Evidence-Based Practice Model to Increase Human Papillomavirus Vaccine Uptake: A Stepwise Approach

Objective: To increase uptake of human papillomavirus (HPV) vaccination by implementing a stepwise evidence-based practice model to offer HPV education along with a strong provider recommendation to parents of youth and adolescents. Design: Evidence-based practice change model. Setting: A nurse practitioner–run, primary care walk-in clinic in a rural area of the southeastern United States. Participants: Parents of youth and adolescents ages 11 to 17 years. Interventions/Measurements: Education targeting parental hesitancy and strong recommendations for immunization was administered by health care providers to parents of youth and adolescents eligible for vaccination. The Parent Attitudes About Childhood Vaccine instrument was used to identify the presence and degree of parental hesitancy. Vaccination uptake was measured and compared to the same time period from the previous year. Results: Data collected from the clinic vaccination log during the same 6-week time period in 2018 identified that four youth/adolescents were vaccinated with the HPV vaccine in 2018. During the same 6-week period in 2019 when the practice change was implemented, 38 parents were approached; 24 met eligibility criteria, and all 24 of their youth/adolescents received HPV vaccination. Conclusion: Implementation of an evidence-based practice model that includes standing vaccine orders and reminders and recalls may provide an effective way to ensure completion of the HPV vaccine series. Every missed clinical opportunity to vaccinate youth and adolescents against HPV can contribute to lower vaccination rates and increased risk for genital warts and cancers associated with HPV infection.