Using the 4 Pillars™ Practice Transformation Program to increase adolescent human papillomavirus, meningococcal, tetanus-diphtheria-pertussis and influenza vaccination.
Vaccine
; 35(45): 6180-6186, 2017 10 27.
Article
en En
| MEDLINE
| ID: mdl-28947346
ABSTRACT
OBJECTIVES:
To report the results of an intervention using the 4 Pillars™ Practice Transformation Program (4 Pillars™ Program) to increase adolescent vaccinations including human papillomavirus vaccine (HPV) and influenza vaccines, which remain underutilized in this population. STUDYDESIGN:
Eleven pediatric and family medicine practices, previously control sites from a randomized controlled cluster trial, with ≥50 adolescent patients participated. The 4 Pillars™ Program was the foundation of the intervention. De-identified demographic, office visit and vaccination data were derived from electronic medical record extractions for patients whose date of birth was 4/1/1997 to 4/1/2004 (ages 11-17years at baseline). Vaccination rates for HPV, influenza, tetanus-pertussis-diphtheria (Tdap) and meningococcal (MenACWY) vaccines were determined for all eligible patients pre- and post intervention (i.e., vaccination rates on 4/1/2015 and 4/30/2016).RESULTS:
Among 9473 patients ages 11-17years at baseline (4/1/2015), mean pre-intervention vaccination rates for HPV initiation and completion, meningococcal, Tdap and influenza vaccines were below national levels. Rates increased significantly post intervention (P<0.001) for HPV initiation which increased 17.1 percentage points (PP) from 51.4%; HPV completion increased 14.8PP from 30.7%, meningococcal vaccine uptake increased 16.6PP from 79.1%, Tdap vaccine uptake increased 14.6PP from 76.9%. Influenza vaccine uptake did not increase significantly (2.3PP from 40.1%). In the regression using generalized estimating equations, odds of vaccination were higher for younger, non-white adolescents for all vaccines; being in a smaller practice decreased the odds of Tdap vaccination but increased the odds of influenza vaccination.CONCLUSION:
Clinically and statistically significant improvements in HPV series initiation and completion, and meningococcal and Tdap vaccinations were observed in primary care practices implementing the 4 Pillars™ Practice Transformation Program. Clinical Trial Registry Number NCT02165722.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
10_ODS3_salud_sexual_reprodutiva
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1_ASSA2030
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2_ODS3
/
3_ND
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4_TD
Problema de salud:
10_sexually_transmitted_infections
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1_doencas_nao_transmissiveis
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1_doencas_transmissiveis
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1_medicamentos_vacinas_tecnologias
/
1_sistemas_informacao_saude
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2_enfermedades_transmissibles
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2_muertes_prematuras_enfermedades_notrasmisibles
/
3_zoonosis
/
4_meningitis
Asunto principal:
Vacunas contra la Influenza
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Vacuna contra Difteria, Tétanos y Tos Ferina
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Vacunas Meningococicas
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Vacunas contra Papillomavirus
Tipo de estudio:
Clinical_trials
Límite:
Adolescent
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
Vaccine
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos