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Engaging practices and communities in the development of interventions to promote HPV vaccine uptake

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Project Summary The Healthy People 2020 report states a goal of 80% uptake of recommended vaccines among adolescents, including the human papillomavirus (HPV) vaccine. However, the rate of uptake of the HPV vaccine has been slow relative to the other vaccines in the adolescent series. The series completion of the HPV vaccine among adolescents is estimated at 48.6% in 2017, which will lead to excess morbidity and mortality from preventable, HPV-related cancers. Reasons for this are multifactorial and include factors at the level of the provider, primary care practice, patient and family, and the community. Previously developed interventions often focus only on one of these aspects and are often tested in academic settings where generalizability is difficult. Therefore, the development of interventions that are responsive to these multifactorial barriers in real-world settings is a priority area for research. This proposal will use the Boot Camp Translation (BCT) methodology to translate the guidelines and evidence for the HPV vaccination into a practice- and provider- level intervention designed to improve the acceptability of the HPV vaccine. As a community engagement approach, BCT is a 6-9 month iterative process that brings together multiple stakeholders to translate evidence-based guidelines and recommendations into locally relevant and meaningful messages, materials, and programs. BCT has demonstrated success in expediting the implementation of guidelines related to several health topics and our own pilot work demonstrates that this methodology is feasible and acceptable when applied to HPV vaccination. We propose to implement an HPV-focused BCT in three counties in Colorado with a below average county-level vaccination rate. Through an iterative, facilitated six-month process, each BCT group will design a multi-pronged intervention targeted at patients, parents, providers, and the general community to then be disseminated in the participating practices and communities over the subsequent six- month period. The strength of this approach is that BCT produces interventions that are dissemination-ready, incorporate both practice and community context, and improve the acceptability of evidence-based interventions to individual communities. The long-term goal is to develop a replicable approach and low-cost method of increasing HPV vaccine uptake that is easily adaptable to different settings and sociodemographic contexts. The Specific Aims of this project - Engaging practices and communities in the development of interventions to promote HPV vaccine uptake - are to (1) implement Boot Camp Translation in three geographically distinct Colorado communities to translate current evidence for HPV vaccination into locally relevant interventions designed to increase vaccine uptake; and (2) evaluate the impact of the BCT-designed intervention on practice-level HPV vaccine initiation rates. We hypothesize that the BCT-designed intervention will increase the rate of HPV vaccine initiation in the practices.
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