Staff Education to Increase HPV Vaccine Uptake in the Medically Underserved Adolescent Population

Background: Human Papillomavirus (HPV) infections and associated cancers are growing at an alarming rate in the United States. HPV is responsible for a significant portion, greater than 50 percent, of genital and oropharyngeal cancers. The Food and Drug Administration (FDA) has approved three vaccines that protect against the most common types of HPV that cause cancer and infection. The Centers for Disease Control and Prevention (CDC) has included the HPV vaccine in its immunization schedule starting at age 11. The goal for HPV vaccination in the U.S. is 80% per Healthy People 2020. In the U.S. the rate is 60% and in Arizona the rate is 68%. There have been multiple studies on interventions to increase the HPV vaccination rate. The purpose of this quality improvement DNP project is to improve a patient safety and public health issue by implementing a provider education program to the staff of a medically underserved clinic in Phoenix, Arizona. The aim of the study is to increase provider knowledge of HPV and the vaccine and the provider’s intention to recommend the HPV vaccine to all children 11-18 year old that they provide care to. Students that provide care in the clinic were invited to participate because they will have an impact on HPV vaccination rates in the future. Methods: Participants were educated about HPV and associated infections and cancers during an education intervention. Prior to the educational intervention participants were surveyed on their knowledge of the virus and vaccine as well as current vaccine habits. After the education intervention the participants were given the same survey and were asked about their intention for future vaccine habits. Results: Survey responses from 13 participants were used in the final analysis. All participants gained knowledge from the educational intervention. This clinic had good vaccine habits in 9 current practice, per the pre-education intervention surveys. The intervention increased the intention of participants to recommend the HPV vaccine, inquire about the vaccine status, and check the Arizona State Immunization Information System (ASIIS) for patients seen by the participant in the future. Conclusions: The staff and students of this medically underserved clinic appear to have good knowledge and practices regarding HPV and the vaccine. Future quality improvement projects should explore other types of interventions that have been shown to increase the rate of HPV vaccination and completion of the vaccine series. Additional quality improvement projects should be done in primary care clinics that offer services to a variety of different populations in Arizona as they may have different needs from populations in the rest of the United States