Improving HPV Immunization Coverage in Arizona Practices (Completed November 2016)

Arizona’s Improvement Partnership, Best Care for Kids, and The Arizona Partnership for Immunization (TAPI) is hosting a national adolescent immunization initiative, “National Immunization Partnership with the APA” (NIPA). This multi-state quality improvement (QI) research project, which is funded by a grant from the Centers for Disease Control and Prevention (CDC), is a collaboration between the National Improvement Partnership Network (NIPN) and the Academic Pediatric Association (APA) and is led by our colleagues at the Vermont Child Health Improvement Program (VCHIP). Arizona is one of the states to enroll in the second cohort of NIPA and engage in this project to improve HPV immunization coverage rates in primary care settings.

As many know, HPV is the most common sexually transmitted disease and causes over 95% of cervical cancers; it is also a leading cause of vaginal, vulvar, penile, anal, and oropharyngeal cancers. HPV vaccination rates in the US are alarmingly low, and Arizona is no exception: in 2014, only 58.2% of females and 40.6% of males 13-17 years of age received the first dose in the three-dose series in our state.[1] Furthermore, despite the CDC’s recommendation to vaccinate at 11-12 years of age, most adolescents do not initiate vaccination at this age. We believe that practice-level change is vital to addressing this gap and improving coverage rates; as such, our project is designed to aid practice teams in implementing evidence-based vaccine delivery strategies in order to lower HPV prevalence in their communities. Combined with efforts by the Arizona Immunization Program who is eager to review your practice-specific data and support improvement efforts, we have a great opportunity to impact vaccination rates in Arizona!

Benefits of project participation (commenced March 2016 and will conclude November 2016):

• Physicians earn 25 credits towards ABP Maintenance of Certification (MOC), Part 4 or Maintenance of Certification for Family Physicians (MC-FP) from the American Board of Family Medicine, Part IV

• Receive QI coaching and support, including project-specific customized tools and materials
• Receive assistance in assessing your system for HPV vaccine delivery, recognizing barriers, and selecting evidence-based strategies to test with PDSA cycles
• Participate in monthly Learning Collaborative webinars on topics such as delivering a strong provider recommendation for HPV vaccine and reducing Missed Opportunities for vaccination
• Track your practice’s progress through monthly feedback reports

Requirements for research project participation:

• Designate a practice Clinic Champion and QI/Change team
• Attend one hour-long orientation call
• Participate in at least 5 of 6 monthly hour-long Learning Collaborative webinars
• Complete pre-intervention and post-intervention chart audits*
• Perform monthly chart audits on tests of change (10 charts/month)*
• Submit monthly PDSA log sheets to guide rapid-cycle improvement

*Funding may be available to support your practice in completing chart audits.

[1] Reagan-Steiner S, Yankey D, Jeyarajah J, Elam-Evans LD,  Singleton JA,  et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years – United States, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(29):784-792.