ASPO Abstracts
An electronic medical record alert intervention to improve HPV vaccination among eligible male college students at a university student health center
Category: Electronic Health Records (EHRs), Behavioral Science & Health Communication
Conference Year: 2018
Abstract Body:
Purpose: Most recent data show that only 31.5% of males ages 13-17 years have completed three doses of the HPV vaccine. Young adults ages 19-26 have even lower documented HPV vaccine completion at only 10.1% among college-aged males. In 2016, Utah was the second lowest state in the nation for percent of boys who are up-to-date with HPV vaccination. This two-part pilot study aims to improve HPV vaccination for college aged males at a student health center in Utah. Methods: The first part of the study consisted of a focus group that assessed the barriers and facilitators of HPV vaccination among healthcare providers and clinic staff (N=16). Providers and clinic staff also discussed missed opportunities for HPV vaccination. For the second part of the study, providers and clinic staff reviewed medical records of patients ages 18-26 with student health insurance and with <3 doses of the HPV vaccine at baseline (12/1/2014-7/31/2015) and follow-up (12/1/2015-7/31/2016). A computer- automated electronic medical record (EMR) alert was generated in the medical record for eligible male patients only (N=386). Z-scores were estimated for two-sample proportions to measure the change in HPV vaccination rates at baseline and follow-up for males and females. Results: In the first part of the study, some focus group participants reported success when recommending HPV vaccines while most acknowledged challenges such as high costs for uninsured patients, patient beliefs that they do not need the vaccine because they plan to stay abstinent until marriage, and a common misconception that only females can receive the HPV vaccine. After the implementation of the pilot EMR reminder tool, HPV vaccine initiation rates increased among males (baseline: 5.2% follow-up: 25.1%, p<0.001). In comparison, the follow-up HPV vaccination initiation rate among eligible females (n=353) was 8.8%, compared to the female baseline rate of 8.0% (difference=-0.01, 95%C -0.05-0.03, z=-0.36, p=0.72). Conclusion: College-age males who have not received the HPV vaccine should not miss the opportunity to protect themselves from HPV and HPV-related cancers while still age eligible for the HPV vaccine. This study shows that EMR alerts improved HPV vaccine initiation rates among insured college-aged males.
Keywords: HPV, HPV vaccine, college- aged men, electronic health records