An educational intervention to improve HPV vaccination: A cluster randomized trial

Brian E. Dixon, Gregory D. Zimet, Shan Xiao, Wanzhu Tu, Brianna Lindsay, Abby Church, Stephen M. Downs

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3 Scopus citations

Abstract

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. METHODS: 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. RESULTS: 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%; P < .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; P < .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; P = .003). CONCLUSIONS: Educational interventions delivered within a clinical setting hold promise to improve vaccination behaviors.

Original languageEnglish (US)
Article numbere20181457
JournalPediatrics
Volume143
Issue number1
DOIs
StatePublished - Jan 2019

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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