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

摘要-项目2 人乳头瘤病毒（HPV）疫苗接种是有效的，并建议防止六种类型的 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 疫苗摄取。我们的项目团队已经证明，宣布方法培训（AAT）有效地 改善提供者沟通，增加HPV疫苗接种率。一个有前途的工具，以扩大 AAT的影响是临床层面的财务激励，这可以激励提供者应用他们在 AAT研讨会。财政激励日益成为支付改革努力的核心部分， 使医疗保健系统中的财政激励措施与护理质量保持一致。没有研究充分确定 经济激励是否激励提供者推荐HPV疫苗接种。作为拟定P01的一部分 计划项目，“改善供应商公告沟通培训（IMPACT）”，这一目标 一项随机临床试验（RCT）旨在测试有希望的替代方案，以激励供应商改进HPV疫苗 通信我们建议研究是否与HPV临床水平改善相关的经济激励措施 疫苗接种率可以改善HPV疫苗的传播和吸收。为了实现这一目标，在目标1中，我们 将描述提供者对与HPV疫苗接种和行为相关的经济激励的看法 通过一项全国初级保健团队调查进行了推动。我们还将完善一份反馈报告， 疫苗接种率与提供者和诊所的改进目标相结合。在目标2中，我们将进行 随机对照试验，将诊所随机分为两组：1）AAT和2）AAT+与诊所水平相关的经济激励 提高HPV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 每增加一名青少年启动HPV疫苗的成本。这项随机对照试验意义重大，因为它将证明 财政激励措施是否以及如何改善提供者的沟通并增加疫苗接种， HPV疫苗接种目标。拟议的研究解决了IMPACT计划项目的主题， 经研究检验的干预计划对改善HPV疫苗在医疗保健中的传播的影响 通过财政激励机制激励供应商提出所需的建议。

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.