The goal of this proposed project is to assess the feasibility and effect of expanding the Adolescent Vaccination Program (AVP), a successful multi-level human papillomavirus (HPV) vaccination program, to another clinical network in Texas.

HPV is a major cause of morbidity and mortality in men and women that can be reduced through vaccination. Persistent infection with high-risk HPV types cause over 70% of cervical cancers, 90% of anal cancers, 60-70% of oropharyngeal cancers, and 40% of vagina, vulva, and penile cancers. Low-risk HPV types cause 90% of genital warts. HPV-related morbidity and mortality can be reduced through vaccination. Despite evidence of safety and efficacy, and endorsem...

Read More

The goal of this proposed project is to assess the feasibility and effect of expanding the Adolescent Vaccination Program (AVP), a successful multi-level human papillomavirus (HPV) vaccination program, to another clinical network in Texas.

HPV is a major cause of morbidity and mortality in men and women that can be reduced through vaccination. Persistent infection with high-risk HPV types cause over 70% of cervical cancers, 90% of anal cancers, 60-70% of oropharyngeal cancers, and 40% of vagina, vulva, and penile cancers. Low-risk HPV types cause 90% of genital warts. HPV-related morbidity and mortality can be reduced through vaccination.

Despite evidence of safety and efficacy, and endorsement by professional organizations, HPV vaccination rates are well below the 2020 Healthy People target of 80%. Increasing uptake of HPV vaccination has the potential to improve health outcomes both short-term (e.g., pre-cancerous cervical lesions and genital warts) and long-term (e.g., adult-onset cancers) by preventing infection with HPV. Both parental and provider factors influence HPV vaccination uptake and completion among adolescents, thus there is a critical need for multi-level strategies to increase HPV vaccination coverage.

We propose to leverage the success of our current CPRIT project titled “Multi-component Interventions to Increase HPV Vaccination in a Network of Pediatric Clinics”. We developed, pretested, and implemented the AVP, which targeted healthcare providers and parents of patients (11-17 years). The AVP comprises a suite of recommended evidence-based strategies: immunization champions, provider assessment and feedback, provider reminders, provider continuing education, patient reminder and recall systems, and patient (parent) education. The AVP was effective at increasing both initiation and completion of the HPV vaccine series among male and female patients in a large pediatric clinic network.

We propose to expand the AVP to a geographic area not well served by other similar CPRIT projects, commencing with the Children’s Hospital of San Antonio Primary Care (CHPC) clinical network. Specific goals and objectives are: Goal 1: Adapt the Adolescent Vaccination Program (AVP) for The Children’s Hospital of San Antonio Primary Care (CHPC) clinics. Obj. 1: Survey 40 healthcare professionals at CHPC clinics to assess individual and organizational factors that may influence current HPV vaccination practices and the implementation of program strategies. Obj. 2: Survey 100 parents of patients ages 11-17 years at CHPC clinics to assess parental attitudes and perceived barriers to HPV vaccination initiation and completion. Obj. 3: Assess acceptability (usability, feasibility) of the adapted AVP program with a target criterion of 70% agreement.

Goal 2: Deliver the adapted AVP to healthcare professionals and parents of patients ages 11-17 years at CHPC clinics. Obj. 1: Deliver the provider-based program to 40 healthcare professionals at CHPC clinics. Obj. 2: Deliver the parent-based program to 1,500 parents of patients ages 11-17 at CHPC clinics.

Goal 3: Evaluate the effectiveness of the adapted AVP at increasing HPV vaccine initiation and completion among male and female patients ages 11-17 at CHPC clinics. Obj. 1: As a result of delivering the program, HPV vaccine initiation among male and female patients ages 11-17 will increase by at least 15% over baseline. Obj. 2: As a result of delivering the program, HPV vaccine completion among male and female patients ages 11-17 will increase by at least 15% over baseline.

This project is significant because it will demonstrate if an innovative and successful multi-level HPV vaccination program can be effective when expanded to other Texas clinical networks.

Read Less