Increasing HPV Immunization Rates in Adolescent Males
Inspired by a year-long focus on improving health disparities in adolescent males, the MDCH Child and Adolescent Health Center’s Quality and Evaluation Support Team (QuEST) initiated a Continuous Quality Improvement (CQI) initiative to increase HPV immunization series completion rates among adolescent males. Four adolescent health centers (three school-based and one school-linked) volunteered for the project, with two focusing on improving parental attitudes and community acceptance of the vaccine for both genders; and two focusing on increasing HPV immunization completion rates among males through review and revision of clinical processes.
Each individual project began with a conference call to review: current available data; data that was needed to set goals; current processes for consent, immunization review and administration; challenges and supports for implementing the initiative; and next steps. A second conference call and a series of email and telephone communications followed to: review data; develop goals and action steps; and to determine resources and support needed for success. QuEST provided ongoing support tailored to each health center which included guidance and support for policy/procedure and process review, revision and development. Access to current and relevant journal articles, tip sheets, brochures, videos and educational materials were provided electronically.
From the project inception, rate of HPV immunization rates in CAHC clients were statistically significantly higher than that of respective sponsoring agency clients, which served as a control group. This speaks to the access CAHC’s have to the school-aged population which facilitates the provision of health care services including preventive services such as immunizations.
HPV immunization series completion rates (three-dose series) among adolescent males ages 11 – 21 years were evaluated over the course of nine months. The results showed statistically significant improvement in HPV immunization series completion rates among the CAHC clients and when compared to the control group. The increase in completion rates in CAHC’s ranged from 9.7% to more than 30%. Increases in completion rates in sponsoring agencies, by comparison, were between zero and two percent over the same time period.
Rates at the sponsoring agencies are consistent with those seen nationally across all health care settings. Therefore, the immunization rates in the sponsoring agencies that participated in this project reflect the general status of HPV immunization rates rather than the level of care provided by these specific agencies.
The graphs below illustrate the change in HPV immunization series completion rates pre to post project among CAHC clients as compared to the control group.