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Simple and Elaborated Clinician Reminder Prompts for Human Papillomavirus Vaccination: A Randomized Clinical Trial

Gregory Zimet1, Brian E Dixon2, Shan Xiao3

  • 1Department of Pediatrics-Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Ind.

Academic Pediatrics
|March 6, 2018
PubMed

Insights

Elaborated health care provider prompts significantly increased human papillomavirus (HPV) vaccine initiation rates in adolescents. Simple prompts showed no significant difference, suggesting tailored recommendations are key for improving HPV vaccination coverage.

Area of Science:

  • Pediatric Health
  • Vaccinology
  • Health Services Research

Background:

  • Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers.
  • Low HPV vaccine initiation rates remain a public health concern, necessitating effective provider-level interventions.
  • Pediatric healthcare providers (HCPs) play a vital role in vaccine recommendations.

Purpose of the Study:

  • To assess the impact of simple and elaborated health care provider (HCP) reminder prompts on human papillomavirus (HPV) vaccine initiation.
  • To compare the effectiveness of different types of prompts delivered through a clinical decision support system.

Main Methods:

  • A randomized trial involving 29 pediatric HCPs across 5 clinics.
  • Three arms: usual practice control, simple reminder prompt, and elaborated reminder prompt with suggested language.
  • HPV vaccine initiation tracked via the Indiana immunization registry for eligible 11-13 year olds.

Main Results:

  • The elaborated prompt group achieved a 62% HPV vaccination rate, significantly higher than the 45% in the control group (aOR=2.76).
  • The simple prompt group did not show a statistically significant increase in HPV vaccine initiation compared to the control.
  • Rates for meningococcal ACWY (MenACWY) and tetanus, diphtheria, and pertussis (Tdap) vaccines remained consistent across all groups.

Conclusions:

  • Elaborated HCP-targeted reminder prompts, including specific recommendation language, may enhance HPV vaccine initiation rates.
  • Simple prompts may be insufficient to significantly improve vaccination uptake.
  • Targeted, actionable prompts integrated into clinical workflows show promise for improving adolescent vaccination coverage.
Abstract

Keywords:
adolescent immunizationcomputer decision supporthuman papillomavirusprovider prompt

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