Impact of a Multilevel Quality Improvement Intervention Using National Partnerships on Human Papillomavirus Vaccination Rates.

To evaluate the effectiveness of a multilevel intervention using national partnerships on human papillomavirus (HPV) vaccination rates. The American Cancer Society's Vaccinate Adolescents against Cancer program is a multilevel intervention focusing on systems and providers. The 2017 cohort introduce...

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Publicado en:Academic Pediatrics Vol. 21; no. 7; pp. 1134 - 1142
Autores principales: Perkins, Rebecca B., Foley, Shaylen, Hassan, Anna, Jansen, Emily, Preiss, Sandy, Isher-Witt, Jennifer, Fisher-Borne, Marcie
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. Sep2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2021
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.acap.2021.05.018
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        atl: Impact of a Multilevel Quality Improvement Intervention Using National Partnerships on Human Papillomavirus Vaccination Rates.
      aug:
        au:
          Perkins, Rebecca B.
          Foley, Shaylen
          Hassan, Anna
          Jansen, Emily
          Preiss, Sandy
          Isher-Witt, Jennifer
          Fisher-Borne, Marcie
        affil: Department of Obstetrics and Gynecology, Boston University School of Medicine/Boston Medical Center (RB Perkins), Boston, Mass
      sug:
        subj:
          Quality Improvement
          Papillomavirus Vaccine
          Vaccination Coverage
          Program Implementation
          Human
          Funding Source
          Surveys
          T-Tests
      ab: To evaluate the effectiveness of a multilevel intervention using national partnerships on human papillomavirus (HPV) vaccination rates. The American Cancer Society's Vaccinate Adolescents against Cancer program is a multilevel intervention focusing on systems and providers. The 2017 cohort introduced national partnerships to deliver intervention elements and Maintenance of Certification and continuing medical education credits for physicians. Eleven federally qualified health center (FQHC) systems completed interventions in 2017. Interventions included provider training and ≥1 other evidence-based systems improvement. We compared adolescent vaccination rates in the preintervention period (2016) and intervention period (2017) among adolescents who turned 13 during the calendar year. Intervention effectiveness was assessed using repeated measures paired t tests and Cohen's d effect size for vaccination rate change. All FQHC systems implemented provider training plus an average of 2.3 additional systems improvements. Series initiation increased by an average of 23.6 percentage points (47.2%–70.8%). HPV completion rates increased by an average of 22.7 percentage points (24.6%–46.3%). Meningococcal and Tdap vaccination rates increased by 23.3 and 25.9 percentage points respectively (47.9%–71.2% and 48.8%–74.7%). All changes were statistically significant (all P <.05) and indicated large effect sizes (Cohen's d 3 1.15). Among clinicians completing postintervention surveys, 90% reported making changes to their health care system or direct patient care based on what they had learned. Multilevel interventions focusing on provider training and systems changes can substantially improve on-time adolescent vaccination coverage and can be successfully performed using national partnerships and a train-the-trainer model.
      pubtype: Academic Journal
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        research
        tables/charts
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      ougenre: Article
    language: English
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