1C 4 A Health Information Technology Intervention Increases HPV Vaccine Series Initiation Among Florida Medicaid and Chip Adolescents

Tuesday, June 10, 2014: 11:15 AM
Grand Ballroom D2/E
Stephanie A. S. Staras, PhD, MSPH1, Susan Vadaparampil, PhD, MPH2, Melvin Livingston III, PhD1, Lindsay Thompson, MD, MS3, Ashley Sanders, MS1 and Elizabeth Shenkman, PhD, MSN1, 1Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, 2H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, 3Department of Pediatrics, University of Florida, Gainesville, FL

Background: HPV vaccine series initiation rates have increased modestly compared to other adolescent vaccines and did not increase from 2011 to 2012.

Methods: We evaluated the feasibility and preliminary efficacy of a multi-component intervention to increase HPV vaccine series initiation among adolescents enrolled in Florida Medicaid and Children’s Health Insurance (CHIP) programs. We assigned 11-17 year old boys and girls without HPV vaccine claims, residing in Gainesville or surrounding primary care service areas (PCSA), and having a preventive care visit in the past year to one of four study arms. We assigned all adolescents with records of visits at five participating Gainesville clinics to a health information technology (HIT) system (n=2071) designed to alert providers of interested unvaccinated adolescents during clinic visits. We mailed postcards to a random half (n=1031). For comparison, we selected a random sample of adolescents living in PCSAs surrounding Gainesville (n=4025) and randomly assigned half to receive postcards (n= 2018).

Results: Preliminary efficacy in the two months following the intervention start suggests that the HIT system improved vaccination rates by 1% [HIT arms: 5% vs. non-HIT arms: 4% – Risk Ratio (RR) = 1.3; 95% Confidence Interval (CI) = 1.0, 1.7]. An additional 1% increase may be achieved by supplementing the HIT system with postcards (HIT and postcard arm: 6% vs. standard of care arm: 4% – RR=1.5; 95% CI = 1.1, 2.0). Within HIT system arms, 71 youth who visited the study providers were invited to participate. Most parents consented (82%; n=58) and 63% of adolescents completed the survey. Of the 80% of youth (n=36) verifying they were unvaccinated, only half were interested in the vaccine (n=18).

Conclusions: The intervention was feasible within the Medicaid and CHIP populations. Preliminary evidence suggests increases in HPV vaccine series initiation with the HIT system arms potentially boosted with parent postcards.