Improving HPV Vaccination Communication: Webinar Delivery of Announcement Approach Training
Creators: name: Todd, Karen
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2019

description: Background/Objectives:Since HPV (human papillomavirus) vaccination was introduced in the U.S. in 2006, adolescent immunization against HPV cancers has lagged expected rates. Educating physicians and other primary care providers to make a strong recommendation for HPV vaccine at every opportunity can lead to increased HPV vaccine uptake. However, it is a challenge to engage providers in continuing medical education (CME) to learn HPV vaccine recommendation techniques. Barriers to providers accessing CME include lack of provider time, lack of interest in subject matter, beliefs that providers are already utilizing this approach, cost, and access. This paper will examine a webinar CME program that teaches HPV vaccination communication strategies, delivered by physicians to physicians and their staff in 3 states, with an evaluation of opportunities and challenges of webinar delivery and the reach of the CME program.Methods:In 2018, our research team recruited and trained five board certified and licensed pediatricians as physician educators to deliver a live webinar continuing medical education (CME) course to clinics in Arizona, New York and Wisconsin. We recruited primary care clinics with the help of the physician educators to participate in a one-hour CME course, Making Effective HPV Vaccine Recommendations using the Announcement Approach. This CME course was presented by the physician educators via live, interactive webinar format during a 21-week period. At the completion of the study period, a co-investigator trained in qualitative methods used phone interviews with the physician educators and research associates to evaluate their experiences. Analysis of clinic participation data were undertaken to determine the reach of this CME training.2Results:The interviewees felt underprepared to recruit clinics to the study, and they agreed that initial contact with clinics would have been enhanced if a contact person had been identified ahead of their first call. Interviewees agreed that summer recruitment was challenging because recruited clinics stated scheduling issues due to provider vacations. The use of influential affiliations, such as the CDC, NCI, or the AAP, was perceived to be valuable in attracting clinics to the CME offering. Physician educators enjoyed using the live webinar software platform (Zoom) for distance education, citing ease of use and no travel as reasons for its appeal; however, technical glitches such as participants lacking webcams or the presentation lacking sound made for frustrations for both the CME presenters and the clinics receiving the instruction.Of the initial pool of 233 clinics in AZ, NY, and WI identified as possible participants in this intervention, 200 clinics were successfully contacted, and 32 of them (16%) participated in the CME webinar. We had an average of 3.3 prescribers per clinic participate in the webinar CME, for the 3 states included in this study. With 16% of clinics successfully completing the webinar, the reach of our program was considered lower than expected.Conclusions:Announcement training about HPV vaccination, using a physician-to-physician live webinar, is a convenient method to deliver training to healthcare providers that can result in improved HPV vaccine coverage for adolescents. Physicians and public health professionals have an important influence over the recommendation of HPV vaccination, and with stronger communication skills, HPV vaccination uptake for adolescents can improve. However, our interventionists experienced challenges in recruiting physicians and their staff to participate in this free CME effort, and our reach was limited to only 16% of clinics contacted.Further implementation research is needed to discern how best to engage the provider and support staff in interventions that will result in strong recommendations.