Announcements versus conversations to improve HPV vaccination coverage: A randomized trial

Noel T. Brewer, Megan E. Hall, Teri L. Malo, Melissa B. Gilkey, Beth Quinn, Christine Lathren

Research output: Research - peer-reviewArticle

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Abstract

OBJECTIVE: Improving provider recommendations is critical to addressing low human papillomavirus (HPV) vaccination coverage. Thus, we sought to determine the effectiveness of training providers to improve their recommendations using either presumptive "announcements" or participatory "conversations." METHODS: In 2015, we conducted a parallel-group randomized clinical trial with 30 pediatric and family medicine clinics in central North Carolina. We randomized clinics to receive no training (control), announcement training, or conversation training. Announcements are brief statements that assume parents are ready to vaccinate, whereas conversations engage parents in open-ended discussions. A physician led the 1-hour, in-clinic training. The North Carolina Immunization Registry provided data on the primary trial outcome: 6-month coverage change in HPV vaccine initiation (≥1 dose) for adolescents aged 11 or 12 years. RESULTS: The immunization registry attributed 17 173 adolescents aged 11 or 12 to the 29 clinics still open at 6-months posttraining. Six-month increases in HPV vaccination coverage were larger for patients in clinics that received announcement training versus those in control clinics (5.4% difference, 95% confidence interval: 1.1%-9.7%). Stratified analyses showed increases for both girls (4.6% difference) and boys (6.2% difference). Patients in clinics receiving conversation training did not differ from those in control clinics with respect to changes in HPV vaccination coverage. Neither training was effective for changing coverage for other vaccination outcomes or for adolescents aged 13 through 17 (n = 37 796). CONCLUSIONS: Training providers to use announcements resulted in a clinically meaningful increase in HPV vaccine initiation among young adolescents.

LanguageEnglish (US)
Article numbere20161764
JournalPediatrics
Volume139
Issue number1
DOIs
StatePublished - Jan 1 2017

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Vaccination
Papillomavirus Vaccines
Registries
Immunization
Parents
Randomized Controlled Trials
Medicine
Confidence Intervals
Pediatrics
Physicians

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Brewer, N. T., Hall, M. E., Malo, T. L., Gilkey, M. B., Quinn, B., & Lathren, C. (2017). Announcements versus conversations to improve HPV vaccination coverage: A randomized trial. Pediatrics, 139(1), [e20161764]. DOI: 10.1542/peds.2016-1764

Announcements versus conversations to improve HPV vaccination coverage : A randomized trial. / Brewer, Noel T.; Hall, Megan E.; Malo, Teri L.; Gilkey, Melissa B.; Quinn, Beth; Lathren, Christine.

In: Pediatrics, Vol. 139, No. 1, e20161764, 01.01.2017.

Research output: Research - peer-reviewArticle

Brewer, NT, Hall, ME, Malo, TL, Gilkey, MB, Quinn, B & Lathren, C 2017, 'Announcements versus conversations to improve HPV vaccination coverage: A randomized trial' Pediatrics, vol 139, no. 1, e20161764. DOI: 10.1542/peds.2016-1764
Brewer NT, Hall ME, Malo TL, Gilkey MB, Quinn B, Lathren C. Announcements versus conversations to improve HPV vaccination coverage: A randomized trial. Pediatrics. 2017 Jan 1;139(1). e20161764. Available from, DOI: 10.1542/peds.2016-1764
Brewer, Noel T. ; Hall, Megan E. ; Malo, Teri L. ; Gilkey, Melissa B. ; Quinn, Beth ; Lathren, Christine. / Announcements versus conversations to improve HPV vaccination coverage : A randomized trial. In: Pediatrics. 2017 ; Vol. 139, No. 1.
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