Trial Outcomes & Findings for Multilevel Interventions to Enhance Provider Recommendations for HPV Vaccination (NCT NCT03501992)

NCT ID: NCT03501992

Last Updated: 2024-10-24

Results Overview

The outcome measure was the proportion of empaneled, HPV-vaccine-dose eligible males and females in the study step who received the dose of HPV vaccine dose due by the end of the study step.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

9242 participants

Primary outcome timeframe

The dose had to have been received during the 12-month-long study step.

Results posted on

2024-10-24

Participant Flow

During each trial month for each practice, we identified patients both age- and dose-eligible. To become age eligible for a particular trial month and for the rest of the step, the patient must turn 11 or 12 years of age during the calendar month that preceded the calendar month before the given trial month. To be dose eligible for the same period, the patient must be due for an HPV vaccine dose in the month following their 11th or 12th birthday (ie, the month prior to the relevant trial month).

A patient empaneled to a practice who was both age and dose eligible for one 12-month step may become age and dose eligible in the following 12-month step. We included patients in a step who were age and dose eligible for a preceding step who remained empaneled to a practice and became age and dose eligible in the next step. The dose eligibility may result from either still being due for the first, initial HPV vaccine dose or now being due for the second, final HPV vaccine dose. Others aged out.

Participant milestones

Participant milestones
Measure
Practice A
24 months usual care, followed by 12 months reminder recall, followed by 12 months combination
Practice B
12 months usual care, followed by 12 months reminder recall, followed by 24 months combination
Practice C
12 months usual care, followed by 24 months feedback, followed by 12 months combination
Practice D
24 months usual care, followed by 12 months feedback, followed by 12 months combination
Practice E
12 months usual care, followed by 24 months reminder recall, followed by 12 months combination
Practice F
12 months usual care, followed by 12 months feedback, followed by 24 months combination
Step 1 - Months 1-12
STARTED
848
228
479
320
414
265
Step 1 - Months 1-12
COMPLETED
848
228
479
320
414
265
Step 1 - Months 1-12
NOT COMPLETED
0
0
0
0
0
0
Step 2 - Months 13-24
STARTED
726
218
434
292
386
264
Step 2 - Months 13-24
COMPLETED
726
218
434
292
386
264
Step 2 - Months 13-24
NOT COMPLETED
0
0
0
0
0
0
Step 3 - Months 25-36
STARTED
702
188
401
241
364
309
Step 3 - Months 25-36
COMPLETED
702
188
401
241
364
309
Step 3 - Months 25-36
NOT COMPLETED
0
0
0
0
0
0
Step 4 - Months 37-48
STARTED
682
161
421
254
342
303
Step 4 - Months 37-48
COMPLETED
682
161
421
254
342
303
Step 4 - Months 37-48
NOT COMPLETED
0
0
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Multilevel Interventions to Enhance Provider Recommendations for HPV Vaccination

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Usual Care
n=3572 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of either step 1 or 2 to usual care.
Parent Reminder-Recall Letter
n=1670 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the parent reminder-recall letter intervention.
Provider Audit-Feedback Intervention.
n=1340 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the provider audit-feedback intervention.
Combination of Parent Reminder-Recall Letter and Provider Audit-Feedback Interventions
n=2660 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 3 and 4 to the combination of parent reminder-recall letter and provider audit-feedback interventions.
Total
n=9242 Participants
Total of all reporting groups
Age, Customized
11 years old
1984 Participants
n=5 Participants
943 Participants
n=7 Participants
741 Participants
n=5 Participants
1497 Participants
n=4 Participants
5165 Participants
n=21 Participants
Age, Customized
12 years old
1588 Participants
n=5 Participants
727 Participants
n=7 Participants
599 Participants
n=5 Participants
1163 Participants
n=4 Participants
4077 Participants
n=21 Participants
Sex: Female, Male
Female
1667 Participants
n=5 Participants
799 Participants
n=7 Participants
648 Participants
n=5 Participants
1280 Participants
n=4 Participants
4394 Participants
n=21 Participants
Sex: Female, Male
Male
1905 Participants
n=5 Participants
871 Participants
n=7 Participants
692 Participants
n=5 Participants
1380 Participants
n=4 Participants
4848 Participants
n=21 Participants
Race/Ethnicity, Customized
White
2517 Participants
n=5 Participants
1161 Participants
n=7 Participants
1036 Participants
n=5 Participants
1984 Participants
n=4 Participants
6698 Participants
n=21 Participants
Race/Ethnicity, Customized
Black
329 Participants
n=5 Participants
179 Participants
n=7 Participants
92 Participants
n=5 Participants
232 Participants
n=4 Participants
832 Participants
n=21 Participants
Race/Ethnicity, Customized
Asian
197 Participants
n=5 Participants
75 Participants
n=7 Participants
51 Participants
n=5 Participants
107 Participants
n=4 Participants
430 Participants
n=21 Participants
Race/Ethnicity, Customized
Hispanic
71 Participants
n=5 Participants
51 Participants
n=7 Participants
18 Participants
n=5 Participants
75 Participants
n=4 Participants
215 Participants
n=21 Participants
Race/Ethnicity, Customized
Other
458 Participants
n=5 Participants
204 Participants
n=7 Participants
143 Participants
n=5 Participants
262 Participants
n=4 Participants
1067 Participants
n=21 Participants
Region of Enrollment
United States
3572 participants
n=5 Participants
1670 participants
n=7 Participants
1340 participants
n=5 Participants
2660 participants
n=4 Participants
9242 participants
n=21 Participants
Human Papillomavirus (HPV) Vaccine Status
Initiating the HPV vaccine series
2738 Participants
n=5 Participants
1167 Participants
n=7 Participants
946 Participants
n=5 Participants
1705 Participants
n=4 Participants
6556 Participants
n=21 Participants
Human Papillomavirus (HPV) Vaccine Status
Completing the HPV vaccine series
834 Participants
n=5 Participants
503 Participants
n=7 Participants
394 Participants
n=5 Participants
955 Participants
n=4 Participants
2686 Participants
n=21 Participants

PRIMARY outcome

Timeframe: The dose had to have been received during the 12-month-long study step.

Population: The overall number of participants analyzed summed the numbers of the empaneled, HPV-vaccine-eligible males and females in each of the study steps in each of the practices assigned to the intervention (arm/group). For example, we allocated all six practices to Usual Care in Step 1 and two practices to Usual Care in Step 2. The numbers from those eight practices add up to the overall number of participants analyzed for the Usual Care Arm/Group, which is 3572.

The outcome measure was the proportion of empaneled, HPV-vaccine-dose eligible males and females in the study step who received the dose of HPV vaccine dose due by the end of the study step.

Outcome measures

Outcome measures
Measure
Usual Care
n=3572 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of either step 1 or 2 to usual care.
Parent Reminder-Recall Letter
n=1670 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the parent reminder-recall letter intervention.
Provider Audit-Feedback Intervention.
n=1340 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the provider audit-feedback intervention.
Combination of Parent Reminder-Recall Letter and Provider Audit-Feedback Interventions
n=2660 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 3 and 4 to the combination of parent reminder-recall letter and provider audit-feedback interventions.
Human Papillomavirus or HPV-vaccine-dose Receipt
782 Participants
578 Participants
408 Participants
1056 Participants

SECONDARY outcome

Timeframe: The initiating dose had to have been received during the 12-month-long study step.

Population: The overall number of participants analyzed summed the numbers of the empaneled, HPV-vaccine-eligible males and females due for their first doses in each of the study steps in each of the practices assigned to the intervention (arm/group). For example, we allocated all six practices to Usual Care in Step 1 and two practices to Usual Care in Step 2. The numbers from those eight practices add up to the overall number of participants analyzed for the Usual Care Arm/Group, which is 2738.

The outcome measure was the proportion of empaneled, HPV-vaccine-dose eligible males and females due for their first doses of the HPV vaccine series in the study step who received the first dose of HPV vaccine dose due by the end of the study step, thus initiating the HPV vaccine series.

Outcome measures

Outcome measures
Measure
Usual Care
n=2738 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of either step 1 or 2 to usual care.
Parent Reminder-Recall Letter
n=1167 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the parent reminder-recall letter intervention.
Provider Audit-Feedback Intervention.
n=946 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the provider audit-feedback intervention.
Combination of Parent Reminder-Recall Letter and Provider Audit-Feedback Interventions
n=1705 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 3 and 4 to the combination of parent reminder-recall letter and provider audit-feedback interventions.
Initiation
482 Participants
329 Participants
251 Participants
490 Participants

SECONDARY outcome

Timeframe: The final dose had to have been received during the 12-month-long study step.

Population: The overall number of participants analyzed summed the numbers of the empaneled, HPV-vaccine-eligible males and females due for their final doses in each of the study steps in each of the practices assigned to the intervention (arm/group). For example, we allocated all six practices to Usual Care in Step 1 and two practices to Usual Care in Step 2. The numbers from those eight practices add up to the overall number of participants analyzed for the Usual Care Arm/Group, which is 834.

The outcome measure was the proportion of empaneled, HPV-vaccine-dose eligible males and females due for their final doses of the HPV vaccine series in the study step who received the final dose of HPV vaccine dose due by the end of the study step, thus completing the HPV vaccine series.

Outcome measures

Outcome measures
Measure
Usual Care
n=834 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of either step 1 or 2 to usual care.
Parent Reminder-Recall Letter
n=503 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the parent reminder-recall letter intervention.
Provider Audit-Feedback Intervention.
n=394 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the provider audit-feedback intervention.
Combination of Parent Reminder-Recall Letter and Provider Audit-Feedback Interventions
n=955 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 3 and 4 to the combination of parent reminder-recall letter and provider audit-feedback interventions.
Completion
300 Participants
249 Participants
157 Participants
566 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: The dose had to have been received during the 12-month-long study step.

Population: The overall number of participants analyzed summed the numbers of the empaneled, HPV-vaccine-eligible females in each of the study steps in each of the practices assigned to the intervention (arm/group). For example, we allocated all six practices to Usual Care in Step 1 and two practices to Usual Care in Step 2. The numbers from those eight practices add up to the overall number of female participants analyzed for the Usual Care Arm/Group, which is 1667.

The outcome measure was the proportion of empaneled, HPV-vaccine-dose eligible females in the study step who received the dose of HPV vaccine dose due by the end of the study step.

Outcome measures

Outcome measures
Measure
Usual Care
n=1667 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of either step 1 or 2 to usual care.
Parent Reminder-Recall Letter
n=799 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the parent reminder-recall letter intervention.
Provider Audit-Feedback Intervention.
n=648 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the provider audit-feedback intervention.
Combination of Parent Reminder-Recall Letter and Provider Audit-Feedback Interventions
n=1280 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 3 and 4 to the combination of parent reminder-recall letter and provider audit-feedback interventions.
HPV-vaccine-dose Receipt in Females
385 Participants
296 Participants
188 Participants
517 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: The dose had to have been received during the 12-month-long study step.

Population: The overall number of participants analyzed summed the numbers of the empaneled, HPV-vaccine-eligible males in each of the study steps in each of the practices assigned to the intervention (arm/group). For example, we allocated all six practices to Usual Care in Step 1 and two practices to Usual Care in Step 2. The numbers from those eight practices add up to the overall number of male participants analyzed for the Usual Care Arm/Group, which is 1905.

The outcome measure was the proportion of empaneled, HPV-vaccine-dose eligible males in the study step who received the dose of HPV vaccine dose due by the end of the study step.

Outcome measures

Outcome measures
Measure
Usual Care
n=1905 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of either step 1 or 2 to usual care.
Parent Reminder-Recall Letter
n=871 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the parent reminder-recall letter intervention.
Provider Audit-Feedback Intervention.
n=692 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 2 or 3 to the provider audit-feedback intervention.
Combination of Parent Reminder-Recall Letter and Provider Audit-Feedback Interventions
n=1380 Participants
Adolescents who turned 11 or 12 years of age, due for a dose of the human papillomavirus vaccine, empaneled in one of the six participating practices that were allocated for the duration of steps 3 and 4 to the combination of parent reminder-recall letter and provider audit-feedback interventions.
HPV-vaccine-dose Receipt in Males
397 Participants
282 Participants
220 Participants
539 Participants

Adverse Events

Usual Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Provider Audit-Feedback Intervention.

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Parent Reminder-Recall Letter

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Combination of Parent Reminder-Recall Letter and Provider Audit-Feedback Interventions

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Robert M Jacobson, MD

Mayo Clinic

Phone: 507-250-4576

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place