FROM PEDIATRICS

Clinics in which providers presented human papillomavirus (HPV) vaccination as an assumed part of tween health care had a 5% increase in HPV vaccination coverage, compared with clinics that did not receive “announcement” training, based on data from a parallel-group, randomized trial of 30 pediatric and family medicine clinics in North Carolina.

Many providers hesitate to recommend HPV vaccination for 11- to 12-year-olds for a number of reasons, including lack of time and anticipation of a lengthy conversation about sex, wrote Noel T. Brewer, PhD, of the University of North Carolina, Chapel Hill, and his colleagues.

The clinics were divided into three groups: two groups received 1-hour training in either announcement training or conversation training and the third received no training (controls). Announcements were defined as “brief statements that assume parents are ready to vaccinate,” while conversations were defined as an approach that “engages parents in open-ended discussions” about HPV vaccination. A key element of announcement training was providers announcing at a visit that the child was due for three vaccines, mentioning HPV in the middle of the list, and stating that they would give the vaccination at that day’s visit.

At 6 months after the training period, 17,173 children aged 11-12 years and 37,796 children aged 13-17 years were seen at the clinics. Overall, clinics that underwent announcement training increased HPV vaccine initiation for 11- and 12-year-olds by 5.4% over the control clinics. Clinics that received conversation training showed no significant increase in vaccine initiation, compared with controls. Intervention groups did not differ from the controls in terms of other ages (adolescents aged 13-17 years) or other immunization coverage, including HPV series completion, Tdap, and meningococcal vaccines.

The findings were limited by several factors, including the collection of data from a single Southeastern state that may not be generalizable to other areas, the researchers noted. The results, however, “support training providers to use announcements as an approach to address low HPV vaccination uptake in primary care clinics,” especially at the recommended ages for routine vaccination, Dr. Brewer and his associates said.

Read the full study here (Pediatrics 2016;139:e20161764. doi: 10.1542/peds.2016-1764).

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