OVERVIEW

Welcome to the Adolescent Vaccination Program Implementation Tool (AVP-IT). The Adolescent Vaccination Program (AVP) is as an evidence-based multi-component program to increase HPV vaccination rates in pediatric clinics. It was developed by researchers and physicians at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health and Baylor College of Medicine. Whether you’re a clinic manager, health care provider, or immunization champion, this website is designed to help you and your clinic implement six strategies that have been demonstrated effective in increasing clinic HPV vaccination rates.

overview
AVP-IT comprises four components

The ‘About’ section will give you an overview and background on this successful program.

Go to ‘My Action Plan’ to get the most from this website. Complete 12 questions about your clinic and current HPV vaccination activities, and use the powerful Action Plan Wizard to dynamically produce an Action Plan tailored specifically for your clinic. The Action Plan comprises information on each AVP evidence-based strategy, a step-by-step guide to implement these strategies in your clinic, templates and tools to save you time, and tips for success.

If you prefer to explore the strategies on your own, go to 'My Toolkit' and select from the array of resources available.

If you have any questions or need support, contact us here.

purpose

The AVP-IT was developed to enable pediatric clinics with the tools to adopt, implement, and maintain the evidence-based AVP strategies to increase their HPV vaccination rates. The AVP-IT includes detailed steps, templates, tips, and testimonials, to aid and empower clinics to incorporate the AVP into their current clinic practices. We hope you enjoy implementing the AVP in your clinic and wish you great success in improving your clinic's HPV vaccination rates.

10 Tips for best use

1. Getting started

Go to ‘My Action Plan’ to obtain your tailored and comprehensive plan for increasing your clinic’s HPV vaccination rates. Using the information you provide the AVP-IT Wizard will dynamically compile an Action Plan tailored to your clinic’s needs. The Action Plan describes the AVP strategies and the steps to implement them (including tools and tips for success).

2. Recipe to ensure greatest impact on HPV vaccination rates

Follow your Action Plan. It provides a powerful and effective approach to increasing your clinic’s HPV vaccination rate by implementing six evidence-based strategies: 1) AVP Champion, 2) Assessment & Feedback, 3) Continuing Education, 4) Provider Prompts, 5) Parent Reminders, and 6) Parent Education. Each strategy includes five sections: About, How To, Tools, Tips for Success, and Testimonials.

3. Identify your AVP Champion

This is key. They are the cornerstone for your success. This person should be dedicated to improving clinical practice, eager to implement the strategies, and capable of taking on a leadership role.

4. Implement all of the AVP strategies

Even if your clinic is already implementing some or all of the AVP strategies, you can review the steps and resources available in your Action Plan to identify opportunities to enhance your existing strategies.

5. Use the toolkit

If you work for a clinic that already has a successful plan in place, you can go to the 'My Toolkit' tab to pick up resources to help implement a particular strategy.

6. Learn from experienced others

Use the Testimonials section to hear the stories from those who have experience implementing the AVP in their clinic and gather tips and advice for overcoming challenges.

7. Contact us

Please know that the AVP-IT development team is always here to support you should you have any questions or concerns. You can find our contact information on the 'Contact Us' tab.

8. Fidelity

Fidelity refers to how closely a program is implemented as intended by the program developers. In order to implement the AVP with fidelity, we recommend using the AVP-IT Action Plan Wizard to obtain a tailored Action Plan for your clinic and to implement the strategies as they are described. Follow the stepped guide. Modifying or deviating from the strategies as described will reduce the fidelity and may decrease effectiveness.

9. Sequence & timing

The Action Plan and toolkit list the strategies in the order in which they were deployed in the field testing of the AVP. This is the recommended sequence and follows this order: 1) AVP Champion, 2) Assesmment & Feedback, 3) Continuing Education, 4) Provider Prompts, 5) Parent Reminders, and 6) Parent Education. This sequence may depend on what strategies are currently offered in the clinic and logistic issues. You are encouraged to determine the deployment sequence that best fits your clinic's needs.

10. Overcoming obstacles

The ‘Tips’ and ‘Testimonials’ sections of the Action Plan contains useful guidance to help overcome obstacles to implementing AVP strategies. These sections can also be accessed on the 'My Toolkit' tab. They provide practical guidance drawn from health care providers to assist you in successfully implementing the strategies while dodging barriers to this process.

Results to Date

Findings from the field

The Adolescent Vaccination Program (AVP) was implemented in a large urban pediatric clinic network in Houston, Texas from November 2015 to February 2019, and it is currently being implemented in a clinic network in San Antonio, Texas. Results indicate the AVP to be feasible for clinic use and effective in increasing both initiation and completion of the HPV vaccine series among male and female patients. The Houston project was associated with an increase in HPV vaccine initiation rates from 62.5% in 2015 to 81.0%. This percent increase was greatest (54.2%) in the primary population for initiation (11-12 year olds). A monthly increase in HPV vaccination initiation of approximately 4% was demonstrated during the field trial following commencement of the AVP.

results
Publications
squareMAIN RESULTS

Vernon SW, Savas LS, Shegog R, Healy CM, Frost EL, Coan SP, Gabay EK, Preston SM, Crawford CA, Spinner SW, Wilber MA. Increasing HPV Vaccination in a Network of Pediatric Clinics using a Multi-component Approach. J Appl Res Child. 2019;10(2):8.

square AVP DEVELOPMENT

Crawford CA, Shegog R, Savas LS, Frost EL, Healy CM, Coan SP, Gabay EK, Spinner SW, Vernon SW. Using Intervention Mapping to Develop an Efficacious Multicomponent Systems-Based Intervention to Increase Human Papillomavirus (HPV) Vaccination in a Large Urban Pediatric Clinic Network. JARC. 2019; 10(2):Article 9.

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square OTHER FINDINGS

Farias AJ, Savas LS, Fernandez ME, Coan SP, Shegog R, Healy CM, Lipizzi E, Vernon SW. Association of physicians perceived barriers with human papillomavirus vaccination initiation. Prev Med 2017;105:219-225. doi: 10.1016/j.ypmed.2017.07.016

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Walker TJ, Rodriguez SA, Vernon SW, Savas LS, Frost EL, Fernandez ME. Validity and reliability of measures to assess constructs from the inner setting domain of the consolidated framework for implementation research in a pediatric clinic network implementing HPV programs. BMC Health Serv Res. 2019 Mar 29;19(1):205. doi: 10.1186/s12913-019-4021-5.

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Eska JS, Lairson DR, Savas LS, Shegog R, Healy CM, Vernon SW. Implementation costs of a multi-component program to increase human papillomavirus (HPV) vaccination in a network of pediatric clinics. JARC. 2019; 10(2):Article 8.

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AVP-IT Team

Erica Frost_Program Manager

Erica Frost, MPH

Program Manager

Lara Savas_Co-Principal Investigator

Lara Savas, PhD

Co-Principal Investigator

Laura Thormaehlen_Research Assistant

Laura Thormaehlen, MPH

Research Assistant

Ross Shegog_Principal Investigator

Ross Shegog, PhD

Principal Investigator

Sally Vernon_Investigator

Sally Vernon, PhD

Investigator

Sharon Coan_Statistician

Sharon Coan, MS

Statistician

Mary Healy, MD

Mary Healy, MD

Infectious Disease Specialist

The AVP-IT Team is comprised of an interdisciplinary team with experience in behavioral science/health promotion, epidemiology, clinical vaccinology, intervention planning and evaluation, and information technology. This collaborative partnership was established in 2014. Since then, we have received funding for three HPV vaccination grants funded by the Cancer Prevention & Research Institute of Texas (CPRIT). All projects led by this team have institutional commitment from the UTHealth School of Public Health (UTSPH) whose mission is to evaluate and disseminate health promotion and disease prevention programs in diverse settings and populations.

our funders

The AVP-IT is funded by the Cancer Prevention and Research Institute of Texas (CPRIT). CPRIT was established to fund cancer research and prevention programs and services through a constitutional amendment approved by Texas voters in 2007. Their mission is to advance cancer research capabilities and related product development, and to make evidence-based prevention programs accessible to all Texas residents.