Grant Number:	5R01CA217889-05 Interpret this number
Primary Investigator:	Jacobson, Robert
Organization:	Mayo Clinic Rochester
Project Title:	"Less Pain, Less Fuss, Right Now!" and "Make It Count!" Multilevel Interventions for Patient, Parent, and Practice to Enhance Provider Recommendations for HPV Vaccination
Fiscal Year:	2023

PROJECT SUMMARY Our broad, long-term objective is to substantially increase human papillomavirus (HPV) vaccination rates by deploying effective population-health interventions in clinical practices across the United States. As part of this effort, we intend to evaluate two evidence-based interventions with innovative enhancements at six Mayo Clinic primary care practices (PCP) to evaluate their individual and combined impact on rates of HPV vaccination among female and male patients. Aim 1, “Less Pain, Less Fuss, Right Now!”, will test the hypothesis that, as compared to no intervention (current practice), a practice-level intervention utilizing reminder-recalls featuring the availability of non-medication and medication anesthetics, the convenience of nurse-only visits, and the use of persuasive language for early, on-time vaccinations will improve HPV vaccine delivery rates. Aim 2, “Make It Count!”, will test the hypothesis that, as compared to no intervention, a provider- level intervention utilizing a missed-opportunities assessment and feedback intervention applying social pressure (specific peer-performance comparisons) and equipping providers with a strong-recommendation toolkit will improve HPV vaccine delivery rates. Aim 3 will test the hypothesis that simultaneous implementation of interventions targeting individual, interpersonal, and organizational factors will have a synergistic effect on HPV vaccine delivery rates. To accomplish Aims 1-3, we will use a stepped-wedge cluster randomized trial with an integrated process evaluation. The cluster approach prevents cross-contamination between patients or providers as we allocate two separate interventions (Aims 1 and 2) in the six PCPs. The stepped-wedge design, which ensures all practices eventually receive the same set of interventions, permits the single institutional review board overseeing all six PCPs to approve the study without requiring recruitment and consent of individual patients or providers. The stepped-wedge approach also permits us to test the presence of each of the interventions in each PCP, making trial participation more attractive, while also allowing each practice to serve as its own control, reducing the bias due to imbalanced risk factors across practices. The factorial design allows us to use a single trial to test two interventions and assess each individually and in combination. The design also conserves sample size while maintaining power. We will measure the impact separately in females and males, 11-12 years of age for the rates of receipt of HPV vaccine doses due. Rigorously tested, highly effective, population-level interventions are essential if we are to reach the Healthy People 2020 goal for HPV vaccination. The rigor, design, and high likelihood of success of this study will provide key evidence regarding practice- and provider-level interventions to improve HPV vaccination rates. Mayo Clinic's best practices inform not only its own 70 practices across five states but its Mayo Clinic Care Network, which consists of nearly 40 health-care organizations across 26 states and Puerto Rico.




Clinical Trials for Special Populations: Children, Older Adults, and Rare Diseases.
Authors: Jacobson R.M. , Pignolo R.J. , Lazaridis K.N. .
Source: Mayo Clinic Proceedings, 2024 Feb; 99(2), p. 318-335.
PMID: 38309939
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Multilevel Implementation Strategies for Adolescent Human Papillomavirus Vaccine Uptake: A Cluster Randomized Clinical Trial.
Authors: Finney Rutten L.J. , Griffin J.M. , St Sauver J.L. , MacLaughlin K. , Austin J.D. , Jenkins G. , Herrin J. , Jacobson R.M. .
Source: Jama Pediatrics, 2024-01-01 00:00:00.0; 178(1), p. 29-36.
PMID: 37983062
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Parent-reported Barriers and Parental Beliefs Associated with Intentions to Obtain HPV Vaccination for Children in a Primary care Patient Population in Minnesota, USA.
Authors: Zhu X. , Jacobson R.M. , MacLaughlin K.L. , Sauver J.S. , Griffin J.M. , Finney Rutten L.J. .
Source: Journal Of Community Health, 2023-03-15 00:00:00.0; , .
EPub date: 2023-03-15 00:00:00.0.
PMID: 36920709
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Disparities in vaccination rates in solid organ transplant patients.
Authors: Felzer J.R. , Finney Rutten L.J. , Wi C.I. , LeMahieu A.M. , Beam E. , Juhn Y.J. , Jacobson R.M. , Kennedy C.C. .
Source: Transplant Infectious Disease : An Official Journal Of The Transplantation Society, 2023-01-30 00:00:00.0; , p. e14010.
EPub date: 2023-01-30 00:00:00.0.
PMID: 36715676
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Feasibility of Instituting a Clinical Otolaryngology Human Papillomavirus (HPV) Vaccination Program.
Authors: Palacios V.J. , Merlino D.J. , Anderson S.S. , Yeakel S.R. , Choby G G.W. , Wiedermann J.P. , Moore E.J. , O'Byrne T.J. , Jacobson R.M. , Van Abel K.M. .
Source: The Laryngoscope, 2023 Jan; 133(1), p. 116-123.
EPub date: 2022-04-02 00:00:00.0.
PMID: 35366006
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Awareness of HPV Testing and Acceptability of Self-sampling for Cervical Cancer Screening Among Women in Minnesota.
Authors: Zhu X. , MacLaughlin K.L. , Fan C. , Jacobson D.J. , Jenkins G.D. , Jacobson R.M. , Finney Rutten L.J. .
Source: Journal Of General Internal Medicine, 2022 May; 37(6), p. 1565-1568.
EPub date: 2021-05-13 00:00:00.0.
PMID: 33987791
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Socioeconomic disadvantage and human papillomavirus (HPV) vaccination uptake.
Authors: Kurani S. , MacLaughlin K.L. , Jacobson R.M. , St Sauver J.L. , Jenkins G.D. , Fan C. , Jacobson D.J. , Inselman J. , Zhu X. , Griffin J.M. , et al. .
Source: Vaccine, 2021-12-13 00:00:00.0; , .
EPub date: 2021-12-13 00:00:00.0.
PMID: 34916103
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Evidence-Based Strategies for Clinical Organizations to Address COVID-19 Vaccine Hesitancy.
Authors: Finney Rutten L.J. , Zhu X. , Leppin A.L. , Ridgeway J.L. , Swift M.D. , Griffin J.M. , St Sauver J.L. , Virk A. , Jacobson R.M. .
Source: Mayo Clinic Proceedings, 2021 03; 96(3), p. 699-707.
EPub date: 2020-12-30 00:00:00.0.
PMID: 33673921
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An innovative housing-related measure for individual socioeconomic status and human papillomavirus vaccination coverage: A population-based cross-sectional study.
Authors: MacLaughlin K.L. , Jacobson R.M. , Sauver J.L.S. , Jacobson D.J. , Fan C. , Wi C.I. , Finney Rutten L.J. .
Source: Vaccine, 2020-09-03 00:00:00.0; 38(39), p. 6112-6119.
EPub date: 2020-07-24 00:00:00.0.
PMID: 32713679
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How health care providers should address vaccine hesitancy in the clinical setting: Evidence for presumptive language in making a strong recommendation.
Authors: Jacobson R.M. , St Sauver J.L. , Griffin J.M. , MacLaughlin K.L. , Finney Rutten L.J. .
Source: Human Vaccines & Immunotherapeutics, 2020-04-03 00:00:00.0; , p. 1-5.
EPub date: 2020-04-03 00:00:00.0.
PMID: 32242766
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Parent's hesitance about HPV Vaccine: Using the CASE approach to address their concerns.
Authors: Jacobson R.M. , Rutten L.J.F. .
Source: Minnesota Medicine, 2019 Jan-Feb; 102(1), p. 24-27.
PMID: 34531616
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Impact of Electronic Point-of-Care Prompts on Human Papillomavirus Vaccine Uptake in Retail Clinics.
Authors: Meyer A.F. , Borkovskiy N.L. , Brickley J.L. , Chaudhry R. , Franqueira A. , Furst J.W. , Hinsch D.M. , McDonah M.R. , Myers J.F. , Petersen R.E. , et al. .
Source: American Journal Of Preventive Medicine, 2018 Dec; 55(6), p. 822-829.
EPub date: 2018-10-19 00:00:00.0.
PMID: 30344033
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Evaluating the impact of multilevel evidence-based implementation strategies to enhance provider recommendation on human papillomavirus vaccination rates among an empaneled primary care patient population: a study protocol for a stepped-wedge cluster randomized trial.
Authors: Finney Rutten L.J. , Radecki Breitkopf C. , St Sauver J.L. , Croghan I.T. , Jacobson D.J. , Wilson P.M. , Herrin J. , Jacobson R.M. .
Source: Implementation Science : Is, 2018-07-13 00:00:00.0; 13(1), p. 96.
EPub date: 2018-07-13 00:00:00.0.
PMID: 30001723
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Direct-to-adolescent text messaging for vaccine reminders: What will parents permit?
Authors: Roberts J.R. , Morella K. , Dawley E.H. , Madden C.A. , Jacobson R.M. , Pope C. , Davis B. , Thompson D. , O'Brien E.S. , Darden P.M. .
Source: Vaccine, 2018-05-11 00:00:00.0; 36(20), p. 2788-2793.
EPub date: 2018-04-10 00:00:00.0.
PMID: 29653849
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