ASPO Abstracts
Interim Results of a Tiered Patient Recall/Reminder Program for Human Papillomavirus Vaccination in a Safety Net Healthcare System in Houston, Texas
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research, Cancer Health Disparities
Conference Year: 2018
Abstract Body:
Purpose: We are implementing a tiered patient tracking, reminder/recall, and navigation program as part of multicomponent intervention to improve HPV vaccine initiation and completion rates in a large, urban safety net healthcare system. Here we present interim results from Year 1 of the program. Methods: The tiered intervention involves creating and managing a registry of age- eligible pediatric patients (age 11-18 years). Patients’ vaccination status is categorized as unvaccinated, partial (1 dose), or complete (2 or 3 doses, according to age-specific guidelines). Patients are group-randomized to the intervention or control group based on the clinic where they were last seen. Patients from intervention group clinics (n=12) are prospectively tracked and their parents/caregivers receive reminder/recalls for doses 2 and 3, as well as assistance making appointments and addressing individual-level barriers. Patients in control group clinics (n=11) are prospectively tracked. Here we compare vaccine completion status among patients in the intervention versus control groups, overall and by age (11-12 versus 13-18 years) and race/ethnicity. Results: There were a total of 7,115 patients in the intervention and 7,475 in the control group. Overall vaccine series completion was significantly higher in the intervention versus control group (57.6% versus 44.2%, p<0.001). Higher completion rates were observed in the intervention versus control group across both age categories: 49.2% versus 25.5% among 11-12 year-olds (p<0.001) and 60.1% versus 50.4% among 13-18 year-olds (p<0.001). Similarly, higher completion rates were observed in the intervention group among patients of all races/ethnicities: 60.9% versus 47.6% among Hispanics (p<0.001), 46.4% versus 28.8% among non-Hispanic blacks (p<0.001), 43.2% versus 23.3% among non-Hispanic whites (p<0.001), and 42.4% versus 21.4% among those of other races/ethnicities. Discussion: After one year of implementation, HPV vaccine completion rates were approximately 13% higher among patients in the intervention versus control group. These data suggest that tiered patient tracking, reminder/recall, and navigation is highly effective at increasing HPV vaccine completion rates in a safety net healthcare system.
Keywords: HPV vaccine; health services research