Making Effective HPV Vaccine Recommendations - PowerPoint Presentation

Making Effective HPV Vaccine Recommendations Announce

DisclosuresPresenter COI[Insert]Planners COI[Insert]Funding for this training[Insert] Announce

Clinicians are uniquely influentialAnnounce

ObjectiveLearn an effective strategy for recommending HPV vaccineActivitiesReview latest HPV vaccination practicesBuild skills for effective communicationPractice the communication strategyComplete post-training survey for CME credit Announce

Review evidence

President’s Cancer Panel Annual Report (2014) HPV-related disease incidence Announce

HPV vaccination guidelinesAnnounce On-time 2 doses, ages 11 or 12 More effective than expected in younger adolescents Universal vaccination is most effective Late Females and MSM to age 26 Males to age 21

HPV vaccination impact BMJ (Ali et al., 2013) HPV vaccination available for females Near-eradication of genital warts in Australia Announce 88%

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9-valent vaccineFDA approvedGive the HPV vaccine you have in stockAdvise parents: don’t delay protectionAnnounce

Low HPV vaccine coverage in NC *3 doses Healthy People 2020 Target National Immunization Survey – Teen, 2014 Announce

Missed opportunities MMWR (CDC, 2012) HPV vaccine initiation, girls 53,000 unnecessary new cervical cancer cases Announce

Parents’ perceived importance of HPV vaccine Vaccine (Healy et al., 2014) According to parents Announce

Parents’ reasons for not getting HPV vaccineNot knowing enoughSafety concerns/side effectsNot necessary No provider recommendation National Immunization Survey – Teen, 2013. (Stokley et al., 2014) Announce

1% 55% AJPH (Reiter et al., 2013) Provider recommendation Announce

Clinicians are uniquely influentialAnnounce

Questions?Announce

Build skills

Announcement “It’s time for shots.” 90% Optional “ What do you want to do about shots? ” 17% Introducing vaccines Accepted vaccine AJPH (Opel et al., 2015) Announce

Announce child is due for 3 vaccines Ease main concern about HPV vaccine Recommend HPV vaccine strongly Ask them to return in two months HPV vaccination Announce © Dr. Noel Brewer, 2015

AnnounceNote child’s age.Announce the child is due for 3 vaccines recommended for children this age, placing HPV vaccine in middle of list.Say you will vaccinate today.Move on with the visit. Announce © Dr. Noel Brewer, 2015

Announce “I see here that Michael just turned 11. Because he’s 11, Michael is due for meningitis, HPV, and Tdap vaccines. We’ll give those at the end of today’s visit.”“Now that Michael is 12, there are three vaccines we give to kids his age. Today, he’ll get meningitis, HPV, and Tdap vaccines.”Announce© Dr. Noel Brewer, 2015

Elicit main concern about HPV vaccine Acknowledge main concern Share your commitment Educate on what research shows Ease main concern Announce E licit main concern about HPV vaccine A cknowledge main concern S hare your commitment E ducate on what research shows © Dr. Noel Brewer, 2015

“I think we can wait until Bianca is a little older, don’t you?”Acknowledge. “I get it, Bianca is young. I can see why you may be worried that she isn’t ready for HPV vaccine.”Elicit. “What’s your main concern about HPV vaccine?”Share your commitment. “Because preventive care for kids Bianca’s age is important to me, I keep up-to-date on vaccine studies and I follow CDC guidelines for vaccination.” Educate on what research shows. “Children Bianca’s age should get HPV vaccine because younger children develop better protection. We want her to get the vaccine far before she is exposed to an infection that could lead to cancer. HPV vaccine is cancer prevention.” Ease main concern © Dr. Noel Brewer, 2015

Give motivational statement. End with the phrase “I recommend …” Encourage getting HPV vaccine today . Recommend Announce © Dr. Noel Brewer, 2015

“I strongly believe in the importance of this cancer-preventing vaccine for Michael. I recommend he get the HPV vaccine today.”“Kayla can get cervical cancer as an adult, but you can stop that right now. The HPV vaccine prevents most cervical cancers. I recommend Kayla get the HPV vaccine today.” Recommend Announce © Dr. Noel Brewer, 2015

Announce child is due for 3 vaccines Ease main concern about HPV vaccine Recommend HPV vaccine strongly Ask them to return in two months HPV vaccination Announce © Dr. Noel Brewer, 2015

Questions?Announce

Demonstration

Announce child is due for 3 vaccines Ease main concern about HPV vaccine Recommend HPV vaccine strongly Ask them to return in two months HPV vaccination Announce © Dr. Noel Brewer, 2015

Focus on cancer prevention, not sex If sex or STIs come up, refocus on cancer preventionTreat HPV vaccine the same as required vaccinesIf the vaccine being “not required” comes up, refocus on recommendations being equally strong for all 3 vaccines 31 Tips from your peers Announce © Dr. Noel Brewer, 2015

Questions?Announce

Practice

1. List three situations when you already use announcements as part of your routine clinical care.2. Create an announcement Note child’s age. Announce the child is due for 3 vaccines recommended for children this age, placing HPV vaccine in middle of list. Say you will vaccinate today. Exercise Announce

Role-playing the provider Effectively recommend HPV vaccineChild11 years oldIn clinic for routine well visit; no serious health issuesHasn’t gotten meningitis, HPV, or Tdap vaccines Role-playing the parent “Not necessary” “Sends message that sex is okay” Announce

How’d it go?Announce

How will you use the strategy with your patients?Announce

Align your communicationConsider other activities 38 HPV vaccination is a team effort Announce

Next steps for vaccine prescribers Use the communication strategy Commit to applying to your practice Set a goal Announce

CME credit Complete yellow CME survey Don’t forget your CME certificate of participation Announce

Thank you!© 2015 University of North Carolina. All Rights Reserved.Developed by Dr. Noel Brewer