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| ID | Type | Description | Link |
|---|---|---|---|
| R37CA253279 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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The safe, highly-effective human papillomavirus (HPV) vaccine remains underused in the US; only 51% of 13- to 17-year-old girls and boys were up-to-date by 2018. The Announcement Approach Training is effective in increasing HPV vaccine uptake during the clinic visit by training providers to make strong vaccine recommendations and answer parents' common questions. Systems communication like recall notifications also improve vaccination by reducing missed clinical opportunities. Although never tested to support HPV vaccination, the ECHO (Extension for Community Healthcare Outcomes) Model is a proven implementation strategy to promote capacity exchange between health care experts at academic centers and primary care providers at the front line of rural community health care. The trial will test the effectiveness of two ECHO-delivered HPV vaccination communication interventions versus control: HPV ECHO will provide Announcement Approach training, and HPV ECHO+ will provide training plus recall notices to communicate with parents who initially decline vaccination.
The investigators will recruit 36 primary care clinics (family medicine and pediatric) in Pennsylvania. Eligible clinics will have at least 100 active patients, ages 11-14, in their electronic health record systems. Recruitment will target clinics in Central Pennsylvania, where most counties are designated as rural. Clinics will be randomized to one of three arms: ECHO-delivered HPV vaccine communication training using the Announcement Approach (HPV ECHO); HPV ECHO plus systems follow-up communication for parents who initially decline vaccination (HPV ECHO+); or control. Covariate-constrained randomization will be used to ensure balance among the three arms with respect to clinic size (adolescent patient population), clinic type (academic vs. non-academic), rurality, and historic adolescent HPV vaccination rates.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HPV ECHO | Experimental | Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times. |
|
| HPV ECHO+ | Experimental | Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania. |
|
| Control | No Intervention | Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Project ECHO | Other | Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice. |
| Measure | Description | Time Frame |
|---|---|---|
| HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months | Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records | Twelve months |
| Measure | Description | Time Frame |
|---|---|---|
| HPV Vaccination (≥1 Dose), 11-14 Year Olds at 3 Months | Coverage change from baseline to 3 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records | Three months |
| HPV Vaccination (≥1 Dose), 11-14 Year Olds at 6 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Tetanus, Diphtheria, and Acellular Pertussis (Tdap) Vaccination, 11-14 Year Olds | Coverage change from baseline to 12 months in Tdap vaccination among 11- to 14-year-old patients, as measured by clinics' records | Twelve months |
| Meningococcal Vaccination (≥1 Dose), 11-14 Year Olds |
Clinics in cluster RCT (main study)
Inclusion Criteria:
Exclusion Criteria:
Parents in nested study survey
Inclusion criteria:
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| William A Calo, PhD, JD, MPH | Penn State College of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Penn State College of Medicine | Hershey | Pennsylvania | 17033 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37301468 | Derived | Calo WA, Shah PD, Fogel BN, Ruffin Iv MT, Moss JL, Hausman BL, Segel JE, Francis E, Schaefer E, Bufalini CM, Johnston N, Hogentogler E, Kraschnewski JL. Increasing the adoption of evidence-based communication practices for HPV vaccination in primary care clinics: The HPV ECHO study protocol for a cluster randomized controlled trial. Contemp Clin Trials. 2023 Aug;131:107266. doi: 10.1016/j.cct.2023.107266. Epub 2023 Jun 9. |
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No raw data will be shared with the general public or other researchers.
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Clinics were randomized using covariate-constrained randomization to ensure balance among the 3 arms with respect to clinic size, clinic type (academic vs non-academic), rurality (defined using RUCC), and initial HPV vaccination rates. Our outcomes were evaluated on the clinic-level. Each clinic reported aggregate immunization data on patients 11-17 years of age. Patients reported in the aggregate data are from the clinics, parents and patients were not enrolled. Only clinic staff were enrolled.
Clinics were recruited using existing professional contacts, purchasing of professional listservs, and participation as an exhibitor at state-wide conferences. The study team employed multiple outreach methods, including personalized mailings, individualized electronic messages, and mass email communications.
| ID | Title | Description |
|---|---|---|
| FG000 | HPV ECHO | Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 8 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times. Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice. Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine. To assess the primary outcome of HPV vaccine uptake, participating clinics will consent to providing aggregate patient immunization data at baseline, 3-, 6-, 9-, and 12-month follow-up throughout the study period. This aggregate data will be reported as it is essential to the study. |
| FG001 | HPV ECHO+ | Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 10 primary care clinics in Pennsylvania. Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice. Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine. Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via mail. To assess the primary outcome of HPV vaccine uptake, participating clinics consent to providing aggregate patient immunization data at baseline, 3-, 6-, 9-, and 12-month follow-up throughout the study. |
| FG002 | Control | Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 10 primary care clinics in Pennsylvania. To assess the primary outcome of HPV vaccine uptake, participating clinics consent to providing aggregate patient immunization data at baseline, 3-, 6-, 9-, and 12-month follow-up throughout the study period. This aggregate data will be reported as it is essential to the study. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
This cluster-randomized trial enrolled primary care clinics. For the primary outcome (HPV vaccine initiation), clinics submitted aggregate immunization data for active patients aged 11-17 years, defined as those with a clinic visit in the 18 months prior to clinic enrollment. These counts represent the total number of age-eligible active patients at each clinic.
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| ID | Title | Description |
|---|---|---|
| BG000 | HPV ECHO | Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 8 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times. Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice. Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Clinics reported aggregate immunization data based on age groupings of 11-14 and 15-17 years. Birthdate ranges were provided to clinics for the groupings and the groupings assigned at baseline remained constant throughout the study period. |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months | Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Twelve months |
|
Throughout the one-year study enrollment period.
This cluster RCT was conducted at the clinic level, and the study team did not have any patient-level interactions. The intervention clinics received an educational training, and clinic patients continued to receive standard pediatric primary care without any study-related procedures or treatments. There were no reported Adverse Events. Clinics were enrolled for one-year period. Clinical staff were not assessed for adverse events.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | HPV ECHO | Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 8 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times. Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice. Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine. |
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Challenges occurred in obtaining aggregate immunization data. Three clinics did not submit data, and others could not consistently follow the same patient cohort across time points, resulting in inconsistencies. The study team collaborated with clinics and EHR servicers to ensure the highest possible data quality.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| William Calo | Milton S. Hershey Medical Center | 717-531-3535 | wcalo@pennstatehealth.psu.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 25, 2024 | Sep 29, 2025 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Feb 2, 2022 | Sep 29, 2025 | ICF_001.pdf |
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Cluster randomized design
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|
|
| Announcement Approach Training | Other | Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine. |
|
| Recall notices | Other | Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication. |
|
Coverage change from baseline to 6 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records |
| Six months |
| HPV Vaccination (≥1 Dose), 11-14 Year Olds at 9 Months | Coverage change from baseline to 9 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records | Nine months |
| HPV Vaccination (Completion), 11-14 Year Olds at 3 Months | Coverage change from baseline to 3 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records | Three months |
| HPV Vaccination (Completion), 11-14 Year Olds at 6 Months | Coverage change from baseline to 6 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records | Six months |
| HPV Vaccination (Completion), 11-14 Year Olds at 9 Months | Coverage change from baseline to 9 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records | Nine months |
| HPV Vaccination (Completion), 11-14 Year Olds at 12 Months | Coverage change from baseline to 12 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records | Twelve months |
| HPV Vaccination (≥1 Dose), 15-17 Year Olds at 3 Months | Coverage change from baseline to 3 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records | Three months |
| HPV Vaccination (≥1 Dose), 15-17 Year Olds at 6 Months | Coverage change from baseline to 6 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records | Six months |
| HPV Vaccination (≥1 Dose), 15-17 Year Olds at 9 Months | Coverage change from baseline to 9 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records | Nine months |
| HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months | Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records | Twelve months |
| HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months by Sex | Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients by sex, as measured by clinics' records | Twelve months |
| HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months by Sex | Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients by sex, as measured by clinics' records | Twelve months |
Coverage change from baseline to 12 months in meningococcal vaccination (≥1 dose), among 11- to 14-year-old patients, as measured by clinics' records |
| Twelve months |
| BG001 | HPV ECHO+ | Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 10 primary care clinics in Pennsylvania. Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice. Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine. Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via mail. |
| BG002 | Control | Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 10 primary care clinics in Pennsylvania. |
| BG003 | Total | Total of all reporting groups |
Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics. |
| Count of Participants |
| Participants |
|
| Sex/Gender, Customized | Gender was collected but not mandatory. Some participants chose not to report their gender. | Clinical staff (n=135) from each clinic enrolled in the study. | Count of Participants | Participants |
|
| Sex: Female, Male | The two different age groups are reported separately to show the sex distribution within each age group. | Count of Participants | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
|
| Region of Enrollment | Aggregate immunization data of 11-17 year old patients at participating primary care clinics in Pennsylvania. | Data reported represent the aggregate patient data reported from clinics enrolled in the cluster RCT. | Number | patients |
|
| OG001 | HPV ECHO+ | Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania. Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice. Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine. Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication. |
| OG002 | Control | Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania. |
|
|
| Secondary | HPV Vaccination (≥1 Dose), 11-14 Year Olds at 3 Months | Coverage change from baseline to 3 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Three months |
|
|
|
| Secondary | HPV Vaccination (≥1 Dose), 11-14 Year Olds at 6 Months | Coverage change from baseline to 6 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Six months |
|
|
|
| Secondary | HPV Vaccination (≥1 Dose), 11-14 Year Olds at 9 Months | Coverage change from baseline to 9 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Nine months |
|
|
|
| Secondary | HPV Vaccination (Completion), 11-14 Year Olds at 3 Months | Coverage change from baseline to 3 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Three months |
|
|
|
| Secondary | HPV Vaccination (Completion), 11-14 Year Olds at 6 Months | Coverage change from baseline to 6 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Six months |
|
|
|
| Secondary | HPV Vaccination (Completion), 11-14 Year Olds at 9 Months | Coverage change from baseline to 9 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Nine months |
|
|
|
| Secondary | HPV Vaccination (Completion), 11-14 Year Olds at 12 Months | Coverage change from baseline to 12 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Twelve months |
|
|
|
| Secondary | HPV Vaccination (≥1 Dose), 15-17 Year Olds at 3 Months | Coverage change from baseline to 3 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records | These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Three months |
|
|
|
| Secondary | HPV Vaccination (≥1 Dose), 15-17 Year Olds at 6 Months | Coverage change from baseline to 6 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records | These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Six months |
|
|
|
| Secondary | HPV Vaccination (≥1 Dose), 15-17 Year Olds at 9 Months | Coverage change from baseline to 9 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records | These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Nine months |
|
|
|
| Secondary | HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months | Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records | These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Twelve months |
|
|
|
| Secondary | HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months by Sex | Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients by sex, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Twelve months |
|
|
|
| Secondary | HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months by Sex | Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients by sex, as measured by clinics' records | These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Twelve months |
|
|
|
| Other Pre-specified | Tetanus, Diphtheria, and Acellular Pertussis (Tdap) Vaccination, 11-14 Year Olds | Coverage change from baseline to 12 months in Tdap vaccination among 11- to 14-year-old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Twelve months |
|
|
|
| Other Pre-specified | Meningococcal Vaccination (≥1 Dose), 11-14 Year Olds | Coverage change from baseline to 12 months in meningococcal vaccination (≥1 dose), among 11- to 14-year-old patients, as measured by clinics' records | These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period. | Posted | Count of Participants | Participants | Twelve months |
|
|
|
| 0 |
| 10 |
| 0 |
| 10 |
| 0 |
| 10 |
| EG001 | HPV ECHO+ | Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania. Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice. Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine. Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via mail. | 0 | 10 | 0 | 10 | 0 | 10 |
| EG002 | Control | Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 10 primary care clinics in Pennsylvania. | 0 | 10 | 0 | 10 | 0 | 10 |
Not provided
Not provided
| 15-17 year olds |
|
| Male |
|
| Not reported |
|
| Male |
|
| Title | Measurements |
|---|---|
| Female |
|
| Male |
|
| Female - Not initiated |
|
| Male - Not initiated |
|
| Female - Not initiated |
|
| Male - Not initiated |
|