AUTHOR=Kepka Deanna , Christini Kaila , McGough Emily , Wagner Anna , Del Fiol Guilherme , Gibson Bryan , Ayres Shauna , Brandt Heather M. , Mann Sara , Petrik Amanda F. , Coronado Gloria D. 

TITLE=Successful Multi-Level HPV Vaccination Intervention at a Rural Healthcare Center in the Era of COVID-19

JOURNAL=Frontiers in Digital Health

VOLUME=3

YEAR=2021

URL=https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2021.719138

DOI=10.3389/fdgth.2021.719138

ISSN=2673-253X

ABSTRACT=<p><bold>Objectives:</bold> To develop and test a human papillomavirus (HPV) vaccination intervention that includes healthcare team training activities and patient reminders to reduce missed opportunities and improves the rate of appointment scheduling for HPV vaccination in a rural medical clinic in the United States.</p><p><bold>Methods:</bold> The multi-level and multi-component intervention included healthcare team training activities and the distribution of patient education materials along with technology-based patient HPV vaccination reminders for parents/caregivers and young adult patients. Missed vaccination opportunities were assessed pre- and post-intervention (<italic>n</italic> = 402 and <italic>n</italic> = 99, respectively) by retrospective chart review and compared using Pearson χ<sup>2</sup>. The patient parent/caregiver and young adult patient population (<italic>n</italic> = 80) was surveyed following the reminder messages and penalized logistic regression quantified unadjusted odds of scheduling a visit.</p><p><bold>Results:</bold> Missed opportunities for HPV vaccination declined significantly from the pre-intervention to the post-intervention period (21.6 vs. 8.1%, respectively, <italic>p</italic> = 0.002). Participants who recalled receipt of a vaccination reminder had 7.0 (95% <italic>CI</italic> 2.4–22.8) times higher unadjusted odds of scheduling a visit compared with those who did not recall receiving a reminder. The unadjusted odds of confirming that they had scheduled or were intending to schedule a follow-up appointment to receive the HPV vaccine was 4.9 (95% <italic>CI</italic> 1.51–20.59) times greater among those who had not received the vaccine for themselves or for their child.</p><p><bold>Conclusions:</bold> Results from this intervention are promising and suggest that vaccination interventions consisting of provider and support staff education and parent/caregiver and patient education materials, and reminders can reduce missed opportunities for vaccinations in rural settings.</p>