Please select the eligibility criteria that correspond to the clinical trial below.
Title: Making Effective HPV Vaccine Recommendations
Brief Summary: Coverage of HPV vaccination among US teens is low, far below Healthy People 2020 goals. A central reason for low coverage is infrequent and inadequate healthcare provider recommendation of HPV vaccine. The proposed intervention aims to train clinicians to provide effective recommendations for the vaccine using participatory or efficient communication strategies.

This study will evaluate the effectiveness of two communication trainings to increase HPV vaccination coverage among adolescent patients. We will compare HPV vaccination for pediatric and family medicine clinics receiving a participatory communication training, efficient communication training, or no training. Ten clinics will be randomly assigned to each study arm for a total of 30 clinics. The primary outcome of this study is to compare the change in clinics' levels of HPV vaccination initiation coverage among 11-12 year old adolescent patients from baseline to 6 month follow-up. Secondarily, we will compare the change in HPV vaccination initiation coverage in 13-17 year old adolescents.


Options:
A: Study population:

* Eligible pediatric and family medicine practices in three counties in Washington State; King, Pierce and Snohomish Counties.
* Mothers whose infants will receive care in participating clinics.

Inclusion Clinics:

* Located in King, Snohomish, Pierce Counties, WA;
* Family practice clinics;
* Pediatric practice clinics;
* Order \> 1000 doses of vaccine in 2009 from State of Washington Department of Health.

Exclusion Clinics: Not willing to be randomized.

Inclusion Mothers:

* Babies born at participating hospitals;
* Mother can be recruited before discharged post-birth;
* Mothers declare pediatric care at one of participating clinics;
* Singleton or twin pregnancies.

Exclusion Mothers:

* Babies born \< 36 weeks gestational age;
* Known medical vaccine contraindications;
* Parental age \< 18;
* NICU;
* Triplet or more;
* Maternal complications.
B: Inclusion criteria:

For children: attendance at the selected health care center within the last year and age \>/=6 months thru 18 years.

Exclusion Criteria:

For children: Severe egg allergy or allergy to influenza vaccine
C: Inclusion Criteria:

* Eligible clinics are pediatric and family medicine practice clinics located within a 2-hour driving distance of Chapel Hill, NC, and have 100 or more 11-12 year old patients with active records in the NCIR. Clinics must have at least one pediatric or family medicine physician who provides HPV vaccine to adolescents ages 11-12.

Exclusion Criteria:

* Ineligible clinics include those that have participated in a quality improvement study to increase HPV vaccination rates in the last 6 months or plan to participate in such a study in the next 6 months.
D: Inclusion Criteria:

* The patient family must include an infant, or infants for families with multiples, born 10 weeks or less prior to recruitment.
* The newborn(s) must be healthy, having been born without known defects or complications that would require early hospitalization.
* The infant must have been discharged from hospital within one week.
* At the time of recruitment, the parent/guardian will have communicated their intent to obtain their newborn infant's primary pediatric care through Boston Medical Center's (BMC's) Primary Pediatric Care Clinic (PPCC).
* The child's parent/guardian must be able to engage in an informed consent process conducted in English or Spanish.
* The child's parent/guardian must be able to complete a questionnaire and/or interview (with or without assistance) in English or Spanish.

Exclusion Criteria:

* The participating parent/guardian is under 18 years of age. As SOC at BMC, mothers under the age of 18 are seen in the The Teen and Tot Program (TTP), a specialized program located within BMC's Adolescent Center.
* The parent/guardian is unable to participate in required data collection activities in the study languages, even with assistance.
* The child/family's physician believes that participation in the evaluation would adversely affect the child/family's health or well being or the ongoing delivery of health care services. Decision will be made based on the physician's clinical judgment. All physicians have the opportunity to opt their patients out.
* The family is already receiving services from another family partner program such as Project RISE, Healthy Steps, etc. through the BMC primary care center.

Answer: C