br Practice specific baseline HPV vaccination rates
Practice-specific baseline HPV vaccination rates for 11- to 12-year-old patients ranged from 19% to 53% for series ini-tiation (Figure 3, A) and from 3% to 24% for series comple-tion (Figure 3, B). Of the 6 practices, baseline vaccination rates in 5 (83%) and 4 (67%) practices were at or above statewide rates for series D-Luciferin (Figure 3, A) and completion (Figure 3, B), respectively. Four (67%) practices had vaccine initiation (Figure 3, A) and completion (Figure 3, B) rates at or above the practice’s county rates.
Cancer Prevention Education for Providers, Staff, Parents, and Teens Improves Adolescent 147 Human Papillomavirus Immunization Rates
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Figure 3. Continued.
For 13- to 18-year-old patients, practice-specific baseline HPV vaccination rates ranged from 39% to 76% for series ini-tiation (Figure 3, C) and from 31% to 63% for series comple-tion (Figure 3, D). Of the 6 practices, baseline vaccination rates in 5 (83%) and 6 (100%) practices were at or above state-wide rates for series initiation (Figure 3, C) and completion (Figure 3, D), respectively. Five (83%) practices were at or above county-specific rates for series initiation (Figure 3, C) and completion (Figure 3, D).
Percent changes in vaccine series initiation and comple-tion rates for each practice over the 12-month study period are shown in Table IV. Three (50%) practices improved vaccine initiation rates by at least 10% and 5 (83%) improved by greater than 5% in both age groups (Table IV). Similarly, 2 (33%) and
When stratified by patients’ sex, there were infrequent in-stances of statistically significant differences in vaccine initia-tion and completion rates among male and female participants in the 11- to 12-year-old age range and in vaccine initiation rates among male and female participants in the 13- to 18-year-old cohort within each practice. However, in the 13- to 18-year-old cohort, HPV vaccine completion rates were sig-nificantly higher among female participants compared with male participants in both the baseline and the postintervention comparisons for all but 1 practice (Table V).
148 Suryadevara et al
February 2019 ORIGINAL ARTICLES
Table IV. HPV vaccine series initiation and completion rates for total adolescent patient population by practice before and after intervention
Before intervention 12 mo after starting intervention
11- to 12-y-olds Vaccine initiation Total patients n Vaccine initiation Total patients n % increase in series initiation over
Figure 3 shows that several of the practices that were below or at baseline countywide vaccination rates were well above countywide rates 12 months after the initiation of phase 2 edu-cation. Taken all together, countywide vaccine completion rates for 13- to 18-year-olds decreased during the 12-month study period in each county represented, and study site-specific vac-cination rates increased in 5 (83%) of the 6 recruited prac-tices. Accounting for the reduction in countywide rates, the corrected improvement for vaccine completion among 13- to 18-year-olds at the 5 practices ranged from 8 to 20 percent-age points.
Following the 12-month study period, the study team held a debriefing session with the project champion from each prac-tice. Project champions from practices with positive changes in immunization rates consistently commented that they
believed the provider education component provided during phase 1 played a vital role for how vaccine recommendations were conveyed in the practice. Champions also provided posi-tive feedback regarding the cancer prevention booklets because none of the practices had previously offered written cancer pre-vention guidance to their families. Providers also reported posi-tive parent feedback regarding the manner in which the booklets combined and reinforced cancer prevention messages, some familiar, and others new.
We show that the introduction of a cancer prevention educa-tion platform geared toward providers, office staff, adolescents,
Table V. Differences in HPV vaccination rates by patient’s sex—practice, before and after the cancer prevention aware-ness program
Vaccine completion among 13- to 18-y-olds
*Statistical difference between female and male vaccination rates.
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