BOSTON--Researchers at Boston Medical Center (BMC) were awarded a three-year, $1.04 million grant from the American Cancer Society to expand an education-based pilot program to improve communication between pediatric physicians and their patients about the Human Papillomavirus (HPV) vaccine. During the pilot study, vaccination rates increased as physicians became more educated about HPV vaccination. This grant will expand this intervention to five additional community health centers in Boston to test its efficacy in a larger, diverse group of patients and families.
While HPV is the most common sexually transmitted virus in the U.S., effecting nearly 80 million people, vaccination rates remain low, with 40 percent of girls and 21 percent of boys having reported completing the series of vaccines against HPV. In addition, the Centers for Disease Control and Prevention (CDC) reports more than 33,000 people will develop HPV-associated cancers each year with the majority of cervical cancers affecting underserved populations such as minority groups or those with low socioeconomic status.
Three HPV vaccines are licensed by the Food and Drug Administration (FDA). The bivalent HPV vaccine prevents the two HPV types, 16 and 18, which cause 70 percent of cervical cancers. The quadrivalent HPV vaccine prevents four HPV types: HPV 16 and 18, as well as HPV 6 and 11, which cause 90 percent of genital warts. The 9-valent HPV vaccine protects against 9 HPV types: 7 that cause cancer and 2 that cause genital warts. Clinical trials and post-marketing studies from the US and around the world show that the vaccines are very effective.
The bivalent vaccine is recommended for girls and the quadrivalent and 9-valent are recommended for both boys and girls at age 11 or 12 through age 26. All vaccines are administered in a three-shot series.
After completing more than 600 interviews at two pilot sites with parents, teenagers and physicians to determine reasons why HPV vaccines are used or not used, BMC researchers implemented an educational program to improve communication around HPV vaccination. The curriculum consisted of seven educational and feedback sessions with physicians as well as baseline and follow-up chart reviews. As a result, boys and girls were substantially more likely to receive the HPV vaccine at the pilot sites than they were at the control sites.
"Universal HPV vaccination has the potential to decrease the overall burdens of these cancers and reduce racial and ethnic disparities, yet many clinicians do not effectively recommend vaccination for young teens," said Rebecca Perkins, MD, MSc, gynecologist at BMC and lead researcher. "It is our responsibility to our youngest and our most marginalized patients to inform them and their parents of the risks of not getting the vaccine."
Moving forward, researchers plan to implement the intervention in five local community health centers to broadly test the program's effectiveness in a diverse group of pediatric and family medicine practices serving low-income and minority patients. They will then analyze if and how much vaccination rates improved following the program, the effects of the program on parent-physician communication by surveying both parties and observing patient visits, and the potential barriers to sustainability with the goal of ensuring that the program can be successfully replicated in other settings.
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About Boston Medical Center
Boston Medical Center is a private, not-for-profit, 496-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. Committed to providing high-quality health care to all, the hospital offers a full spectrum of pediatric and adult care services including primary and family medicine and advanced specialty care with an emphasis on community-based care. Boston Medical Center offers specialized care for complex health problems and is a leading research institution, receiving more than $118 million in sponsored research funding in fiscal year 2014. It is the 11th largest recipient of funding in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. It does business in Massachusetts as BMC HealthNet Plan and as Well Sense Health Plan in New Hampshire, serving more than 315,000 people, collectively. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet - 13 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit http://www.bmc.org.