This clinical trial develops and tests how well a clinical decision support (CDS) tool works to increase human papillomavirus (HPV) vaccination of children between the age of 9-17 (adolescents) in pharmacies. HPV vaccination rate in eligible adolescents remains low even though over 90% of the cancers in adults caused by HPV can be prevented by the HPV vaccine. The National Vaccine Advisory Committee recommends HPV vaccinations to be given in pharmacies to increase access to vaccines, but pharmacy processes and lack of awareness of the service among parents impact the use of local pharmacies for HPV vaccinations. Using a focus group may be an effective method to develop a CDS tool and create a process that may be more convenient for parents to get their adolescent's vaccine at their local pharmacy. A CDS tool may make it easier to obtain HPV vaccines, and as a result increase the adolescent HPV vaccination rate and reduce the incidence of cancer caused by HPV.
OUTLINE: Participants are assigned to 1 of 3 groups. Group I: Staff participate in facilitated planning discussions to develop CDS tools on study. (Aim I) Group II: Staff receives CDS tools training and implements CDS tools to facilitate HPV vaccination on study. (Aim II) Group III: Parents complete survey post-intervention on study. (Aim II)
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
31
Participate in focus group
Undergo training to use CDS tool
Utilize CDS tool
Complete survey
Fred Hutch/University of Washington Cancer Consortium
Seattle, Washington, United States
Development/refinement of the CDS tools to support and guide any adaptations to the pharmacy staff's vaccination workflow to improve vaccine delivery. (Aim 1)
The research team will analyze the collected qualitative data using framework-guided rapid analyses described by Gale et al. The qualitative data will be used to direct and document the development and refinement process for the CDS tools to support HPV vaccination and to guide any adaptations to the pharmacy staff's vaccination workflow to improve their delivery of HPV vaccine. Adaptations made to a pharmacy's vaccination workflow will be methodically documented using Stirman's Taxonomy of Adaptation Characteristics.
Time frame: Up to 6 months
Acceptability of CDS tools: Pharmacy staff (Aim II)
Will use validated survey measure to assess pharmacy staff's report of the acceptability of the CDS tools to support HPV Vaccination. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Post-implementation of CDS tools survey (at Months 11-12)
Change in Acceptability of pharmacy-based HPV vaccination: Pharmacy staff (Aim II)
The survey will ask pharmacy staff to respond to statements designed to measure acceptability of pharmacy-based HPV vaccination. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Pre-implementation of CDS Tools survey (at Months 4-5) and post- test implementation survey (at Months 11-12)
Acceptability of pharmacy-based HPV vaccination: Parents (Aim II)
The survey will ask parents to respond to statements designed to measure acceptability of their vaccine experience at the pharmacy. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Post-vaccination experience survey (at Months 8-12)
Appropriateness of CDS tools: Pharmacy staff (Aim II)
The survey will ask pharmacy staff to respond to statements designed to measure appropriateness of the CDS tools to support HPV vaccination. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Post-test implementation survey (at Months 11-12)
Appropriateness of pharmacy-based HPV vaccination: Pharmacy staff (Aim II)
The survey will ask pharmacy staff to respond to statements designed to measure appropriateness of pharmacy-based HPV vaccination. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Pre-test implementation survey (at Months 4-5) and post- test implementation survey (at Months 11-12)
Appropriateness of pharmacy-based HPV vaccination: Parents (Aim II)
The survey will ask parents to respond to statements designed to measure appropriateness of their vaccine experience at the pharmacy. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Post-vaccination experience survey (at Months 8-12)
Feasibility of CDS tools: Pharmacy staff (Aim II)
The survey will ask pharmacy staff to respond to statements designed to measure feasibility of the CDS tools to support HPV vaccination. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Post-test implementation survey (at Months 11-12)
Feasibility of pharmacy-based HPV vaccination: Pharmacy staff (Aim II)
The survey will ask pharmacy staff to respond to statements designed to measure feasibility of pharmacy-based HPV vaccination. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Pre-test implementation survey (at Months 4-5) and post- test implementation survey (at Months 11-12)
Feasibility of pharmacy-based HPV vaccination: Parents (Aim II)
The survey will ask parents to respond to statements designed to measure feasibility of their vaccine experience at the pharmacy. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Post-vaccination experience survey (at Months 8-12)
Usability of CDS tools: Pharmacy staff (Aim II)
The survey will ask pharmacy staff to respond to statements designed to measure usability of the CDS tools to support HPV vaccination. Survey responses will include 5-point scales: 1. = Not at all confident 2. = Not very confident 3. = Neither (neutral) 4. = Moderately confident 5. = Completely confident And 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree
Time frame: Post-test implementation survey (at Months 11-12)
Parents' experience Survey (Aim II)
This is a 30-question survey asking about experience with getting child vaccinated at participating pharmacy. Survey responses will include a 5-point scales: 1. = Strongly disagree 2. = Somewhat disagree 3. = Neither agree nor disagree 4. = Somewhat agree 5. = Strongly agree And 1. Completely dissatisfied 2. Somewhat dissatisfied 3. Neither satisfied nor dissatisfied 4. Somewhat satisfied 5. Completely satisfied
Time frame: Post-implementation of CDS tools up to 12 months
HPV vaccination rate per pharmacist at each pharmacy (Aim II)
Outcomes of implementation analyzed using nonparametric tests appropriate for small sample statistics, like Wilcoxon sign-rank test.
Time frame: 12 months prior to CDS tool implementation (baseline) up to 5 months post-implementation
Rate of other adolescent vaccinations per pharmacist at each pharmacy (Aim II)
Outcomes of implementation analyzed using nonparametric tests appropriate for small sample statistics, like Wilcoxon sign-rank test.
Time frame: 12 months prior to CDS tool implementation (baseline) up to 5 months post-implementation
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