ACA Provisions Associated With Increase In Percentage Of Young Adult Women Initiating And Completing The HPV Vaccine

Lipton, Brandy J.; Decker, Sandra L.

doi:10.1377/hlthaff.2014.1302

Cited by 43 publications

(34 citation statements)

References 24 publications

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“…Evidence of increased utilization of preventive services associated with implementation of the ACA is beginning to emerge, particularly among persons aged 19 to 25 years as covered dependents in family insurance policies. Nearly 1 million additional women have received human papillomavirus vaccinations 12 through expanded insurance coverage. From 2009 to 2011, hypertension screening, cholesterol screening, and annual dental visits increased among young adults, though influenza vaccinations did not.…”

Section: Introductionmentioning

confidence: 99%

Updated Priorities Among Effective Clinical Preventive Services

et al. 2017

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PURPOSEThe Patient Protection and Affordable Care Act's provisions for firstdollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services. METHODSWe assessed the potential impact of 28 evidence-based clinical preventive services in terms of their cost-effectiveness and clinically preventable burden, as measured by quality-adjusted life years (QALYs) saved. Each service received 1 to 5 points on each of the 2 measures-cost-effectiveness and clinically preventable burden-for a total score ranging from 2 to 10. New microsimulation models were used to provide updated estimates of 12 of these services. Priorities for improving delivery rates were established by comparing the ranking with what is known of current delivery rates nationally. RESULTSThe 3 highest-ranking services, each with a total score of 10, are immunizing children, counseling to prevent tobacco initiation among youth, and tobacco-use screening and brief intervention to encourage cessation among adults. Greatest population health improvement could be obtained from increasing utilization of clinical preventive services that address tobacco use, obesityrelated behaviors, and alcohol misuse, as well as colorectal cancer screening and influenza vaccinations.CONCLUSIONS This study identifies high-priority preventive services and should help decision makers select which services to emphasize in quality-improvement initiatives. 2017;15:14-22. https://doi.org/10.1370/afm.2017. Ann Fam Med INTRODUCTIONT he landscape for prevention in primary care has changed dramatically since the Committee on Clinical Preventive Service Priorities published the first ranking of clinical preventive services in 2001, 1 and the National Commission on Prevention Priorities (NCPP) last updated the list in 2006. 2 A growing evidence base has expanded knowledge about effective preventive services. At the same time, the Patient Protection and Affordable Care Act (ACA) and the pursuit of the Triple Aim 3 seek to expand access to and the efficiency of primary care.Changes in primary care have potential to improve utilization of preventive services. Patient-centered medical homes (PCMHs) have been associated with increased use of preventive services, though it is not clear whether health and financial outcomes are affected. [4][5][6] Accountable Care Organizations (ACOs), when combined with PCMHs, may empower primary care and incentivize change, 7 and ACO shared-savings contracts may encourage hospital systems and specialty providers to become vested stakeholders in evidence-based prevention. Preventive care quality measures and incentives in ACO contracts might ass...

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Section: Introductionmentioning

confidence: 99%

Updated Priorities Among Effective Clinical Preventive Services

et al. 2017

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“…22 Other studies have reported that ACA was associated with a significant increase in the percentage of young adult women aged 19 to 25 years initiating HPV vaccination. 23 …”

Section: Discussionmentioning

confidence: 99%

Human Papillomavirus Vaccination and Age at First Sexual Activity, National Health and Nutrition Examination Survey

Petrosky

Gui

Hariri

et al. 2016

Clin Pediatr (Phila)

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The National Health and Nutrition Examination Survey (NHANES) collects information on human papillomavirus (HPV) vaccination history as well as sexual activity. We evaluated data from NHANES to assess report of HPV vaccination with ≥1 dose and 3 doses among females and males aged 11 to 26 years during 2007–2014. We also examined age at first vaccine dose and age at first sexual activity among females aged 14 to 26 years. Vaccination significantly increased in females aged 13 to 26 years, but not among 11- to 12-year-old girls, and remained low for both females and males. In NHANES 2011–2014, among females with known age at first vaccine dose, 43.1% reported having had sex before or in the same year they received their first HPV vaccine, and this varied by race/ethnicity. Clinicians should provide strong recommendations consistent with guidelines, including routine vaccination of girls and boys at age 11 or 12 years.

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“…For instance, in assessing the impact of the ACA on cervical cancer prevention, Lipton and Decker estimated a 6-percentagepoint increase in completion of the human papillomavirus vaccine series by young women that could be attributed to enhanced ACA coverage. 3 The extent to which this increased uptake leads to future reductions in the occurrence of cervical abnormalities and overt malignancies remains to be documented.…”

Section: Examplesmentioning

confidence: 99%

Evaluating Public Health Interventions: 1. Examples, Definitions, and a Personal Note

Spiegelman

2016

Am J Public Health

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In the first contribution to a new section in AJPH that will address critical methodological issues in evaluations of public health interventions, I will discuss topics in study design and analysis, covering the most innovative emerging methodologies and providing an overview of best practices. The methods considered are motivated by public health evaluations, both domestic and global. In this first contribution, I also define implementation science, program evaluation, impact evaluation, and cost-effectiveness research, disciplines that have tremendous methodological and substantive overlap with evaluation of public health interventions--the focus of this section.

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ACA Provisions Associated With Increase In Percentage Of Young Adult Women Initiating And Completing The HPV Vaccine

Cited by 43 publications

References 24 publications

Updated Priorities Among Effective Clinical Preventive Services

Updated Priorities Among Effective Clinical Preventive Services

Human Papillomavirus Vaccination and Age at First Sexual Activity, National Health and Nutrition Examination Survey

Evaluating Public Health Interventions: 1. Examples, Definitions, and a Personal Note

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