ages 11-21 were compared at baseline and two follow-up periods in two intervention health centers (n4093 patients) and six control health centers (n9025 patients). We conducted multivariable logistic regression accounting for clustering by practice.
  
  
  RESULTS
  Girls and boys in intervention practices significantly increased HPV vaccine initiation during the active intervention period relative to control practices (girls OR 1.6, boys OR 11; p<0.001 for both). Boys at intervention practices were also more likely to continue to initiate vaccination during the post-intervention/maintenance period (OR 8.5; p<0.01). Girls and boys at intervention practices were more also likely to complete their next needed HPV vaccination (dose 1, 2 or 3) than those at control practices (girls OR 1.4, boys OR 23; p<0.05 for both). These improvements were sustained for both boys and girls in the post-intervention/maintenance period (girls OR 1.6, boys OR 25; p<0.05 for both).
  
  
  CONCLUSIONS
  Provider-focused interventions including repeated contacts, education, individualized feedback, and strong quality improvement incentives have the potential to produce sustained improvements in HPV vaccination rates.
authors.affiliation: Boston University School of Medicine/Boston Medical Center, Department of Obstetrics and Gynecology, 85 E. Concord St 6th Floor Boston MA 02118, USA. Electronic address: rbperkin@bu.edu.
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: Perkins
authors.affiliation: Boston University School of Medicine Continuing Medical Education, Boston MA, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Zisblatt
authors.affiliation: Veterans Affairs Boston Healthcare System, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Legler
authors.affiliation: Boston University School of Medicine Continuing Medical Education, Boston MA, USA.
authors.forename: Emma
authors.initials: E
authors.lastname: Trucks
authors.affiliation: Veterans Affairs Boston Healthcare System/Boston University School of Medicine, Boston MA, USA.
authors.forename: Amresh
authors.initials: A
authors.lastname: Hanchate
authors.affiliation: Leidos Biomedical Research Inc. [SAIC], Division of Cancer Control and Population Sciences, NCI, NIH, Bethesda, MD, USA; New York Physicians against Cancer (NYPAC), Herbert Irving Comprehensive Cancer Center, New York, NY, USA.
authors.forename: Sherri Sheinfeld
authors.initials: SS
authors.lastname: Gorin
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D005260:Female; D006266:Health Education; D006282:Health Personnel; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccination; Intervention; Provider education; Quality improvement