Communication Strategy to PROMOTE HPV Vaccination in Pharmacies: PROMOTE Study

Study Overview
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Brief Summary
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This trial investigates how a communication strategy works in increasing human papillomavirus (HPV) vaccines in community pharmacies among adolescents. Although pharmacies are vaccine providers, low vaccination rates are persistent as a result of low awareness of pharmacy services and poor engagement by pharmacy staff with adolescents about vaccines. The purpose of this study is to test a communication strategy that identifies vaccine-eligible children and teaches pharmacy staff how to effectively communicate with them about HPV vaccination in order to increase HPV vaccination rates.

Detailed Description
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OUTLINE: AIM 1: Participants participate in a semi-structured interview in-person or via phone over 90 minutes about barriers/facilitators of HPV vaccination in pharmacies. AIM 2: Participants provide feedback on survey questions via cognitive testing. Pharmacy staff complete an online survey over 10-15 minutes to assess the acceptability, appropriateness, and feasibility of providing HPV vaccination to children aged 9-17 in their pharmacies. Pharmacy staff then attend two, 60-minute vaccine communication training sessions, consisting of identifying vaccine-eligible children and recommending HPV and other vaccines. Pharmacy staff employ the new communication strategy in their pharmacy up to 6 months, and then complete an online survey over 10-15 minutes. Pharmacies of which the pharmacy staff participants work undergo an environmental scan to characterize the pharmacy's environment, vaccination workflow, and team dynamics. Additionally, pharmacy audits will be conducted from the pharmacy electronic records to assess adoption of HPV vaccination, and the impact of the communication strategy on adoption of other adolescent vaccines (e.g., tetanus, diphtheria, acellular pertussis; meningococcal conjugate; influenza).

Official Title
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PROMOTE Pilot Study: Pharmacy Multimodal Communication Strategy to Promote HPV Vaccination

Conditions
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Human Papillomavirus Infection

Intervention / Treatment
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* Other: Communication Intervention
* Other: Communication Skills Training
* Behavioral: Healthcare Activity
* Behavioral: Healthcare Activity
* Other: Survey Administration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: AIM 1 (PARENTS/GUARDIANS): Individuals with children between the ages of 9-17 in their care who are English speakers, live in Washington state, and have access to a telephone or computer with internet access (up to 12 parents) AIM 1 (PHARMACY STAFF): Employed at a Western Washington Bartell Drugs pharmacy sites and have access to a telephone or computer with internet access AIM 2: Pharmacy staff employed at up to four independent pharmacies in western Washington state who speak English and have access to a computer with internet access Exclusion Criteria: AIM 1 (PARENTS/GUARDIANS): Those who object to having their interview audio recorded AIM 1 and AIM 2 (PHARMACY STAFF): Floaters/per diem. Those who object to having their interview audio recorded

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Aim I (interview)<br>Participants participate in a semi-structured interview in-person or via phone over 90 minutes about barriers/facilitators of HPV vaccination in pharmacies. | Behavioral: Healthcare Activity<br>* Participate in interview<br>* Other names: Healthcare;|
| Experimental: Aim 2 (survey, training, communication intervention, and environmental scan)<br>Participants provide feedback on survey questions via cognitive testing. Pharmacy staff complete an online survey over 10-15 minutes to assess the acceptability, appropriateness, and feasibility of providing HPV vaccination to children aged 9-17 in their pharmacies. Pharmacy staff then attend two, 60- minute vaccine communication training sessions, consisting of identifying vaccine-eligible children and recommending HPV and other vaccines. Pharmacy staff employ the new communication strategy in their pharmacy up to 6 months, and then complete an online survey over 10-15 minutes. Pharmacies of which the pharmacy staff participants work undergo an environmental scan to characterize the pharmacy's environment, vaccination workflow, and team dynamics. | Other: Communication Intervention<br>* Undergo communication strategy intervention<br>Other: Communication Skills Training<br>* Undergo communication training sessions<br>Behavioral: Healthcare Activity<br>* Undergo environmental scan<br>* Other names: Healthcare;Other: Survey Administration<br>* Complete survey<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Behavioral barriers to human papillomavirus (HPV) vaccination in pharmacies | Assess experiences and perceptions among parents and pharmacy staff on the challenges of obtaining/delivering HPV vaccination in pharmacies. Assessments will be done through semi-structured interviews informed by the Theoretical Domains Framework. Qualitative data will be analyzed using framework-guided rapid analyses | Up to 2 months after consent | 
| Behavioral facilitators to human papillomavirus (HPV) vaccination in pharmacies | Assess experiences and perceptions among parents and pharmacy staff on how pharmacies support, promote, and increase access and opportunities for HPV vaccination for children. Assessments will be done through semi-structured interviews informed by the Theoretical Domains Framework. Qualitative data will be analyzed using framework-guided rapid analyses | Up to 2 months after consent | 
| Behavioral barriers to human papillomavirus (HPV) vaccination in pharmacies: Pharmacy staff | Obtain feedback from pharmacy staff on how the communication strategy being tested addresses barriers to obtaining/delivering HPV vaccination in pharmacies. Assessments will be done through pre and post intervention surveys. | Up to 6 months after baseline survey and communication training | 
| Behavioral facilitators to human papillomavirus (HPV) vaccination in pharmacies: Pharmacy staff | Obtain feedback from pharmacy staff on how the communication strategy being tested can help improve obtaining/delivering HPV vaccination in pharmacies. Assessments will be done through pre and post intervention surveys. | Up to 6 months after baseline survey and communication training | 
| Acceptability of providing HPV vaccination to children and of the proposed communication strategy to support HPV vaccination | Will use adapted, validated, four-item pre/post survey measure to assess pharmacy staff's report of the acceptability of providing HPV vaccination to children and of the communication strategy to support HPV vaccination. | Up to 6 months after baseline survey and communication training | 
| Appropriateness of providing HPV vaccination to children and of the proposed communication strategy to support HPV vaccination | Will use adapted, validated, four-item pre/post survey measure to assess pharmacy staff's report of the appropriateness of providing HPV vaccination to children and of the communication strategy to support HPV vaccination. | Up to 6 months after baseline survey and communication training | 
| Feasibility of providing HPV vaccination to children and of the proposed communication strategy to support HPV vaccination | Will use adapted, validated, four-item pre/post survey measure to assess pharmacy staff's report of the feasibility of providing HPV vaccination to children and of the communication strategy to support HPV vaccination. | Up to 6 months after baseline survey and communication training | 
| Self-efficacy of providing HPV vaccination | Will use adapted, validated pre/post survey measures to assess pharmacy staff's report of the self-efficacy (i.e., confidence in their ability) to provide HPV vaccination. | Up to 6 months after baseline survey and communication training | 
| Adoption of HPV vaccination | Will conduct audits of the pharmacy electronic records to assess adoption of HPV vaccination, measured as the average HPV vaccination rate per pharmacist at each pharmacy. | Up to 6 months after baseline survey and communication training | 
| Adoption of other adolescent vaccines | Will assess the impact of the communication strategy on adoption of other adolescent vaccines using pre-post data analysis methods like Wilcoxon signed-rank test or other nonparametric tests appropriate for small sample statistics. | Up to 6 months after baseline survey and communication training |