Using Electronic Reminders to Improve Human Papillomavirus (HPV) Vaccinations among Primary Care Patients

Abstract

The COVID-19 pandemic led to delays in routine preventative primary care and declines in HPV immunization rates. Providers and healthcare organizations needed to explore new ways to engage individuals to resume preventive care behaviors. Thus, we evaluated the effectiveness of using customized electronic reminders with provider recommendations for HPV vaccination to increase HPV vaccinations among adolescents and young adults, ages 9–25. Using stratified randomization, participants were divided into two groups: usual care (control) (N = 3703) and intervention (N = 3705). The control group received usual care including in-person provider recommendations, visual reminders in exam waiting rooms, bundling of vaccinations, and phone call reminders. The intervention group received usual care and an electronic reminder (SMS, email or patient portal message) at least once, and up to three times (spaced at an interval of 1 reminder per month). The intervention group had a 17% statistically significantly higher odds of uptake of additional HPV vaccinations than the usual care group (Adjusted Odds Ratio: 1.17, 95% CI: 1.01–1.36). This work supports previous findings that electronic reminders are effective at increasing immunizations and potentially decreasing healthcare costs for the treatment of HPV-related cancers.

Individual, systemic and state factors associated with provider recommendation of HPV vaccination: Findings from NIS-Teen, 2020

“… 52 , 53 Healthcare providers should utilize proven strategies such as the combination of phone calls, SMS, e-mail, or patient portal message reminders ahead of clinic appointments to minimize no-shows at routine well-child checks and increase HPV vaccination recommendation and uptake. 22 , 54 Additionally, our study revealed that teens from families living below the poverty or those with fathers or male guardians as survey respondents had lower odds of receiving HPV vaccination recommendations from their providers. This finding resonates with a previous study that found higher rates of HPV vaccine hesitancy among male teens whose fathers were survey respondents.…”

Multiple Messaging Strategies for Increasing HPV Vaccination Intentions among English- and Spanish-Speaking Parents in the United States and Mexico

“…There is a growing body of evidence demonstrating that parent-directed text message reminders can improve HPV vaccine series initiation and completion rates for eligible children. This evidence comes from prospective cohort studies, randomized controlled trials, and pragmatic clinical trials [ 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. The current study adds to this research literature in three important respects.…”

Effect of an HPV Vaccination Multi-Level, Multi-Component Program on HPV Vaccination Initiation and Completion in a Pediatric Clinic Network

“…Evidence for system-, provider-and parent-targeted strategies to mitigate these barriers has been established. Strategies include system-level changes to electronic health records to routinize provider prompts to recommend HPV vaccination and audit and feedback strategies [22], provider-level interventions to promote effective provider communication (including presumptive, bundled, and/or unqualified provider recommendations) [23], and patient reminders [24] and parent education [25] aimed at parent determinants. There is also modest evidence for the implementation of parent-and patient-focused apps to promote HPV education and vaccination [26][27][28].…”