Year: 2013
Funding: NNPHI PHS3 Award
Status: Completed
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Overview
This multi-state randomized controlled trial aims to address low HPV vaccination coverage among adolescents by enhancing a systems intervention now used with a quarter of the nation's vaccine providers. The modified intervention uses quality improvement measures and ongoing feedback for providers who treat adolescent patients in primary care settings. The specific aims of this research are: 1) to develop an improved Adolescent AFIX (Assessment, Feedback, Incentives, and eXchange) consultation; 2) to assess the impact of consultations delivered in two modes, in-person and webinar, on providers' use of immunization best practices and adolescents' vaccination status; and 3) to assess the feasibility of Adolescent AFIX for state health department personnel and vaccine providers.
The research team works in partnership with state health department immunization specialists in three states (Illinois, Michigan, and Washington) to deliver information about HPV vaccination to providers, encourage strong recommendations for vaccination, and provide ongoing feedback to providers about their clinics’ immunization rates via an HPV immunization report card. For each state, a simple randomization is used in a 1:1:1 ratio to assign clinics with at least 500 adolescent patients to receive an in-person AFIX consultation, a webinar consultation, or no consultation. For this pragmatic clinical trial, the sample size was based on the number of AFIX consultations that many state health departments can deliver in a 6-month period.
Publication
- Using HPV Vaccine-specific Quality Improvement Tools to Increase Immunization Coverage in Primary Care (Policy and Practice Brief, February 2017)
Presentations
- Adolescent AFIX: A Multi-state Randomized Control Trial to Increase Adolescent Immunization through Vaccine Provider Best Practices (PHSSR Research in Progress Webinar, September 2015 recording)
- Using webinar technology to increase the efficiency of a nationally implemented approach to immunization quality improvement (8th Annual Conference on Science of Dissemination and Implementation, December 2015)
- Improving provider self-efficacy and behavior related to HPV vaccination: Can webinar-delivered quality improvement work? (Society of Behavioral Medicine Annual Meeting, March 2016)
- UNC Adolescent AFIX Study (Webinar for Association of Immunization Managers, April 2016)
- Research Project Update: AFIX Program Strategies for Improving HPV Vaccination Rates in the Field (Association of Immunization Managers, hosted by CDC, May 2016)
- Optimizing AFIX for HPV Vaccine Quality Improvement (Poster presented at National Immunization Conference, September 2016)
- Adolescent AFIX: A Multi-state Randomized Control Trial to Increase Adolescent Immunization through Vaccine Provider Best Practices (Systems for Action Research in Progress Webinar, September 2017 recording)
Tools
- http://www.hpviq.org/ (Website for public health professionals and primary care providers on improving and increasing HPV vaccine delivery to adolescents, May 2017)
- Adolescent AFIX Study: Reviewing the Science & Rationale for HPV Vaccination Quality Improvement (Introductory presentation to state study partners, 2014)
- Immunization Report Card (Quality Improvement Feedback Tool for Vaccine Providers and coaching messages, 2014)
- Quality Improvement for HPV vaccination: Adolescent AFIX (Presentation used by state vaccine coordinators in primary care provider webinar intervention)
- HPV Vaccination Quality Improvement Action Plan, 2014
- Study tools: state partner time log; webinar intervention evaluation tool; post in-person pilot test call guide; state partner technical assistance call guide; state partner debriefing guide
Research Areas
- Information and Technology
- Translation and Dissemination of Research-Tested Public Health Strategies
Contact
PIs: Noel T. Brewer, Ph.D., M.S. and Melissa B. Gilkey, Ph.D., M.P.H.
Project Manager: Jennifer MacKinnon, University of North Carolina