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Randomized Controlled Trial
. 2016 Apr;25(4):593-602.
doi: 10.1158/1055-9965.EPI-15-1243.

Results of a Multilevel Intervention Trial to Increase Human Papillomavirus (HPV) Vaccine Uptake among Adolescent Girls

Electra D Paskett  1 , Jessica L Krok-Schoen  2 , Michael L Pennell  3 , Cathy M Tatum  2 , Paul L Reiter  4 , Juan Peng  3 , Brittany M Bernardo  2 , Rory C Weier  5 , Morgan S Richardson  6 , Mira L Katz  7
Affiliations
Randomized Controlled Trial

Results of a Multilevel Intervention Trial to Increase Human Papillomavirus (HPV) Vaccine Uptake among Adolescent Girls

Electra D Paskett et al. Cancer Epidemiol Biomarkers Prev. 2016 Apr.

Abstract

Background: Uptake of the human papillomavirus (HPV) vaccine is low in Appalachian Ohio and areas with high cervical cancer rates.

Methods: We conducted a group-randomized trial among 12 counties in Appalachian Ohio randomized to receive either an HPV vaccine (intervention counties) or influenza vaccine (comparison counties) multilevel intervention (MLI). Parents (n = 337) who had a daughter aged 9 to 17 years who had not received the HPV vaccine were recruited from commercial lists. Clinics (N = 24) and 119 providers from these clinics were also recruited. The primary outcome was medical record-confirmed receipt of the first shot of the HPV vaccine 3 months after receiving the intervention among daughters of parents enrolled in the study. Secondary outcomes included receipt of the first HPV vaccine shot by 6 months and changes in provider knowledge.

Results: According to medical records, 10 (7.7%) daughters of intervention participants received the first shot of the HPV vaccine within 3 months of being sent the intervention materials compared with 4 (3.2%) daughters of comparison group participants (P = 0.061). By 6 months, 17 (13.1%) daughters of intervention participants received the first HPV vaccine shot compared with eight (6.5%) daughters of comparison group participants (P = 0.002). Provider knowledge about HPV increased (P < 0.001, from baseline to after education).

Conclusions: The MLI increased uptake of the HPV vaccine among girls aged 9 to 17 years; however, uptake was low.

Impact: To improve HPV vaccine uptake, attention to additional levels of influence (e.g., policy, community) and more elements within levels (e.g., reminders, automated prompts) may be needed. Cancer Epidemiol Biomarkers Prev; 25(4); 593-602. ©2016 AACR SEE ALL ARTICLES IN THIS CEBP FOCUS SECTION, "MULTILEVEL APPROACHES TO ADDRESSING CANCER HEALTH DISPARITIES".

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Conflict of interest statement

Conflict of Interest Statement: E.D. Paskett has received research grants from Merck Sharp & Dohme Corp. P.L. Reiter has received research grants from Merck Sharp & Dohme Corp. and Cervical Cancer-Free America, via an unrestricted educational grant from GlaxoSmithKline. These funds were not used to support this research study.

Figures

Figure 1
Figure 1. CONSORT Diagram of Parent Participants by Intervention Group
Figure 2
Figure 2. CONSORT Diagram of Clinic and Provider Participants by Intervention Group
See this image and copyright information in PMC

References

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