Announcements Versus Conversations to Improve HPV Vaccination Coverage: A Randomized Trial

Area of Science:

• Public Health
• Vaccinology
• Clinical Trials

Background:

• Low human papillomavirus (HPV) vaccination coverage is a significant public health concern.
• Provider recommendations play a crucial role in improving vaccination rates.
• Novel training strategies are needed to enhance provider communication regarding HPV vaccination.

Purpose of the Study:

• To evaluate the effectiveness of two distinct provider training methods—presumptive announcements and participatory conversations—on HPV vaccination coverage.
• To determine if these training interventions can improve HPV vaccine initiation in adolescents.

Main Methods:

• A parallel-group randomized clinical trial was conducted across 30 pediatric and family medicine clinics.
• Clinics were randomized to receive no training (control), announcement training, or conversation training.
• The primary outcome was the 6-month change in HPV vaccine initiation (≥1 dose) for adolescents aged 11 or 12 years, measured via the North Carolina Immunization Registry.

Main Results:

• Six-month HPV vaccination coverage increased by 5.4% in clinics utilizing announcement training compared to control clinics.
• Announcement training demonstrated effectiveness for both girls (4.6% increase) and boys (6.2% increase).
• Conversation training did not yield a significant difference in HPV vaccination coverage compared to control clinics. No significant changes were observed for other vaccines or older adolescents (13-17 years).

Conclusions:

• Training healthcare providers to use presumptive announcements is an effective strategy for increasing HPV vaccine initiation in young adolescents.
• This approach offers a clinically meaningful improvement in HPV vaccination rates for the target age group.
• Further research may be needed to optimize strategies for older adolescents and other vaccination outcomes.