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BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Pragmatic trial of an intervention to increase human papillomavirus vaccination in safety-net clinics

Authors: Maureen Sanderson, Juan R. Canedo, Dineo Khabele, Mary K. Fadden, Cynthia Harris, Katina Beard, Marilyn Burress, Helen Pinkerton, Cynthia Jackson, Tilicia Mayo-Gamble, Margaret K. Hargreaves, Pamela C. Hull

Published in: BMC Public Health | Issue 1/2017

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Abstract

Background

Human papillomavirus (HPV) infection has been causally linked to six cancers, and many disproportionately affect minorties. This study reports on the development and effectiveness of an intervention aimed at increasing HPV vaccine uptake among African American and Hispanic pediatric patients in safety-net clinics.

Methods

Formative research, community engagement, and theory guided development of the intervention. A clustered, non-randomized controlled pragmatic trial was conducted in four clinics providing healthcare for the underserved in Tennessee, U.S., with two intervention sites and two usual care sites. Patients aged 9-18 years (N = 408) and their mothers (N = 305) enrolled, with children clustered within families. The intervention consisted of two provider/staff training sessions and provision of patient education materials, consisting of a video/flyer promoting HPV vaccine. Medical records were reviewed before/after the initial visit and after 12 months.

Results

At the initial visit, provision of patient education materials and provider recommendation were higher at intervention sites versus usual care sites, and receipt of HPV vaccine was higher at intervention sites (45.4% versus 32.9%) but not significantly after adjusting for patient’s age and mother’s education. Provider recommendation, but not education materials, increased the likelihood of vaccine receipt at the initial visit, although over one-third of intervention mothers cited the flyer/video as motivating vaccination. Completion of the 3-dose series at follow-up was lower in the intervention arm.

Conclusions

Future interventions should combine patient education, intensive provider/staff education, and patient reminders. Research should compare patient education focusing on HPV vaccine only versus all adolescent vaccines.

Trial registration

Retrospectively registered with ClinicalTrials.gov NCT02808832, 9/12/16
Appendix
Available only for authorised users
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Metadata
Title
Pragmatic trial of an intervention to increase human papillomavirus vaccination in safety-net clinics
Authors
Maureen Sanderson
Juan R. Canedo
Dineo Khabele
Mary K. Fadden
Cynthia Harris
Katina Beard
Marilyn Burress
Helen Pinkerton
Cynthia Jackson
Tilicia Mayo-Gamble
Margaret K. Hargreaves
Pamela C. Hull
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4094-1

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