Strategies for Improving HPV Vaccination Coverage Rates & Motivating Diverse Partners

Transcription

1 Strategies for Improving HPV Vaccination Coverage Rates & Motivating Diverse Partners Jill B Roark, MPH Lead, Adolescent Immunization Communications Health Communication Science Office National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention OVERVIEW 1

2 How to increase the number of target patients who come in & leave vaccinated 1. Know your coverage rates Clinic level rates are great, but rates for individual clinicians are even better! Other than AFIX visits, rates can come from Data from EHR IIS inputs How to increase the number of target patients who come in & leave vaccinated 2. Align office/clinic policy with mission Immunize at every opportunity Implement and utilize standing orders Prompt the person ordering the vaccine in multiple ways Reminders & Recalls 2

3 How to increase the number of target patients who come in & leave vaccinated 3. Align communication with mission Give staff a cancer prevention mission All staff need to be saying the same thing Share talking points Use the Tip Sheet Hold an in service ALIGNING COMMUNICATION 3

4 How Parents Feel Median Values Parent Meningitis Hepatitis Pertussis Influenza HPV Adolescent vaccines 4

5 How Providers Think Parents Feel Median Values Parent Provider's estimate Meningitis Hepatitis Pertussis Influenza HPV Adolescent vaccines The Difference Median Values Parent Provider's estimate Meningitis Hepatitis Pertussis Influenza HPV Adolescent vaccines 7.8 5

6 What is an EFFECTIVE recommendation for HPV vaccination? Make an Effective Recommendation Same way: Effective recommendations group all of the adolescent vaccines Recommend HPV vaccination the same way you recommend Tdap & meningococcal vaccines. Same day: Recommend HPV vaccine today Recommend HPV vaccination the same day you recommend Tdap & meningococcal vaccines. Brewer at al. Pediatrics Jan;139(1). Unpublished CDC data,

7 Tdap MenACWY HPV Your preteen needs 3 vaccines today, to protect against the infections that can cause meningitis, HPV cancers, and pertussis. Brewer at al. Pediatrics Jan;139(1). 7

8 Now that Sophia is 11, she is due for three vaccines today. These will help protect her from the infections that can cause meningitis, HPV cancers, and pertussis. We ll give those shots at the end of the visit. Do you have any questions for me? Now that Sophia is 11, she is due today for three important vaccines. The first is to help prevent an infection that can cause meningitis, which is very rare, but potentially deadly. The second is to prevent a very common infection, HPV, that can cause several kinds of cancer. The third is the tetanus booster which also protects against pertussis, so your child doesn t get whooping cough, but also to protect babies too young to be vaccinated. We ll give those shots at the end of the visit. Do you have any questions for me? 8

9 Some Parents Need Reassurance Many parents simply accept of this bundled recommendation Some parents may be interested in vaccinating, yet still have questions. Interpret a question as they need additional reassurance from YOU, the clinician they trust with their child s health care Ask parents about their main concern (be sure you are addressing their real concern) Unpublished CDC data, Is my child really at risk for HPV? 9

10 HPV is a very common and widespread virus that infects both females and males. We can help protect your child from the cancers and diseases caused by the virus by starting HPV vaccination today. Why at 11 or 12 years old? 10

11 When should the bike helmet go on? A. Before they get on their bike B. When they are riding their bike in the street C. When they see the car heading directly at them D. After the car hits them Temte JL. Pediatrics When do we put our seat belts on? A.Before turning on car B. When leaving driveway C. After a near accident Temte JL. Pediatrics

12 As with all vaccine preventable diseases, we want to protect your child early. If we start now, it s one less thing for you to worry about. Also, your child will only need two shots of HPV vaccine at this age. If you wait until 15, your child will need three shots. We ll give the first shot today and then you ll need to bring your child back in 6 to 12 months from now for the second shot. How long can we wait and still give just two doses? 12

13 The two dose schedule is recommended if the series is started before the 15th birthday. However, I don t recommend waiting to give this cancer preventing vaccine. As children get older and have busier schedules, it becomes more difficult to get them back in. I d feel best if we started the series today to get your child protected as soon as possible. A few words on risk profiling: Don t do it! 80% of people will be exposed to HPV You can t predict who or when 13

14 We just want to get the vaccines required for school. All three vaccines are strongly and equally recommended by the CDC. All three are also recommended by Pediatric, Adolescent, and Family Medicine doctors and groups. School entry requirements don t always reflect the current recommendations for your child s health. 14

15 Will my child be protected with just two shots? Yes! Studies have shown that just two shots given at least six months apart when kids are between 9 and 14 years worked as well or better than three shots given to older adolescents and young adults. 15

16 Partnerships to prevent HPV cancers MOTIVATING DIVERSE PARTNERS TO COLLABORATE 16

17 Are they motivated already? Then make it easier to participate. 17

18 Establish HPV Vaccination as a Priority Communicate three elements to convince partners to prioritize HPV vaccination focus: 1. Potential for high impact: HPV vaccination is reducing HPV disease 2. Data on state performance: Big opportunities to improve vaccination rates 3. Presence of strong national support: Momentum and support from National HPV Vaccination Roundtable, CDC Immunization, CDC Cancer, NCI 1. Establish HPV Vaccination as a Priority: Provide Data on State/Local Performance 18

19 1. Establish HPV Vaccination as a Priority: Emphasize Strong National Support Develop and convene partners Focus on Key Partners: State and Local Immunization Coalitions Cancer Center(s) Pediatric & Family Medicine: AAP, AAFP chapters HPV Vaccine Champions in Pediatrics American Cancer Society Other Immunization Partners Cancer Coalition/Partners Community Measurement 19

20 Develop and convene partners 1. Prepare the case for participation The right presentation will present the coalition as an organized, well defined effort and generate excitement for the cause. 2. Meet partners needs Pay attention to the partner s strategic needs look for win win opportunities. 3. Set expectations for involvement Communicate that they are signing up for a work group, not an advisory committee, and that they are being asked to contribute something concrete. Create Action Plan Develop a measurable goal based on SMART objectives: Specific Measurable Achievable Relevant Time Oriented 20

21 Create Action Plan Examples of tasks: Incorporate HPV vaccination coverage improvement into state cancer plan Conduct trainings/webinars for immunization providers Letter from school nurse or administration to parents of years about recommended vaccines for preteens Use ordering data to identify clinics/practices for quality improvement projects Hold a screening with panel of Someone You Love Launch parent outreach campaign Screen Someone You Love 21

22 Provide Marketing/Press Kit Possible Content: One pager Why HPV vaccination is critical for HPV cancer prevention List of organizations participating Factsheets and infographics Matte articles Logos and other shareable images Clinician tip sheet Materials for parents Provide Marketing/Press Kit: Content Examples 22

23 What Can [Health Departments] Do? Work with faith based health initiatives to have HPV vax info included Ask pharmacies to hang HPV vax posters next to other vax info Offer in service or feedback visit to every pediatric/fp practice in local area Work with the state Medicaid office to send information to parents of 9 12 year olds Ask largest employers in area to send HPV vaccine and cancer screening info to employees What Can [Cancer Centers] Do? Provide speakers for provider groups/grand rounds CME events on why HPV vaccination is an urgent priority Sponsor a screening of Someone You Love for pediatricians and family physicians (offer CME credit) Write a letter to all family physicians and pediatricians on the urgency of HPV vaccinations Reach out to health system executives to encourage HPV vaccination initiatives 23

24 What Can [Cancer Programs] Do? Include HPV vax as a priority & include in the Comprehensive Cancer Control State plan Analyze and share local data on cancers caused by HPV Share survivor/caregiver stories Work with partners to promote HPV vaccination at other cancer events Ask local ACS chapter to co sponsor events and/or co brand materials/psas What Can [Communicators] Do? Pitch Local radio stations to run state or CDC Radio PSAs Local TV stations to run state or CDC Video PSAS Local movie theaters to run state or CDC Video PSAS Local airports to post PSA style ads Work with local university Greek system to take on HPV vaccination as their cause Encourage local book clubs skip a book one month and watch Someone You Love instead 24

25 What Can [Clinicians] Do? Every clinician knows their individual HPV vaccination rates Open scheduling up to 6 months in advance (like all dentists do) Print registry of all 13 year old patients who haven t initiated series and call/mail/text; repeat for series completion Send adolescent vaccine info to parents of all 10 year old patients Use CDC s hold message scripts and content syndication Utilize standing orders for nurses to administer HPV vaccine Offer nurse only appointments or no wait walk in hours for 2 nd (and 3 rd ) dose What Can [Healthcare Professionals] Do? Pediatric dentists send info to parents of 9 12 year old patients Family dentists send info to all families about HPV vaccination and oral cancer screening Ob Gyns send letters to all patients about HPV vaccination and cervical cancer screening recommendations Ob Gyns add HPV vaccine info to pap results 25

26 What Can [Medical Societies] Do? Include cancer specialists in conferences as speakers on why HPV vaccination is urgent Distribute a joint letter with cancer center about the urgency of HPV vaccination Identify and spotlight providers with high HPV vax coverage Peer to peer sessions Lunch and learn webinars with CE Distribute educational materials to offices of clinicians who see patients age 9 12 What Can [Payers] Do? For Cervical Cancer Awareness Month in January, send postcards to moms with reminders for cervical cancer screening for themselves and HPV vaccination for their kids Send Tips & Timesavers and info on state/local rates to every pediatric and family medicine clinician in your plan 26

27 What Can [Health Systems] Do? Begin an HPV vaccination quality improvement project for the system Provide each pediatric clinician with their individual HPV vaccination rates Send information about HPV vaccination and cervical cancer screening to all mothers of patients 9 12 years 27

28 What Can [CBOs/NGOs] Do? Planned Parenthood clinics send HPV cancer prevention info to all patients Local Boys & Girls Clubs and YMCAs send info to all families on adolescent vaccination and cancer screening Local public health educators (via local AHEC) offer classroom lectures to health classes on vaccines and VPDs What Can [School Systems] Do? Have sports/camp physical forms changed to list all recommended vaccines Adolescent vaccine promotion at high school sporting event venues Send letters to parents of year old students about recommended vaccinations Invite speakers to health classes to talk about vaccines and VPDs 28

29 What Can [YOU] Do? Make a commitment to cancer prevention by ensuring that every preteen who crosses your path has the opportunity to be vaccinated Want to know when we have new resources and tools? Send us an to request our newsletter: PreteenVaccines@cdc.gov 29