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High and Low Resource Interventions to Promote HPV Vaccines

Primary Purpose

Human Papilloma Virus, Tdap - Tetanus, Diphtheria and Acellular Pertussis Vaccination, Meningitis, Meningococcal

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
AFIX Only
AFIX+ Provider Communication Training
Sponsored by
Children's Mercy Hospital Kansas City
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Human Papilloma Virus focused on measuring Adolescent Vaccines

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Parent or legal guardian of a child 11-18 years of age or a pediatric health care provider
  • Parent or legal guardian of a child being seen for a well-child visit
  • Ability to provide informed consent

Exclusion Criteria:

  • Prior participation in the study
  • Unable to read or understand English

Sites / Locations

  • Children's Mercy Hospital Kansas City

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

AFIX Only

AFIX+ Provider Communication Training

Arm Description

Practices enrolled in the AFIX only arm will receive an in-person AFIX consultation that includes assessment of current HPV vaccination rates and feedback on strategies to increase vaccination rates.

Practices enrolled in the AFIX+ Provider Training arm will receive an in-person AFIX consultation along with a brief communication training for providers and poster and brochure displays in clinic waiting and exam rooms.

Outcomes

Primary Outcome Measures

HPV vaccination rates
Practice and provider level HPV vaccination rates will be collected from patient de-identified claims data.

Secondary Outcome Measures

Parent Satisfaction
Parent satisfaction with visit will be collected using validated measures on tablet computers

Full Information

First Posted
January 29, 2019
Last Updated
January 19, 2021
Sponsor
Children's Mercy Hospital Kansas City
Collaborators
University of Kansas Medical Center, Midwest Cancer Alliance
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1. Study Identification

Unique Protocol Identification Number
NCT03824093
Brief Title
High and Low Resource Interventions to Promote HPV Vaccines
Official Title
High and Low Resource Interventions to Promote HPV Vaccines
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Completed
Study Start Date
July 1, 2018 (Actual)
Primary Completion Date
May 6, 2020 (Actual)
Study Completion Date
May 6, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Children's Mercy Hospital Kansas City
Collaborators
University of Kansas Medical Center, Midwest Cancer Alliance

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Human Papillomavirus (HPV) is a significant public health issue affecting nearly 14 million people in the United States. HPV can lead to cervical, oropharyngeal, anal, and penile cancers as well as genital warts.The purpose of this study is to test the comparative effectiveness of two interventions, AFIX only vs. AFIX + communication training, to increase Human Papillomavirus (HPV) vaccination rates among adolescent patients in outpatient clinic settings. Providers and staff at four pediatric practices will be randomized to receive an in-person AFIX consultation or an AFIX consultation combined with communication training and commitment poster displays. Provider and parent data will be collected via a tablet computer RedCap survey. Additional practice and provider level HPV vaccination rates will be collected via patient de-identified claims data. The results of this study could contribute to the existing body of literature that suggests provider recommendations and routine vaccination assessments are key to increasing HPV vaccination uptake. This project has the potential to lead to the implementation and dissemination of low resource interventions to increase HPV vaccination rates among children and adolescents.
Detailed Description
Significance: Human Papillomavirus (HPV) is the most common sexually transmitted infection in the United States with an estimated 14 million new infections each year. While most HPV infections resolve without any symptoms or signs of infection, some HPV infections can lead to genital warts and cancer. Every year, more than 30,000 people are affected by an HPV-related cancer, including cervical, oropharyngeal, vaginal and anal cancers. Because most adults will become infected with HPV at some point in their lives, the CDC recommends routine vaccination for girls aged 11-26 and boys aged 11-21. While vaccines to prevent HPV infection have been widely available for more than a decade nearly 38% of eligible girls and 50% of eligible boys have not initiated the HPV vaccine series and more than 70% of boys and 50% of girls have not completed the full vaccine series. Rates of HPV vaccination are significantly lower than rates for other adolescent recommended vaccines including, tetanus, diptheria, and acellular pertussis (Tdap), and meningococcal conjugate (MenACWY), which range from 81 to 86 percent. There are many factors that contribute to less than optimal HPV vaccination rates but chief among them is lack of a strong provider recommendation to initiate and complete the HPV vaccine series. Innovation: This study will be the first randomized controlled trial comparing the effectiveness of an AFIX intervention vs. an AFIX intervention combined with a provider "nudge" that includes a brief communication skills training and commitment messaging displays to increase HPV vaccination rates in pediatric outpatient settings. Approach: 200 eligible parents (or caregivers) of adolescents between the ages of 11 and 18 will be enrolled and exposed to one of the interventions based on their clinic location. Parents will be recruited from the Children's Mercy Hospital Primary Care Clinic (CMH PCC) and Cradle Thru College Care Pediatrics in Kansas City, MO, Preferred Pediatrics in Lee's Summit, MO, and Cass County Pediatrics in Belton,MO. Practices will be randomized to receive either an in-person AFIX assessment or an in-person AFIX assessment combined with a brief, provider communication training and adolescent vaccine commitment poster displays. The primary outcome of this study is HPV vaccination rates. A secondary outcome is parent ratings of satisfaction with their child's visit with the health care provider. Data will be collected via a tablet computer administered RedCap survey in the exam room immediately following the child's visit. Public Health Impact: This study could have a significant public health impact and contribute to meeting the Healthy People 2020 goals to reduce vaccine preventable infections by increasing vaccination rates in the pediatric population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Human Papilloma Virus, Tdap - Tetanus, Diphtheria and Acellular Pertussis Vaccination, Meningitis, Meningococcal, Communication, Satisfaction
Keywords
Adolescent Vaccines

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Masking Description
Practices will be randomly assigned to the AFIX only or AFIX+ communication training study arms. Both groups will receive identical AFIX consultations, but only practices assigned to the AFIX+ communication training arm will receive brief, provider communication training and commitment poster displays. Once practices have been randomized, parents of adolescent patients will be exposed to one of the interventions based on their practice location. Participants will not be informed of their practice's study arm.
Allocation
Randomized
Enrollment
225 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AFIX Only
Arm Type
Active Comparator
Arm Description
Practices enrolled in the AFIX only arm will receive an in-person AFIX consultation that includes assessment of current HPV vaccination rates and feedback on strategies to increase vaccination rates.
Arm Title
AFIX+ Provider Communication Training
Arm Type
Active Comparator
Arm Description
Practices enrolled in the AFIX+ Provider Training arm will receive an in-person AFIX consultation along with a brief communication training for providers and poster and brochure displays in clinic waiting and exam rooms.
Intervention Type
Behavioral
Intervention Name(s)
AFIX Only
Intervention Description
The intervention will include an in-person AFIX assessment of the practice's adolescent vaccination rates.
Intervention Type
Behavioral
Intervention Name(s)
AFIX+ Provider Communication Training
Intervention Description
The intervention will include an in-person AFIX assessment of the practice's adolescent vaccination rates along with communication training for providers and poster and brochure displays.
Primary Outcome Measure Information:
Title
HPV vaccination rates
Description
Practice and provider level HPV vaccination rates will be collected from patient de-identified claims data.
Time Frame
18 months
Secondary Outcome Measure Information:
Title
Parent Satisfaction
Description
Parent satisfaction with visit will be collected using validated measures on tablet computers
Time Frame
18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Parent or legal guardian of a child 11-18 years of age or a pediatric health care provider Parent or legal guardian of a child being seen for a well-child visit Ability to provide informed consent Exclusion Criteria: Prior participation in the study Unable to read or understand English
Facility Information:
Facility Name
Children's Mercy Hospital Kansas City
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64108
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
We will create a clean, de-identified copy of our final dataset that will be available to other researcher groups, upon request, within 9 months of the end of the study period. Prior to data sharing, we will remove all identifying information. We will make data and associated documentation available to users under a data-sharing agreement.
IPD Sharing Time Frame
Data will be made available 9 months after the conclusion of the study upon request and completion of a data sharing agreement.

Learn more about this trial

High and Low Resource Interventions to Promote HPV Vaccines

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