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

• 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
• 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

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 在美国，持续不断的预防癌症预防挑战是HPV疫苗覆盖率低，部分原因是 不频繁和低质量的提供商建议。我们的1小时公告方法培训（AAT） 教会提供者使用假定孩子将接种疫苗并使用的假定公告 当父母出现时，尊重父母关注的最佳实践。 AAT增加了HPV疫苗 启动，是NCI指定的研究测试干预计划。为了增加AAT的影响， 我们建议利用整个初级保健团队，包括注册护士（RNS）和医疗助理 （MAS），通过支持实施现有常规订单。常规订单广泛可用，但 经常没有用。作为P01计划项目的一部分，“改善提供商的公告通信 培训（影响）”，项目1将重点介绍AAT增强，并通过常规订单支持以扩大整体 初级保健团队参与HPV疫苗建议。我们将在医疗保健系统中做这项工作 服务农村和非农村地区。目的1是表征RN和MAS的角色以及常规的角色 HPV疫苗接种。我们将进行形成性访谈（n = 20），然后进行国家初级保健团队调查 （n = 2,500）使用我们的P01的数据核心，以更好地了解如何扩展RN和MAS在 建议HPV疫苗并实施HPV疫苗的现有常规订单。目标2是评估 支持对整个初级保健实施现有常规订单的影响 组合HPV疫苗通信和RCT吸收。常规订单支持将是一系列 与系统领导者，诊所领导者和诊所工作人员一起使用说服力和技能的激活会议。 我们将在密西西比州，密苏里州和德克萨斯州的40个初级保健诊所进行试验，该诊所接受了HPV疫苗接种 常规订单，为来自粗糙和非农村地区的患者提供服务，并且是医疗系统的一部分。诊所会 随机分配到AAT或AAT通过常规支撑增强。主要试验结果将是诊所 验证的11-12岁儿童的HPV疫苗开始。我们假设有常规订单的AAT 通过改善HPV疫苗通信，支持可以增加HPV疫苗的摄取。目标3是生成 医疗保健系统的指南，以支持实施HPV疫苗常规订单以利用 整个初级保健团队。我们将收集和共享干预数据（成本，影响和实施 数据）通过项目4支持成本效益分析和开发其决策支持工具。我们 将使用我们的P01的干预核心来确定干预实施。最后， 我们将为AAT干预软件包贡献模块，为医疗系统提供指导 改善HPV疫苗接种。项目1通过建立能力来解决影响计划项目主题 HPV疫苗通信干预医疗系统中的初级保健团队之间的干预措施。