IMPACT Project 3 – Engaging clinical champions to improve HPV vaccine communication and uptake in healthcare systems

IMPACT 项目 3 — 让临床倡导者参与改善 HPV 疫苗的传播和医疗保健系统的采用

• 批准号: 10266274
• 负责人: Melissa B Gilkey
• 金额: $ 45.72万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-23 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10266274
• 关键词: Address; Adolescent; Age; Clinic; Clinical; Communication; Data; Dose; Educational Intervention; Educational workshop; Electronic Health Record; Face; Family Physicians; Goals; Healthcare Systems; Hour; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papillomavirus; Intervention; Interview; Knowledge; Malignant Neoplasms; Modeling; Outcome; Participant; Physicians; Primary Care Physician; Primary Health Care; Program Research Project Grants; Protocols documentation; Provider; Qualitative Research; Randomized; Randomized Clinical Trials; Recommendation; Research; Rural; Series; Surveys; System; Testing; Training; Training Activity; Training Programs; West Virginia; Wisconsin; Work; arm; base; communication behavior; comparative cost effectiveness; compare effectiveness; comparison intervention; cost; cost effectiveness; data sharing; follow-up; implementation measures; implementation outcomes; improved; innovation; intervention cost; intervention program; novel strategies; pediatrician; preference; prevent; primary outcome; programs; rural area; rural dwellers; scale up; training project; uptake; vaccination outcome; vaccine acceptance

ABSTRACT – Project 3 Widespread HPV vaccination could prevent most HPV cancers, but uptake among US adolescents remains far below national goals. To increase uptake, we developed Announcement Approach Training (AAT). AAT is a 1-hour communication workshop in which our physician facilitators train primary care teams to address the most critical barrier to HPV vaccination: infrequent and ineffective recommendations. AAT is effective for increasing HPV vaccine uptake among adolescents and is certified as an NCI Research-Tested Intervention Program. One of the most promising opportunities for scaling up AAT is to implement the intervention in healthcare systems, where most US pediatricians and family physicians now work. However, new approaches to delivering AAT will be needed to bring the intervention to scale effectively in these settings. Thus, as part of the P01 Program Project, “Improving Provider Announcement Communication Training (IMPACT),” Project 3 will enhance AAT to train systems' own clinical champions to deliver AAT, thereby building capacity for HPV vaccine communication training. In Aim 1, we will identify opportunities to engage clinical champions in delivering AAT within their own healthcare systems. Working with 6 partnering healthcare systems, we will interview 24 champions to understand: anticipated barriers and facilitators to AAT delivery; opportunities to extend AAT activities to increase reach and sustainability; and preferences for receiving training on how to deliver AAT. In Aim 2, we will compare the impact of Champion AAT to Traditional AAT on HPV vaccine uptake and communication. Using Aim 1 findings, we will adapt our existing intervention package to train champions to deliver AAT to clinics in their own systems. In a 2-arm non-inferiority trial, we will randomize 40 clinics in our 6 systems to receive Champion AAT or Traditional AAT. We will compare interventions on the primary outcome of HPV vaccine initiation, among adolescents ages 11- 12, at 12-month follow-up. We hypothesize that Champion AAT will be non-inferior to (i.e., as effective as) Traditional AAT. We will also compare our interventions on intermediate outcomes, including changes in workshop participants' communication, to identify mechanisms that may explain improvements in HPV vaccine uptake. In Aim 3, we will generate guidance to help healthcare systems compare and implement Champion AAT and Traditional AAT. We will compare our interventions on implementation measures to understand whether Champion AAT offers advantages, such as higher reach to primary care professionals, compared to Traditional AAT. Lastly, to integrate Project 3 with other IMPACT projects, we will share data to support cost-effectiveness modeling in Project 4 and contribute the Champion AAT module to the P01-wide AAT Intervention Package. In this way, we will prepare our highly scalable intervention for national dissemination. Project 3 addresses the IMPACT Program Project theme by engaging clinical champions to build capacity for HPV vaccine communication interventions among primary care teams in healthcare systems.

摘要 – 项目 3 广泛的 HPV 疫苗接种可以预防大多数 HPV 癌症，但美国青少年的接种率较低 仍远低于国家目标。为了提高采用率，我们开发了公告方法培训 (AAT)。 AAT 是一个时长 1 小时的沟通研讨会，我们的医师协调员将培训初级保健团队 解决 HPV 疫苗接种的最关键障碍：AAT 的建议不频繁且无效。 提高青少年 HPV 疫苗接种率的有效性，并获得 NCI 研究测试认证 扩大 AAT 的最有希望的机会之一是实施 对医疗保健系统进行干预，大多数美国儿科医生和家庭医生现在都在医疗保健系统工作。 需要采取新的方法来提供 AAT，以便在这些环境中有效地扩大干预范围。 因此，作为 P01 计划项目的一部分，“改进提供商公告沟通培训” (IMPACT)”，项目 3 将增强 AAT，以培训系统自己的临床冠军来提供 AAT，从而 建立 HPV 疫苗交流培训的能力 在目标 1 中，我们将寻找机会： 与 6 合作，让临床冠军在自己的医疗保健系统内提供 AAT。 我们将与医疗保健系统合作，采访 24 位冠军，以了解： 预期的障碍和 AAT 交付的促进者；扩大 AAT 活动以扩大影响范围和可持续性的机会； 在目标 2 中，我们将比较冠军的影响。 关于 HPV 疫苗的摄取和传播的 AAT 与传统 AAT 的比较 我们将根据目标 1 的研究结果进行调整。 我们现有的干预方案旨在培训冠军在他们自己的系统中向诊所提供 AAT。 非劣效性试验，我们将随机分配 6 个系统中的 40 家诊所接受冠军 AAT 或传统 AAT。 我们将比较针对 11 岁至 11 岁青少年接种 HPV 疫苗的主要结果的干预措施 12，在 12 个月的随访中，我们发现冠军 AAT 将不劣于（即与以下一样有效）。 我们还将比较我们对传统 AAT 的干预措施，包括中间结果的变化。 研讨会参与者的交流，以确定可以解释 HPV 疫苗改进的机制 在目标 3 中，我们将制定指南来帮助医疗保健系统进行比较和实施。 我们将比较我们对实施措施的干预措施。 Champion AAT 是否具有优势，例如更广泛地接触初级保健专业人员， 与传统 AAT 相比，最后，为了将项目 3 与其他 IMPACT 项目集成，我们将共享数据 支持项目 4 中的成本效益建模，并将 Champion AAT 模块贡献给 P01 范围 通过这种方式，我们将为国家准备高度可扩展的干预措施。 项目 3 通过让临床冠军参与来解决 IMPACT 项目的主题。 建设医疗保健系统初级保健团队中 HPV 疫苗沟通干预的能力。