IMPACT Project 2 – The impact of clinic-level financial incentives on HPV vaccine communication and uptake

摘要-项目2 接种人乳头状瘤病毒疫苗是有效的，建议预防六种类型的 癌症，但HPV疫苗覆盖率仍然很低。提供者沟通对HPV有很大的影响 疫苗接种率。我们的计划团队已经有效地证明了公告方法培训(AAT) 改善提供者沟通，提高HPV疫苗接种率。一个很有前途的工具，可以扩展 AAT的影响是临床层面的财务激励，它可以激励提供者将他们在 一个AAT车间。财政激励日益成为支付改革努力的核心部分，重点是更好地 使医疗系统的财务激励与医疗质量保持一致。还没有研究充分地建立起 经济激励是否会激励提供者推荐HPV疫苗接种。作为拟议P01的一部分 计划项目“改善提供商公告沟通培训(Impact)”，目标是 随机临床试验(RCT)旨在测试有前景的替代方案，以激励供应商改进HPV疫苗 沟通。我们建议研究财政激励是否与HPV临床水平的改善有关 疫苗接种率可以提高HPV疫苗的沟通和接种率。为了实现这一目标，在目标1中，我们 将描述提供商对与HPV疫苗接种和行为相关的财务激励的看法 通过一项国家初级保健团队调查进行了推动。我们还将完善反馈报告以跟踪HPV 疫苗接种率与提供者和诊所的改善目标相匹配。在目标2中，我们将进行 RCT，将诊所随机分配到两个分支之一：1)AAT和2)AAT加上与临床水平挂钩的财政激励 提高人乳头瘤病毒疫苗接种率。在目标3中，我们将评估干预措施的实施情况，包括 每增加一名青少年接种HPV疫苗的成本。这一RCT意义重大，因为它将证明 财政激励是否以及如何改善提供者的沟通并增加疫苗接种率以实现 人乳头瘤病毒疫苗接种目标。建议的研究涉及放大的影响方案项目主题 一项研究测试的干预计划对改善HPV疫苗在医疗保健中传播的影响 系统通过财政奖励激励供应商提出必要的建议。

ABSTRACT – Project 2 Human papillomavirus (HPV) vaccination is effective and recommended to protect against six types of cancer, but HPV vaccine coverage remains low. Provider communication has a powerful influence on HPV vaccine uptake. Our program team has demonstrated that Announcement Approach Training (AAT) effectively improves provider communication and increases HPV vaccination uptake. A promising tool to expand the impact of AAT is clinic-level financial incentives, which can motivate providers to apply what they learn in the AAT workshop. Financial incentives are increasingly a central part of payment reform efforts focusing on better aligning financial incentives in healthcare systems with quality of care. No studies have adequately established whether financial incentives motivate providers to recommend HPV vaccination. As part of the proposed P01 Program Project, “Improving Provider Announcement Communication Training (IMPACT),” the goal of this randomized clinical trial (RCT) is to test promising alternatives to motivate providers to improve HPV vaccine communication. We propose to examine whether financial incentives tied to clinic-level improvement in HPV vaccination rates can improve HPV vaccine communication and uptake. To achieve this goal, in Aim 1, we will characterize providers’ perceptions of financial incentives tied to HPV vaccination and behavioral nudges via a national primary care team survey. We will also refine a feedback report to track HPV vaccination rates paired with improvement targets to providers and clinics. In Aim 2, we will conduct the RCT, randomizing clinics to one of two arms: 1) AAT and 2) AAT plus financial incentive tied to clinic-level improvement in HPV vaccination rates. In Aim 3, we will evaluate intervention implementation, including cost per additional adolescent initiating HPV vaccine. This RCT is significant because it will demonstrate whether and how financial incentives improve provider communication and increase vaccine uptake to achieve HPV vaccination goals. The proposed research addresses the IMPACT Program Project theme of amplifying the impact of a Research-Tested Intervention Program to improve HPV vaccine communication in healthcare systems via financial incentives to motivate providers to make needed recommendations.