Adolescent Health Services, Immunization
Conditions
Keywords
Diphtheria-Tetanus-Pertussis Vaccine, Measles-Mumps-Rubella Vaccine, Meningococcal Vaccines, Hepatitis B Vaccines, Chickenpox Vaccine, Papillomavirus Vaccines
Brief summary
The North Carolina Immunization Branch will evaluate the use of the CDC program to improve adolescent vaccination practices (called Assessment, Feedback, Incentives, and eXchanges, or AFIX). This evaluation is the first of its kind in the nation and may have a profound impact on prevention. AFIX has four major components: 1) Assessment of a provider's current immunization practices and vaccination levels, 2) Feedback of the assessment results and strategies to improve coverage levels, 3) Incentives to improve coverage levels, and 4) eXchange of information and resources necessary to facilitate improvement. This program will evaluate the effectiveness of AFIX visits on affecting provider practices to increase adolescent (age 11-18) immunization. Visits include discussion of that practice's immunization rates and strategies for improving rates. The investigators will compare the changes, from baseline to 5 months, in immunization for practices receiving virtual visits (webinars), in-person visits, and no visits (control group). Thirty practices will be randomly assigned to each intervention type. The main outcomes of this study are practice-wide uptake rates of several adolescent vaccines (Tdap, HPV, and MCV4) as well as pre- and post-AFIX visit surveys focusing on recall tactics utilized by each practice. Data will be collected on practices with at least 200 adolescent patients (note: there is no patient-level data collected in this study).
Interventions
OTHERAssessment , Feedback, Incentives, and eXchange Program
The NC Immunization Branch uses Adolescent AFIX (Assessment, Feedback, Incentives and eXchange) Program, a quality improvement strategy developed by the CDC to improve the immunization practices and vaccination coverage levels of public and private health care providers. It has four main components: 1) Assessment of a provider's current immunization practices and vaccination levels, 2) Feedback of the assessment results and strategies to improve coverage levels, 3) Incentives to improve coverage levels, and 4) eXchange of information and resources necessary to facilitate improvement.
Sponsors
North Carolina Division of Public Health
University of North Carolina, Chapel Hill
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Pediatric and/or family practices participating in the North Carolina Immunization Program * A minimum of 200 active adolescent patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Vaccination Rate: HPV vaccine initiation among 11-12 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (age 11-12) for the first dose of human papillomavirus (HPV) vaccine at baseline and 5 months follow-up. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Vaccination Rate: Tdap vaccine among 11-12 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (age 11-12) for tetanus, diphtheria, and pertussis booster (Tdap) at baseline and 5 months follow-up. |
| Change in Vaccination Rate: HPV vaccine initiation among 13-18 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (age 13-18) for the first dose of human papillomavirus (HPV) vaccine at baseline and 5 months follow-up. |
| Change in Vaccination Rate: Tdap vaccine among 13-18 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (age 13-18) for tetanus, diphtheria, and pertussis booster (Tdap) at baseline and 5 months follow-up. |
| Change in Vaccination Rate: Meningitis vaccine among 11-12 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (age 11-12) for meningococcal conjugate (i.e., meningitis vaccine) at baseline and 5 months follow-up. |
| Change in Vaccination Rate: Meningitis vaccine among 13-18 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (age 13-18) for meningococcal conjugate (i.e., meningitis vaccine) at baseline and 5 months follow-up. |
| Change in Vaccination Rate: HPV vaccine completion among 11-12 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (age 11-12) for the third and final dose of human papillomavirus (HPV) vaccine at baseline and 5 months follow-up. |
| Change in Vaccination Rate: HPV vaccine completion among 13-18 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (age 13-18) for the third and final dose of human papillomavirus (HPV) vaccine at baseline and 5 months follow-up. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in Vaccination Rate: Hepatitis B vaccine among 11-12 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (ages 11-12) for hepatitis B vaccine at baseline and 5 months follow-up. This is a childhood vaccine that is not targeted for adolescents; however the intervention may impact hepatitis B vaccine coverage. |
| Change in Vaccination Rate: Hepatitis B vaccine among 13-18 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (ages 13-18) for hepatitis B vaccine at baseline and 5 months follow-up. This is a childhood vaccine that is not targeted for adolescents; however the intervention may impact hepatitis B vaccine coverage. |
| Change in Vaccination Rate: Varicella vaccine among 11-12 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (ages 11-12) for varicella vaccine at baseline and 5 months follow-up. This is a childhood vaccine that is not targeted for adolescents; however the intervention may impact varicella vaccine coverage. |
| Change in Vaccination Rate: Varicella vaccine among 13-18 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (ages 13-18) for varicella vaccine at baseline and 5 months follow-up. This is a childhood vaccine that is not targeted for adolescents; however the intervention may impact varicella vaccine coverage. |
| Change in Vaccination Rate: MMR among 13-18 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (ages 13-18) for measles, mumps, and rubella (MMR) vaccine at baseline and 5 months follow-up. This is a childhood vaccine that is not targeted for adolescents; however the intervention may impact MMR coverage. |
| Change in Vaccination Rate: MMR among 11-12 year olds | Baseline and 5 months follow-up | We will gather practice-specific rates of coverage for adolescents (ages 11-12) for measles, mumps, and rubella (MMR) vaccine at baseline and 5 months follow-up. This is a childhood vaccine that is not targeted for adolescents; however the intervention may impact MMR coverage. |
Countries
United States
Outcome results
None listed