Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State.

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  • Additional Information
    • Affiliation:
      Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, 52242, Iowa City, IA, USA
      Public Policy Center, University of Iowa, 310 S Grand Ave, Iowa City, Iowa, USA
      Bureau of Immunization and Tuberculosis, Iowa Department of Public Health, Des Moines, Iowa, USA
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Efforts to understand low human papillomavirus vaccine coverage led us to explore quality improvement (QI) decision-making programs and processes to increase vaccine uptake. These QI programs often include interventions recommended by the AFIX (Assessment Feedback Incentives eXchange) Program that supports Vaccines for Children (VFC) clinics. However, little is known about decision-making around intervention selection or extent of implementation. In collaboration with the state public health department in the rural Midwestern, investigators developed a survey to explore vaccine-related QI in VFC clinics. The survey was distributed via email to all VFC clinics (n = 605); results presented are from the primary care clinics (n = 115). Respondents (VFC liaisons) reported decisions about vaccine QI were made by multiple actors within their own clinics (45.1%), by a clinic manager in charge of multiple clinics (33.0%) and/or at a centralized administrative office (35.2%). Additionally, the majority of respondents considered external actors, like insurance companies (52.7%) or Medicaid/Medicare (50.5%), important to the decision-making process. Most commonly implemented interventions focused on provider knowledge and patient education. Least commonly implemented interventions required systematic changes, such as reminder/recall and follow-up after missed appointments. This preliminary research indicates there are multiple points of decision-making within clinics and health care systems, and therefore change agents at all points need to be involved. The most commonly implemented interventions focus on providers and patients, with an emphasis on education. Interventions requiring system-level changes and use of electronic health records are less common and more attention should be directed towards such interventions.
    • Journal Subset:
      Biomedical; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; Public Health; USA
    • ISSN:
      0094-5145
    • MEDLINE Info:
      NLM UID: 7600747
    • Publication Date:
      20190709
    • Publication Date:
      20200731
    • DOI:
      10.1007/s10900-019-00676-z
    • Accession Number:
      137339168
  • Citations
    • ABNT:
      ASKELSON, N. M. et al. Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State. Journal of Community Health, [s. l.], v. 44, n. 4, p. 790–795, 2019. DOI 10.1007/s10900-019-00676-z. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137339168. Acesso em: 5 dez. 2020.
    • AMA:
      Askelson NM, Ryan G, Seegmiller L, Pieper F, Kintigh B, Callaghan D. Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State. Journal of Community Health. 2019;44(4):790-795. doi:10.1007/s10900-019-00676-z
    • APA:
      Askelson, N. M., Ryan, G., Seegmiller, L., Pieper, F., Kintigh, B., & Callaghan, D. (2019). Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State. Journal of Community Health, 44(4), 790–795. https://doi.org/10.1007/s10900-019-00676-z
    • Chicago/Turabian: Author-Date:
      Askelson, Natoshia M., Grace Ryan, Laura Seegmiller, Felicia Pieper, Bethany Kintigh, and Donald Callaghan. 2019. “Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State.” Journal of Community Health 44 (4): 790–95. doi:10.1007/s10900-019-00676-z.
    • Harvard:
      Askelson, N. M. et al. (2019) ‘Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State’, Journal of Community Health, 44(4), pp. 790–795. doi: 10.1007/s10900-019-00676-z.
    • Harvard: Australian:
      Askelson, NM, Ryan, G, Seegmiller, L, Pieper, F, Kintigh, B & Callaghan, D 2019, ‘Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State’, Journal of Community Health, vol. 44, no. 4, pp. 790–795, viewed 5 December 2020, .
    • MLA:
      Askelson, Natoshia M., et al. “Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State.” Journal of Community Health, vol. 44, no. 4, Aug. 2019, pp. 790–795. EBSCOhost, doi:10.1007/s10900-019-00676-z.
    • Chicago/Turabian: Humanities:
      Askelson, Natoshia M., Grace Ryan, Laura Seegmiller, Felicia Pieper, Bethany Kintigh, and Donald Callaghan. “Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State.” Journal of Community Health 44, no. 4 (August 2019): 790–95. doi:10.1007/s10900-019-00676-z.
    • Vancouver/ICMJE:
      Askelson NM, Ryan G, Seegmiller L, Pieper F, Kintigh B, Callaghan D. Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State. Journal of Community Health [Internet]. 2019 Aug [cited 2020 Dec 5];44(4):790–5. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137339168