The STOP-HPV Trial 4: Bundle Intervention

HPV vaccine rates remain lower than rates for other adolescent vaccines. Missed opportunities
(MOs) are healthcare visits during which a patient is eligible, but does not receive a
vaccine. MOs for vaccination contribute strongly to low HPV vaccination rates. This cluster
randomized clinical trial will test the effectiveness (and cost-effectiveness) of a bundled
intervention training providers first in HPV vaccine communication skills (done through
online educational modules and live office practice sessions), with the addition of
performance feedback reports (that pull from electronic health record (EHR) data, and compare
participants' performance to their own previous performance and performance of others)
followed by the addition of provider prompts (via EHR and also office staff prompts, e.g.,
placing Vaccine Information Statements (VISs) on desk) to reduce MOs and increase HPV
vaccination rates. Throughout the intervention participants will also receive weekly text
message mini-lessons that will remind participants of the project.

Practice Inclusion Criteria:

- The practice provides HPV vaccination services to adolescents.

- The practice is part of Physician's Computer Company (PCC), Office Practicum (OP) or
(a) yet-to-be selected health system(s).

- The practice has had the same EHR system in place for a year or more (with special
consideration on a case by case basis if they are close to but not do not reach a
year).

- The practice agrees to not participate in other HPV-related QI projects or research
interventions during the study period (with special consideration on a case by case
basis).

Practice Exclusion Criteria:

- The practice plans to change EHR systems in the next three years.

- The practice participated in the last year, is currently engaged in, or plans to
participate in an office-based HPV-related quality improvement (QI) project or
research intervention during the study period (with special consideration on a case by
case basis).

- Estimated 20% or more of adolescents at the practice receive HPV vaccinations at
schools or health department clinics (given standard practice and published data, the
investigators expect that few to no practices will need to be excluded based on this
restriction).

Patient inclusion criteria:

-All patients of participating practices (intervention and comparison) aged 11-17 years who
have at least 1 visit to the practice within the past two years.

Patient exclusion criteria:

-None apart from age of patients (above).