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Roura-Monllor J, Nieves-Muñoz J, Ortiz AP, Romaguera J. HPV knowledge, vaccine knowledge, and vaccine acceptance in women with cervical cytology anomalies attending colposcopy clinics in Puerto Rico. Int J Gynaecol Obstet 2018; 143:52-58. [DOI: 10.1002/ijgo.12594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 05/15/2018] [Accepted: 07/09/2018] [Indexed: 01/05/2023]
Affiliation(s)
- Jaime Roura-Monllor
- Department of Obstetrics and Gynecology; University of Puerto Rico School of Medicine; San Juan Puerto Rico
| | - Jose Nieves-Muñoz
- Department of Obstetrics and Gynecology; University of Puerto Rico School of Medicine; San Juan Puerto Rico
| | - Ana P. Ortiz
- University of Puerto Rico Comprehensive Cancer Center; San Juan Puerto Rico
- Department of Biostatistics and Epidemiology; Graduate School of Public Health; University of Puerto Rico; San Juan Puerto Rico
| | - Josefina Romaguera
- Department of Obstetrics and Gynecology; University of Puerto Rico School of Medicine; San Juan Puerto Rico
- Department of Obstetrics and Gynecology; San Juan City Hospital; San Juan Puerto Rico
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Finney Rutten LJ, Radecki Breitkopf C, St Sauver JL, Croghan IT, Jacobson DJ, Wilson PM, Herrin J, Jacobson RM. Evaluating the impact of multilevel evidence-based implementation strategies to enhance provider recommendation on human papillomavirus vaccination rates among an empaneled primary care patient population: a study protocol for a stepped-wedge cluster randomized trial. Implement Sci 2018; 13:96. [PMID: 30001723 PMCID: PMC6043954 DOI: 10.1186/s13012-018-0778-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 06/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Each year, human papillomavirus (HPV) causes 30,000 cancers in the USA despite the availability of effective and safe vaccines. Uptake of HPV vaccine has been low and lags behind other adolescent vaccines. This protocol describes a multilevel intervention to improve HPV vaccination rates. Methods Using a cluster randomized trial, we will evaluate the independent and combined impact of two evidence-based implementation strategies with innovative enhancements on HPV vaccination rates for female and male patients. The clusters are six primary care sites providing care to pediatric populations. We will use a stepped-wedge cluster randomized design, including process evaluation, to test the hypothesis that compared with the current course of care and a practice-level intervention using reminder-recall interventions coupled with provider-level audit and feedback with education increases HPV vaccination rates in exposed clusters. The factorial design allows us to use a single trial to test these two interventions and to assess each individually and in combination. Our design has four 12-month steps. The first step will be a baseline period; data collected during it will provide a within-practice control group for each cluster. Second, two clusters will be randomly assigned to receive intervention 1 (reminder and recall), and two clusters will be randomly selected to receive intervention 2 (audit and feedback with education). Third, the other two clusters will be randomly allocated to intervention 1 or 2. Clusters initially with intervention 1 will be randomly allocated to 1 + 2 or 1; clusters initially with intervention 2 will be randomly allocated to 1 + 2 or 2. Fourth, all clusters will receive both interventions. To ensure balance of patient numbers across interventions, we will use block randomization at the first step, with the six clusters grouped into three pairs according to volume. Our primary outcome will be vaccination rates. Discussion Results of our clinical trial and process evaluation will provide evidence showing whether practice- and provider-level interventions improve HPV vaccination rates and will offer insight into contextual factors associated with direction and magnitude of trial outcomes. Trial registration ClinicalTrials.gov, NCT03501992, registered April 18, 2018. Electronic supplementary material The online version of this article (10.1186/s13012-018-0778-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lila J Finney Rutten
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA. .,Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
| | | | - Jennifer L St Sauver
- Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Ivana T Croghan
- Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.,Nicotine Dependence Center, Mayo Clinic, Rochester, MN, USA
| | - Debra J Jacobson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Patrick M Wilson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Robert M Jacobson
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA.,Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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