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

Gregory Zimet, Brian Dixon, Shan Xiao, Wanzhu Tu, Amit Kulkarni, Tamara Dugan, Meena Sheley, Stephen Downs

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To evaluate the effects of simple and elaborated health care provider (HCP) reminder prompts on human papillomavirus (HPV) vaccine initiation rates. Methods: Twenty-nine pediatric HCPs serving 5 pediatric clinics were randomized to 1 of 3 arms: 1) usual practice control, 2) simple reminder prompt, and 3) elaborated reminder prompt, which included suggested language for recommending the early adolescent platform vaccines. Prompts were delivered via a computer-based clinical decision support system deployed in the 5 clinics. Eligible patients were ages 11 to 13 years, had not received HPV vaccine, and were due for meningococcal ACWY (MenACWY) vaccine and/or the tetanus, diphtheria, and pertussis booster (Tdap). Receipt of HPV vaccine was determined via automated queries sent to the Indiana immunization registry. Data were analyzed via logistic regression models, with generalized estimating equations used to account for the clustering of patients within HCPs. Results: Ten HCPs in the control group saw 301 patients, 8 HCPs in the simple prompt group saw 124, and 11 HCPs in the elaborated prompt group saw 223. The elaborated prompt arm had a higher rate of HPV vaccination (62%) than the control arm (45%): adjusted odds ratio, 2.76; 95% confidence interval, 1.07 to 7.14. The simple prompt arm did not differ significantly from the control arm with respect to HPV vaccine initiation, which might have been because of the small sample size for this arm. MenACWY and Tdap rates did not vary across the 3 arms. Conclusions: Results suggest that an elaborated HCP-targeted reminder prompt, with suggested recommendation language, might improve rates of HPV vaccine initiation.

Original languageEnglish (US)
Pages (from-to)S21-S22
JournalAcademic Pediatrics
Volume18
Issue number2
DOIs
StatePublished - Mar 1 2018

Fingerprint

Papillomavirus Vaccines
Vaccination
Randomized Controlled Trials
Diphtheria
Whooping Cough
Tetanus
Health Personnel
Language
Logistic Models
Clinical Decision Support Systems
Meningococcal Vaccines
Pediatrics
Sample Size
Cluster Analysis
Registries
Immunization
Vaccines
Odds Ratio
Confidence Intervals
Control Groups

Keywords

  • adolescent immunization
  • computer decision support
  • human papillomavirus
  • provider prompt

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Simple and Elaborated Clinician Reminder Prompts for Human Papillomavirus Vaccination : A Randomized Clinical Trial. / Zimet, Gregory; Dixon, Brian; Xiao, Shan; Tu, Wanzhu; Kulkarni, Amit; Dugan, Tamara; Sheley, Meena; Downs, Stephen.

In: Academic Pediatrics, Vol. 18, No. 2, 01.03.2018, p. S21-S22.

Research output: Contribution to journalArticle

@article{7db436858d8d4be2936f97970c1a7640,
title = "Simple and Elaborated Clinician Reminder Prompts for Human Papillomavirus Vaccination: A Randomized Clinical Trial",
abstract = "Objective: To evaluate the effects of simple and elaborated health care provider (HCP) reminder prompts on human papillomavirus (HPV) vaccine initiation rates. Methods: Twenty-nine pediatric HCPs serving 5 pediatric clinics were randomized to 1 of 3 arms: 1) usual practice control, 2) simple reminder prompt, and 3) elaborated reminder prompt, which included suggested language for recommending the early adolescent platform vaccines. Prompts were delivered via a computer-based clinical decision support system deployed in the 5 clinics. Eligible patients were ages 11 to 13 years, had not received HPV vaccine, and were due for meningococcal ACWY (MenACWY) vaccine and/or the tetanus, diphtheria, and pertussis booster (Tdap). Receipt of HPV vaccine was determined via automated queries sent to the Indiana immunization registry. Data were analyzed via logistic regression models, with generalized estimating equations used to account for the clustering of patients within HCPs. Results: Ten HCPs in the control group saw 301 patients, 8 HCPs in the simple prompt group saw 124, and 11 HCPs in the elaborated prompt group saw 223. The elaborated prompt arm had a higher rate of HPV vaccination (62{\%}) than the control arm (45{\%}): adjusted odds ratio, 2.76; 95{\%} confidence interval, 1.07 to 7.14. The simple prompt arm did not differ significantly from the control arm with respect to HPV vaccine initiation, which might have been because of the small sample size for this arm. MenACWY and Tdap rates did not vary across the 3 arms. Conclusions: Results suggest that an elaborated HCP-targeted reminder prompt, with suggested recommendation language, might improve rates of HPV vaccine initiation.",
keywords = "adolescent immunization, computer decision support, human papillomavirus, provider prompt",
author = "Gregory Zimet and Brian Dixon and Shan Xiao and Wanzhu Tu and Amit Kulkarni and Tamara Dugan and Meena Sheley and Stephen Downs",
year = "2018",
month = "3",
day = "1",
doi = "10.1016/j.acap.2017.11.002",
language = "English (US)",
volume = "18",
pages = "S21--S22",
journal = "Academic Pediatrics",
issn = "1876-2859",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Simple and Elaborated Clinician Reminder Prompts for Human Papillomavirus Vaccination

T2 - A Randomized Clinical Trial

AU - Zimet, Gregory

AU - Dixon, Brian

AU - Xiao, Shan

AU - Tu, Wanzhu

AU - Kulkarni, Amit

AU - Dugan, Tamara

AU - Sheley, Meena

AU - Downs, Stephen

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objective: To evaluate the effects of simple and elaborated health care provider (HCP) reminder prompts on human papillomavirus (HPV) vaccine initiation rates. Methods: Twenty-nine pediatric HCPs serving 5 pediatric clinics were randomized to 1 of 3 arms: 1) usual practice control, 2) simple reminder prompt, and 3) elaborated reminder prompt, which included suggested language for recommending the early adolescent platform vaccines. Prompts were delivered via a computer-based clinical decision support system deployed in the 5 clinics. Eligible patients were ages 11 to 13 years, had not received HPV vaccine, and were due for meningococcal ACWY (MenACWY) vaccine and/or the tetanus, diphtheria, and pertussis booster (Tdap). Receipt of HPV vaccine was determined via automated queries sent to the Indiana immunization registry. Data were analyzed via logistic regression models, with generalized estimating equations used to account for the clustering of patients within HCPs. Results: Ten HCPs in the control group saw 301 patients, 8 HCPs in the simple prompt group saw 124, and 11 HCPs in the elaborated prompt group saw 223. The elaborated prompt arm had a higher rate of HPV vaccination (62%) than the control arm (45%): adjusted odds ratio, 2.76; 95% confidence interval, 1.07 to 7.14. The simple prompt arm did not differ significantly from the control arm with respect to HPV vaccine initiation, which might have been because of the small sample size for this arm. MenACWY and Tdap rates did not vary across the 3 arms. Conclusions: Results suggest that an elaborated HCP-targeted reminder prompt, with suggested recommendation language, might improve rates of HPV vaccine initiation.

AB - Objective: To evaluate the effects of simple and elaborated health care provider (HCP) reminder prompts on human papillomavirus (HPV) vaccine initiation rates. Methods: Twenty-nine pediatric HCPs serving 5 pediatric clinics were randomized to 1 of 3 arms: 1) usual practice control, 2) simple reminder prompt, and 3) elaborated reminder prompt, which included suggested language for recommending the early adolescent platform vaccines. Prompts were delivered via a computer-based clinical decision support system deployed in the 5 clinics. Eligible patients were ages 11 to 13 years, had not received HPV vaccine, and were due for meningococcal ACWY (MenACWY) vaccine and/or the tetanus, diphtheria, and pertussis booster (Tdap). Receipt of HPV vaccine was determined via automated queries sent to the Indiana immunization registry. Data were analyzed via logistic regression models, with generalized estimating equations used to account for the clustering of patients within HCPs. Results: Ten HCPs in the control group saw 301 patients, 8 HCPs in the simple prompt group saw 124, and 11 HCPs in the elaborated prompt group saw 223. The elaborated prompt arm had a higher rate of HPV vaccination (62%) than the control arm (45%): adjusted odds ratio, 2.76; 95% confidence interval, 1.07 to 7.14. The simple prompt arm did not differ significantly from the control arm with respect to HPV vaccine initiation, which might have been because of the small sample size for this arm. MenACWY and Tdap rates did not vary across the 3 arms. Conclusions: Results suggest that an elaborated HCP-targeted reminder prompt, with suggested recommendation language, might improve rates of HPV vaccine initiation.

KW - adolescent immunization

KW - computer decision support

KW - human papillomavirus

KW - provider prompt

UR - http://www.scopus.com/inward/record.url?scp=85042800596&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042800596&partnerID=8YFLogxK

U2 - 10.1016/j.acap.2017.11.002

DO - 10.1016/j.acap.2017.11.002

M3 - Article

AN - SCOPUS:85042800596

VL - 18

SP - S21-S22

JO - Academic Pediatrics

JF - Academic Pediatrics

SN - 1876-2859

IS - 2

ER -