A multifaceted, targeted intervention to improve human papillomavirus vaccination rates in general practice: A...

Human papillomavirus (HPV) vaccination rates are low in Switzerland. The aim of the study was to test a pragmatic multifaceted targeted intervention among general practitioners (GPs) to increase HPV vaccination (HPVv) rates in general practice.

In this cluster-randomized controlled trial, two equally sized groups of GPs each received an educational session on vaccination in general and on the national vaccination schedule. Treatment group GPs additionally received detailed information about HPV, information leaflets, and were instructed on HPV announcement training as an approach to recommend HPVv. Primary outcome was the number of first HPVv doses administered per GP up to six months after study start (T6). Secondary outcomes were first HPVv dose counts at T3 and T12 and the GPs' changes in attitudes and knowledge regarding HPVv from baseline to T6. Outcomes were analysed using mixed-effects Poisson and logistic regression models.

A total of N = 56 practices with n = 72 GPs were randomized. GPs administered a total of 5329 vaccine doses including 195 HPVv doses. The intervention had no effect on the primary outcome (adjusted rate ratio [95 % CI]: 1.55 [0.72-3.37]), and none of the secondary HPVv count outcomes reached statistical significance. The treatment group showed significantly higher odds of changing attitudes towards HPVv (adjusted odds ratio [95 % CI]: 17.89 [3.36-95.23]). We found no difference in knowledge gain between the groups.

The multifaceted intervention improved attitudes towards HPVv but failed to increase HPVv rates or knowledge. Insights from the study can help inform the development of future HPVv interventions.

ISRCTN 55473884, first registered on 04/06/2021.