Fighting HPV in practice
We know a lot about how to deal with HPV-caused disease -- vaccinate,
screen, treat. What are some ways people have tried to improve how
we put these tools into practice? Here are some references, most recent
first, grouped by measured endpoint. (Caution: there is a bias in this list towards things reported
to significantly change initiation or completion rate, and papers
that reported no effect are not included, so this may present an
overly rosy picture.)
interventions to improve HPV vaccination coverage among 13- to 15-year-old
females: measures implemented by local governments in Japan (PLoS One.
2013 Dec 16;8(12):e84126) -- measured
vaccine coverage; control was zero, and either school-based vaccination or
the combination of a free ticket, direct mail and recall achieved 90%
Impact of a physician recommendation and parental immunization attitudes on
receipt or intention to receive adolescent vaccines (Hum Vaccin
Immunother. 2013 Dec 1;9(12):2627-33)
-- "Physician recommendation of any of the four vaccines was associated with
receipt of Tdap (p<0.001), MCV4 (p<0.001), and HPV (p = 0.03)".
(An editorial held
up this study as an example.)
health department-school partnership to boost HPV vaccination among middle
school girls (141st APHA Annual Meeting) -- "HPV vaccine provision was
higher among girls attending host schools than satellite schools (6% vs.
1%, OR=6.56, CI=3.99-10.78). Of those who initiated HPV vaccine, 80%
received all three doses."
school health centers to increase uptake of HPV and other adolescent
vaccines (141st APHA Annual Meeting) -- "Supplemental consent
procedures dramatically reduced initial consent rates, largely due to the
inability of SHC staff to re-contact families." (i.e. giving parents too
many choices led to confusion and delay)
- Effectiveness of
decision support for families, clinicians, or both on HPV vaccine receipt
(Pediatrics. 2013 Jun;131(6):1114-24) -- measured days to 50% completion and final completion rate for three interventions
- Early lessons
learned from extramural school programs that offer HPV vaccine (J Sch
Health. 2013 Feb;83(2):119-26) -- interviewed five programs that offered
extramural HPV vaccination programs at schools without health centers.
"HPV vaccine uptake was lowest for a program that offered only HPV vaccine."
Pap" Intervention Improves HPV Vaccine Series Completion Among Appalachian
(Journal of Communication, 63: 95-115) -- intervention was watching a 13-minute educational DVD.
Completion rate was 32% in controls, 43% in intervention group.
- Effectiveness and Cost of Immunization Recall at School-Based Health Centers
(Pediatrics. 2012 Jun;129(6):e1446-52) -- measured effectiveness of recall
among sixth-grade boys
- Integration of Theory and Evidence-Based Practice in the
Promotion of Humann Papillomavirus Vaccine Acceptance on Air Force Military Bases
(MS thesis, 2008)
Corrections and suggestions welcome, please send them to dank at kegel com.
Copyright 2014, Dan Kegel
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