Accelerating Uptake of the Human Papillomavirus (HPV) Vaccine in Inland Northern California

Transcription

1 Accelerating Uptake of the Human Papillomavirus (HPV) Vaccine in Inland Northern California Julie Dang, PhD, MPH Administrative Director, Community Engagement and Outreach Duke LeTran, BS, Catrina Franco, BA, & Moon S. Chen Jr., PhD., MPH University of California, Davis Comprehensive Cancer Center June 7, 2018

2 To investigate barriers, facilitators, and implementation strategies so as to customize interventions and approaches that will accelerate HPV vaccination uptake in our 13-county inland northern California catchment are Purpose

3 Specific Aims Conduct key informant interviews and administer online surveys with stakeholders representing pediatric providers, parents of adolescents, adolescents, healthcare professional associations/organizations, health-care organizations and local county health departments. Determine and validate available sources of HPV vaccination rate data by county. Examine current and pending state laws as well as current state legislation as it pertains to HPV vaccination.

4 Progress to date 32 Interviews Completed 69 Surveys 4 Pieces of CA Legislation Data gaps in HPV vaccination reported rates

5 All: Safety? All: Time Rural: Limited appt. times Minorities: Immigratio n Patterns All: Misinformati on Rural: Stock Urban: Social Media All: Not a priority What are some challenges to HPV vaccination? BARRIERS

6 parents get many negative stories from Facebook and online communities Dr. Google

7 did you hear what happened in Placer County? We don t want to have that type of backlash

8 being in the U.S. they are more open and freed, so they feel that they have choices choosing to vaccinate or not...

9 inundating providers and clinic staff with educational tools not useful not enough time -Rural Months to get an appointment School mandated vaccines only Clinic Capacity Stock/availability

10 Strong provider recommendation & Bundling FACILITATORS

11 Addressing misinformation & parental concerns STRATEGIES

12 Addressing Misinformation Rural & Minority: If you can get an expert and allow people to ask questions and get answers from that community forum and panel Urban: if you can do a social media campaign get Doctors to post on their Facebook page

13 Clinic Staff Personal Stories I vaccinated my children. My grandchildren are vaccinated. My parents did not vaccinate me when I was little..and now as an adult I feel vulnerable.

14 Name and Shame Professional organizations, health plans, provider groups need to evaluate providers on how well they re performing Name and shame, reward and incentivize there has to be accountability at the provider level

15 Tracking, Monitoring & Reporting HPV VACCINATION RATES

16 Electronic Health System No Electronic Health Records No reminders in place, no automated systems. Maintains yellow immunization cards for vaccinations, kept in their charts. Becomes challenging to keep track of cards: parents lose them, etc.

17 Takeaways RECOMMENDATIONS

18 A one size fit all approach will not work: Community differences Hispanic or Latino (of any race), 28.70% Asian, 13.40% Black or African American, 8.00% Some other race, 9.80% American Indian and Alaska Native, 2.70% Native Hawaiian and Other Pacific Islander, 1.20% White, 43.00%

19 Intervening at multiple levels Patient Medical visits Parental approval Painful Knowledge and awareness Multiple dose Parent Greenlight for sexual activity? Safety, efficacy Cost Multiple dose Knowledge and awareness Insurance Provider Strength & quality of rec. Comm. with parents and patients Health System Reimbursem ent Reminder systems Vaccine availability Tracking system Community/ Public Policy Vaccine rollout & rec. State policies School mandates

20 BUNDLE LOW RATES ENGAGE PROTECTION MULTILEVEL GIRLS BOYS 9-VALENT STRONG RECOMMENDATION IMMUNIZE SAFE MISSED OPPORTUNITIES ORAL SEX IMPROVING EFFECTIVE BARRIERS RISK MISSED CLINIC Cancer CLINICAL SUPPORT PROVIDER PARENTS Cervical Head/Neck VIRAL SKIN TO SKIN 2 shots