Improving HPV Vaccination Rates: A Randomized Trial Makes It Happenby Lewis First MD, MS, Editor in Chief, Pediatrics
We have published studies and commentaries in search of ways to boost vaccination against humanpapillomavirus (HPV) infection, given it is one of the most commonly sexually transmitted infection andresponsible for cervical, ano-genital, and head and neck cancers. This week, we add to those studies with onethat has been quite successful in improving HPV vaccine rates. Dixon et al. (10.1542/peds.2018-1457) sharewith us the results of a cluster randomized trial involving an intervention in some clinics in an urban healthsystem that had parents in some clinics randomized to watch a digital video (with different videos showndependent on parental attitude toward the vaccine and whether their child had received one or none already)that highlighted the risks and benefits of the HPV vaccine while other clinics got routine care. The desiredoutcome was the change in HPV rates two weeks after the clinic visit. 1596 teenagers were enrolled with a thirdof these teens visiting an intervention clinic. When those teens and their caregivers did visit those clinics, asignificantly higher change or increase in those vaccinated occurred when compared to those in the controlclinics. (64.8% versus 50.1%). If the parents of adolescents watched the videos, they had three times the oddsof their child getting an HPV vaccine than those whose parents did not watch the videos in those clinics.
So how can we take from this study and apply it to our practice? Do waiting room videos make sense for usewith other vaccines as well? We asked Dr. Amanda Dempsey formerly at the Child Health and Evaluation andResearch Unit at the University of Michigan and now at the University of Colorado to weigh in with anaccompanying commentary (10.1542/peds.2018-2370). She notes the solid methodology used in thisintervention study and the strong results obtained, but also notes that the feasibility of generalizing their resultsmay be easier said than done-given that only 1 of 4 parents targeted to get the intervention in a designated clinicactually did so. The low numbers of parents who got to watch the videos was attributed to clinic workflow issuesthat might have resulted in a teen being seen or a parent asked to join into the visit before they could spend timewatching the video. Perhaps someday we will be able to have families watch a tailored video on their smartdevice even before coming into the office such that the effect of the video intervention can be effectivelydelivered, just not while waiting in the waiting room. Check out this study and commentary-and consider howyour office might do a similar intervention.
Parent-Provider Communication of HPV Vaccine Hesitancy●
Legislation to Increase Uptake of HPV Vaccination and Adolescent Sexual Behaviors●
Provider Communication, Prompts, and Feedback to Improve HPV Vaccination Rates in Resident Clinics●
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Copyright © 2018 American Academy of Pediatrics
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