December 10, 2018
By Anne Harding
NEW YORK (Reuters Health) - Adolescents are three times as likely to be vaccinated against human papillomavirus (HPV) if they and their parents view a digital video on the risks and benefits of the HPV shot while waiting for the pediatrician, a study suggests.
"An educational intervention can be delivered in a clinic office environment effectively to activate patients to ask questions or make preventative health care decisions," Dr. Brian E. Dixon, an associate professor at Indiana University's Richard M. Fairbanks School of Public Health in Indianapolis, the study's first author, told Reuters Health in a telephone interview.
The 9-valent HPV vaccine can prevent genital warts and cervical and other cancers, and the Advisory Committee on Immunization Practices recommends HPV immunization for all 11- and 12-year-old girls and boys, Dr. Dixon and his team note in their December 10 report. But as of 2016, only 65% of girls and 56% of boys age 13-17 had received at least one dose of the HPV vaccine, while 49.5% and 37.5%, respectively, had received the full three-dose series.
In their new cluster randomized trial, Dr. Dixon and his team observed 1,596 adolescents aged 11-17 who attended five pediatric clinics within a large safety net health system. One-third of the adolescents and their parents went to clinics where the intervention was offered, and the rest went to control clinics. Most patients were people of color and insured through Medicaid.
At the intervention clinics, parents and adolescents were given a tablet while waiting in the pediatrician's office. Those who said they intended to get the vaccine received a brief reinforcing message. Adolescents who had not yet received an HPV shot and whose parents requested more information watched a digital video focused on the safety profile and cancer prevention benefits of the vaccine. Those who had received the first or second vaccine watched a video emphasizing the importance of receiving all three doses.
The intervention group was younger, with 72.4% aged 11 or 12, compared to 49.8% of the control group, the authors reported December 10 online in Pediatrics.
Intention to treat analysis found that 50.1% of the control group received a dose of the HPV vaccine within two weeks of the visit, versus 64.8% of the intervention group.
One-quarter of the adolescents attending intervention clinics received a tablet, 78% of whom received a dose of the HPV vaccine. Among those who did not receive a tablet, 52.8% received the vaccine. The adolescents who received a tablet had an odds ratio of 3.07 for receiving the vaccine within two weeks of their clinic visit compared to those who did not receive a tablet.
Several factors made distributing the tablets in a busy pediatrician's office difficult, the authors note, including, for example, the need to manually enter a patient's study identifier into the tablet.
"I think there will be a few logistical challenges to get through, but they are straightforward ones," Dixon said.
The Merck-Regenstrief Program in Personalized Health Care Research and Innovation supported the research. One author has received funding from Merck & Co, one is an employee of the company, and one founded a company to commercialize the Child Health Improvement through Computer Automation (CHICA) clinical decision support system used in the study.
(c) Copyright Thomson Reuters 2018. Click For Restrictions - https://agency.reuters.com/en/copyright.html
For more Pharmacy Learning Network articles, visit the homepage