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IMPACT Project 1 – The impact of standing orders support on HPV vaccine communication and uptake

IMPACT 项目 1 — 常规订单支持对 HPV 疫苗传播和采用的影响

基本信息

批准号：
10266272
负责人：
Noel Todd Brewer
金额：
$ 37.43万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-23 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10266272
关键词：
Address Adolescent Age Area Child Clinic Clinic Visits Clinical Communication Complement Cost Effectiveness Analysis Data Development Educational Intervention Educational workshop Healthcare Healthcare Systems Hour Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Immunization Intervention Interview Language Laws Medical Mississippi Missouri Motivation Nurses Outcome Parents Participant Patients Persuasive Communication Primary Health Care Program Research Project Grants Provider Publications Randomized Randomized Clinical Trials Recommendation Registered nurse Research Role Rural Series Slide Specific qualifier value Surveys System Testing Texas Training Training Programs Trust Update Vaccines Work arm base cancer prevention cost cost effectiveness implementation determinants implementation intervention implementation outcomes improved informant innovation intervention program meetings member patient population programs rural area rural patients rurality skills support tools training project uptake vaccine acceptance vaccine delivery

项目摘要

ABSTRACT – Project 1 An ongoing and pressing cancer prevention challenge in the US is low HPV vaccine coverage, due in part to infrequent and low-quality provider recommendations. Our 1-hour Announcement Approach Training (AAT) teaches providers to use presumptive announcements that presume the child will receive vaccines and to use best practices for respectfully addressing parent concerns when they arise. The AAT increases HPV vaccine initiation and is an NCI-designated Research-Tested Intervention Program. To increase the impact of the AAT, we propose to leverage the whole primary care team, including registered nurses (RNs) and medical assistants (MAs), by supporting the implementation of existing standing orders. Standing orders are widely available but often underused. As part of the P01 Program Project, “Improving Provider Announcement Communication Training (IMPACT),” Project 1 will focus on AAT enhanced with standing orders support to expand the whole primary care team's involvement in HPV vaccine recommendations. We will do this work in healthcare systems serving rural and nonrural areas. Aim 1 is to characterize the role of RNs and MAs and standing orders in HPV vaccination. We will conduct formative interviews (n=20) and then a national primary care team survey (n=2,500) with our P01's Data Core to better understand how to expand the role of RNs and MAs in recommending HPV vaccine and to implement existing standing orders for HPV vaccine. Aim 2 is to evaluate the impact of supporting the implementation of existing standing orders for the whole primary care team on HPV vaccine communication and uptake in an RCT. The standing orders support will be a series of activation meetings that use persuasion and skills building with system leaders, clinic leaders and clinic staff. We will conduct a trial in 40 primary care clinics in Mississippi, Missouri, and Texas that have HPV vaccination standing orders, serve patients from rural and nonrural areas, and are part of a healthcare system. Clinics will be randomized to AAT or AAT enhanced with standing orders support. The primary trial outcome will be clinic- verified HPV vaccine initiation among children ages 11-12. We hypothesize that AAT with standing orders support increases HPV vaccine uptake by improving HPV vaccine communication. Aim 3 is to generate guidance for healthcare systems to support implementation of HPV vaccine standing orders to leverage the whole primary care team. We will gather and share intervention data (cost, impact, and implementation data) with Project 4 to support cost-effectiveness analyses and development of their decision support tool. We will examine intervention implementation determinants and outcomes with our P01's Intervention Core. Finally, we will contribute modules to the AAT Intervention Package that provides guidance to healthcare systems for improving HPV vaccination. Project 1 addresses the IMPACT Program Project theme by building capacity for HPV vaccine communication interventions among primary care teams in healthcare systems.

摘要-项目1