An Educational Intervention to Improve HPV Vaccination: A Cluster Randomized Trial

• Published in: Pediatrics (Evanston) Vol. 143; no. 1
• Main Authors: Dixon, Brian E, Zimet, Gregory D, Xiao, Shan, Tu, Wanzhu, Lindsay, Brianna, Church, Abby, Downs, Stephen M
• Format: Journal Article
• Language: English
• Published: United States 01.01.2019
• Subjects: Adolescent; Child; Cluster Analysis; Female; Humans; Male; Papillomavirus Infections - epidemiology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines - therapeutic use; Parents - education; Patient Education as Topic - methods; Patient Education as Topic - trends; Vaccination - methods; Vaccination - trends
• ISSN: 1098-4275
• DOI: 10.1542/peds.2018-1457

: media-1vid110.1542/5849572217001PEDS-VA_2018-1457 BACKGROUND: Human papillomavirus (HPV) infection can lead to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. In a cluster randomized trial, an intervention used to target parents of adolescents (11-17 years) eligible for a dose of HPV vaccine, was tested in pediatric clinics part of an urban health system. Parents watched a digital video outlining the risks and benefits of vaccine using a tablet in the examination room. The primary outcome was change in HPV vaccine status 2 weeks after the clinic visit. An intention-to-treat analysis for the primary outcome used generalized estimating equations to accommodate the potential cluster effect of clinics. A total of 1596 eligible adolescents were observed during the 7-month trial. One-third of adolescents visited an intervention clinic. Adolescents who attended an intervention clinic were more likely to be younger (11-12 years) than those who attended a control clinic (72.4% vs 49.8%; < .001). No differences in race or sex were observed. The proportion of adolescents with an observed change in vaccine status was higher for those attending an intervention clinic (64.8%) versus control clinic (50.1%; odds ratio, 1.82; 95% confidence interval, 1.47-2.25; < .001). Adolescents whose parents watched the video had a 3-times greater odds of receiving a dose of the HPV vaccine (78.0%; odds ratio, 3.07; 95% confidence interval, 1.47-6.42; = .003). Educational interventions delivered within a clinical setting hold promise to improve vaccination behaviors.