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Grant Details

Grant Number: 5P01CA250989-05 Interpret this number
Primary Investigator: Brewer, Noel
Organization: Univ Of North Carolina Chapel Hill
Project Title: Program Project – Improving Provider Announcement Communication Training (IMPACT)
Fiscal Year: 2025


Abstract

Provider recommendations are uniquely powerful in improving health care use. However, primary care teams and healthcare systems experience challenges with clinical communication, and many questions remain unanswered about how to increase the potency of provider recommendations. We propose the P01 Program Project, “Improving Provider Announcement Communication Training (IMPACT).” The goal of IMPACT is to improve clinical communication and health care use among children ages 9-12 years. IMPACT's specific aims are to 1) Identify opportunities to improve clinical communication; 2) Evaluate the impact and cost of clinical communication interventions in cluster randomized clinical trials; and 3) Support implementation of clinical communication interventions in healthcare systems. The IMPACT Program Project's shared theme is amplifying the impact of a Cancer Control Program to improve clinical communication in healthcare systems. The projects will work together to enhance the impact of the Announcement Approach Training (AAT), a clinical communication training for primary care professionals, which received designation as a Cancer Control Program from the National Cancer Institute. Project 1 will establish how to involve the whole primary care team in recommendations for primary care. The project will examine whether optimizing the use of standing orders support increases health care use in clinics receiving the AAT. Project 2 will examine what motivates providers to make clinical recommendations for primary care. The project will establish whether clinic-level financial incentives increase heath care use in clinics receiving the AAT. Project 3 will examine who should facilitate the trainings. The project will establish whether engaging clinical champions in healthcare systems to implement the AAT within their own systems increases health care use. Project 4 will examine which interventions fit systems' resources. The project will examine the budget impact, cost-effectiveness, and population health impact of these interventions in rural and nonrural areas and aid decision makers with a decision support tool to facilitate the adoption of promising interventions. The research projects will receive support from 3 cores: Administrative, Data, and Intervention. IMPACT's activities will culminate with the creation of the Implementation Guide to support improving health care use in healthcare systems. Throughout the proposed Program Project, the shared theme and AAT focus will create synergies among the projects and cores that generate significant and novel insights into how to improve clinical communication and health care use. Our approach will also accelerate the evolution of communication trainings for primary care professionals, accomplishing in 5 years what might otherwise take two decades.



Publications

Improvements in Health-Related Quality of Life After Financial Navigation Among Cancer Survivors.
Authors: Waters A.R. , Thom B. , Deal A.M. , Murray C.R. , Pignone K. , Manning M.L. , Gellin M. , Padilla N.R. , Spees L.P. , Planey A.M. , et al. .
Source: Psycho-oncology, 2026 Sep; 35(9), p. e70605.
PMID: 42770487
Related Citations

Impact of standing orders on vaccine uptake: A systematic review.
Authors: Ellingson M.K. , Sudarsanam V. , Goddard K. , Tomar A. , Nachman S. , Brewer N.T. .
Source: Vaccine, 2026-06-20 00:00:00.0; 84, p. 128664.
EPub date: 2026-05-08 00:00:00.0.
PMID: 42105399
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Parents' role as advocates for and against childhood vaccination: Findings from a nationally representative survey.
Authors: Kennedy K.L. , Queen T.L. , Ellingson M.K. , Elias E.H. , Calo W.A. , Rosenberg N.E. , Brewer N.T. , Gilkey M.B. .
Source: Plos One, 2026; 21(7), p. e0354147.
EPub date: 2026-07-23 00:00:00.0.
PMID: 42490635
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Implementation strategies to enhance confidence in a whole team approach to HPV vaccine communication in pediatric care.
Authors: Ellingson M.K. , Kahn B.Z. , Kritikos K.I. , Goddard K. , Reiter P.L. , Queen T.L. , Gilkey M.B. , Brewer N.T. .
Source: Academic Pediatrics, 2025-12-21 00:00:00.0; , p. 103208.
EPub date: 2025-12-21 00:00:00.0.
PMID: 41435912
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Identifying HPV vaccination research priorities for the US.
Authors: Brewer N.T. , Tomar A. , Perkins R. , Darville-Sanders G. , Fisher-Borne M. , Footman A. , Naavaal S. , Oliver K. , Saslow D. , Brandt H.M. .
Source: Human Vaccines & Immunotherapeutics, 2025 Dec; 21(1), p. 2590263.
EPub date: 2025-12-02 00:00:00.0.
PMID: 41328527
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Prevalence and inclusiveness of pay-for-performance incentives for HPV vaccination.
Authors: Trogdon J.G. , Brignole K.R. , Fogel B. , Queen T.L. .
Source: The American Journal Of Managed Care, 2025-07-01 00:00:00.0; 31(7), p. e183-e190.
EPub date: 2025-07-01 00:00:00.0.
PMID: 40705762
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How Immunization Information Systems Inform Age-Based HPV Vaccination Recommendations in the United States: A Mixed-Methods Study.
Authors: Vielot N.A. , Bucklin I.K. , Westfall K. , Kepka D. , Zimet G. , Zorn S. .
Source: Vaccines, 2025-06-30 00:00:00.0; 13(7), .
EPub date: 2025-06-30 00:00:00.0.
PMID: 40733693
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Rural patients' experiences with diagnosis and treatment of endometrial cancer.
Authors: Petermann V.M. , Taffe B.D. , Biru B.M. , Leeman J. , Leak Bryant A. , Albright B.B. , Wheeler S.B. , Bae-Jump V.L. , Grainger L. , Spees L.P. .
Source: The Journal Of Rural Health : Official Journal Of The American Rural Health Association And The National Rural Health Care Association, 2025 Jun; 41(3), p. e70065.
PMID: 40844702
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"It really takes a village": perspectives on multi-level barriers to endometrial cancer care for rural patients.
Authors: Taffe B.D. , Petermann V. , Biru B.M. , Albright B.B. , Wheeler S.B. , Bae-Jump V.L. , Leeman J. , Lanneau G. , Spees L.P. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2025-05-21 00:00:00.0; 33(6), p. 490.
EPub date: 2025-05-21 00:00:00.0.
PMID: 40399577
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Methodological Approaches for Incorporating Marginalized Populations into HPV Vaccine Modeling: A Systematic Review.
Authors: Spencer J.C. , Yanguela J. , Spees L.P. , Odebunmi O.O. , Ilyasova A.A. , Biddell C.B. , Hassmiller Lich K. , Mills S.D. , Higgins C.R. , Ozawa S. , et al. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2025-03-15 00:00:00.0; 45(4), p. 272989X251325509.
EPub date: 2025-03-15 00:00:00.0.
PMID: 40088125
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Identifying Measures for Understanding and Addressing County-Level Disparities in Adolescent HPV Vaccination Coverage in North Carolina.
Authors: Grabert B.K. , McKeithen M.C. , Trogdon J.G. , Spees L.P. , Wheeler S.B. , Myers J.K. , Spencer J.C. , Gilkey M.B. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2025-01-09 00:00:00.0; 34(1), p. 151-158.
PMID: 39417713
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Gains vs losses in pay-for-performance: Stated preference evidence from a U.S. survey.
Authors: Trogdon J.G. , Khanderia A. , Brignole K. , Lewis J.A. , Licciardello Queen T. .
Source: Plos One, 2025; 20(2), p. e0318704.
EPub date: 2025-02-10 00:00:00.0.
PMID: 39928672
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Design of Pay-for-Performance Programs Affects Clinical Staff Perceptions of HPV Vaccine Incentives: Evidence from a US Survey.
Authors: Trogdon J.G. , Brignole K. , Licciardello Queen T. .
Source: Inquiry : A Journal Of Medical Care Organization, Provision And Financing, 2025 Jan-Dec; 62, p. 469580251353406.
EPub date: 2025-07-01 00:00:00.0.
PMID: 40590373
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Benefits, challenges, and strategies related to using presumptive recommendations for HPV vaccination: A qualitative study with rural and non-rural-serving primary care professionals.
Authors: Odebunmi O.O. , Spees L.P. , Biddell C.B. , Yemeke T. , Yanguela J. , Higgins C. , Gilkey M. , Ozawa S. , Wheeler S.B. .
Source: Human Vaccines & Immunotherapeutics, 2024-12-31 00:00:00.0; 20(1), p. 2347018.
EPub date: 2024-05-06 00:00:00.0.
PMID: 38708779
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Identifying and supporting vaccine champions in pediatric primary care: a qualitative interview study.
Authors: Kong W.Y. , Heisler-MacKinnon J. , Oh N.L. , McKeithen M.C. , Stalford S.R. , Brennan M.B. , Shea C.M. , Liu A. , Gottfredson O'Shea N. , Ozawa S. , et al. .
Source: Translational Behavioral Medicine, 2024-11-25 00:00:00.0; 14(12), p. 722-731.
PMID: 39402839
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Clinical Staff Perceptions of Pay-for-Performance Financial Incentives for HPV Vaccine Promotion.
Authors: Rodriguez V. , Brignole K. , Licciardello Queen T. , Trogdon J.G. .
Source: American Journal Of Medical Quality : The Official Journal Of The American College Of Medical Quality, 2024 Nov-Dec 01; 39(6), p. 267-274.
EPub date: 2024-10-30 00:00:00.0.
PMID: 39472771
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Pervasiveness and clinical staff perceptions of HPV vaccination feedback.
Authors: Lewis J.A. , Brignole K. , Queen T.L. , Trogdon J.G. .
Source: The American Journal Of Managed Care, 2024-11-01 00:00:00.0; 30(11), p. e320-e328.
EPub date: 2024-11-01 00:00:00.0.
PMID: 39546752
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Mental health and lower adolescent HPV vaccine coverage.
Authors: Ellingson M.K. , Brewer N.T. .
Source: The Lancet. Public Health, 2024 Sep; 9(9), p. e642-e643.
PMID: 39214634
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Conceptualizing vaccine champions from an implementation science perspective: Findings from a national survey of primary care health professionals.
Authors: Kennedy K.L. , Gilkey M.B. , Queen T.L. , Heisler-MacKinnon J.A. , Hanson B. , Kong W.Y. , Brewington M.K. , Grabert B.K. .
Source: Preventive Medicine, 2024-08-17 00:00:00.0; 187, p. 108104.
EPub date: 2024-08-17 00:00:00.0.
PMID: 39159866
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HPV vaccine standing orders and communication in primary care: A qualitative study.
Authors: Mansfield L.N. , Kahn B.Z. , Kokitkar S. , Kritikos K.I. , Brantz S.N. , Brewer N.T. .
Source: Vaccine, 2024-05-29 00:00:00.0; , .
EPub date: 2024-05-29 00:00:00.0.
PMID: 38816304
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LGBTQ+ cancer: priority or lip service? A qualitative content analysis of LGBTQ+ considerations in U.S. state, jurisdiction, and tribal comprehensive cancer control plans.
Authors: Waters A.R. , Bono M.H. , Ito Fukunaga M. , Masud M. , Mullins M.A. , Suk R. , O'Leary M.C. , Adams S.A. , Ferrari R.M. , Wangen M. , et al. .
Source: Cancer Causes & Control : Ccc, 2024-05-25 00:00:00.0; , .
EPub date: 2024-05-25 00:00:00.0.
PMID: 38796675
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Identifying effective vaccine champions: Findings from a national survey of primary care professionals.
Authors: Heisler-MacKinnon J.A. , Queen T. , Yi Kong W. , Kennedy K.L. , Thomas T. , Calo W.A. , Gilkey M.B. .
Source: Vaccine, 2024-05-10 00:00:00.0; 42(13), p. 3148-3152.
EPub date: 2024-04-04 00:00:00.0.
PMID: 38575435
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Inclusion of marginalized populations in HPV vaccine modeling: A systematic review.
Authors: Spencer J.C. , Spees L.P. , Biddell C.B. , Odebunmi O.O. , Ilyasova A.A. , Yanguela J. , Lich K.H. , Mills S.D. , Higgins C.R. , Ozawa S. , et al. .
Source: Preventive Medicine, 2024 May; 182, p. 107941.
EPub date: 2024-03-24 00:00:00.0.
PMID: 38522627
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Policy Approaches for Increasing Adolescent HPV Vaccination Coverage: A Systematic Review.
Authors: McKeithen M.C. , Gilkey M.B. , Kong W.Y. , Oh N.L. , Heisler-MacKinnon J. , Carlson R. , James G. , Grabert B.K. .
Source: Pediatrics, 2024-04-16 00:00:00.0; 153(5), .
EPub date: 2024-04-16 00:00:00.0.
PMID: 38623635
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Who are vaccine champions and what implementation strategies do they use to improve adolescent HPV vaccination? Findings from a national survey of primary care professionals.
Authors: Brewington M.K. , Queen T.L. , Heisler-MacKinnon J. , Calo W.A. , Weaver S. , Barry C. , Kong W.Y. , Kennedy K.L. , Shea C.M. , Gilkey M.B. .
Source: Implementation Science Communications, 2024-03-22 00:00:00.0; 5(1), p. 28.
EPub date: 2024-03-22 00:00:00.0.
PMID: 38520032
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Impact of visit characteristics on intention to recommend HPV vaccine: An experiment with US health care professionals.
Authors: Kong W.Y. , Queen T.L. , Gottfredson O'Shea N. , Heisler-MacKinnon J. , Liu A. , Ozawa S. , Brewer N.T. , Gilkey M.B. .
Source: Preventive Medicine, 2024 Feb; 179, p. 107841.
EPub date: 2023-12-30 00:00:00.0.
PMID: 38160884
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Identifying Healthcare Professionals With Lower Human Papillomavirus (HPV) Vaccine Recommendation Quality: A Systematic Review.
Authors: Kong W.Y. , Oh N.L. , Kennedy K.L. , Carlson R.B. , Liu A. , Ozawa S. , Brewer N.T. , Gilkey M.B. .
Source: The Journal Of Adolescent Health : Official Publication Of The Society For Adolescent Medicine, 2024-01-16 00:00:00.0; , .
EPub date: 2024-01-16 00:00:00.0.
PMID: 38231146
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Capturing Catchment Area Data Comprehensively: The North Carolina Cancer Health Assets and Needs Assessment (CHANA) Approach.
Authors: Spees L.P. , Baggett C.D. , Johnson K.E. , Salas A.I. , Morris H.N. , Arsali E.G. , Emerson M.A. , Roberson M.L. , Olshan A.F. , Wheeler S.B. .
Source: Preventive Oncology & Epidemiology, 2024; 2(1), .
EPub date: 2024-06-06 00:00:00.0.
PMID: 39720021
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Framing of national HPV vaccine recommendations and willingness to recommend at ages 9-10.
Authors: Kahn B.Z. , Reiter P.L. , Kritikos K.I. , Gilkey M.B. , Queen T.L. , Brewer N.T. .
Source: Human Vaccines & Immunotherapeutics, 2023-12-31 00:00:00.0; 19(1), p. 2172276.
EPub date: 2023-02-07 00:00:00.0.
PMID: 36749614
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Eliminating cervical cancer as a global public health problem requires equitable action.
Authors: Rahangdale L. , Teodoro N. , Chinula L. , Brewer N.T. .
Source: Bmj (clinical Research Ed.), 2023-12-22 00:00:00.0; 383, p. 2978.
EPub date: 2023-12-22 00:00:00.0.
PMID: 38135345
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It's Time for a National Surveillance System for Vaccine Confidence and Hesitancy.
Authors: Gilkey M.B. , Brewer N.T. .
Source: Pediatrics, 2023-10-23 00:00:00.0; 152(5), .
EPub date: 2023-10-23 00:00:00.0.
PMID: 37867453
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Optimizing Cancer Prevention in Adolescents by Improving HPV Vaccine Delivery.
Authors: Vielot N.A. , Brewer N.T. .
Source: North Carolina Medical Journal, 2023 Sep; 85(1), p. 33-36.
PMID: 39374359
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How to make effective HPV vaccine recommendations starting at age 9.
Authors: Brewer N.T. , Kahn B.Z. , Kritikos K.I. , Heisler-MacKinnon J.A. , Young J.D. , Gilkey M.B. .
Source: Human Vaccines & Immunotherapeutics, 2023-08-01 00:00:00.0; 19(2), p. 2216117.
EPub date: 2023-05-29 00:00:00.0.
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