Virtual HPV Vaccination Quality Improvement Program

Online registration is closed. This 2023 program was free to the first 15 practice teams to register. If you have questions, please contact Kaitlin McGuffie.

Team Resources & Materials

The selected Ohio Academy of Family Physicians members and their practice teams have the unique opportunity to take part in a virtual quality improvement (QI) project to improve Human Papilloma Virus (HPV) vaccination rates in adolescents – improving patient care and meeting ongoing board certification requirements.

Selected teams have access to recorded presentations delivered by expert speakers in HPV-related cancer care, with topics ranging from the clinical background of HPV-related cancers, up-to-date guidelines, the importance of QI in patient care and population health as a whole, and best practices for team-based intervention implementation in everyday practice. Additional content will be available including data collection tools, website links to evidence-based resources, and more.

Selected teams will join a kick-off meeting in mid-January 2023 to gain further insight into the program, review practice expectations, and have a chance to meet other team participants. Following the kick-off, teams will engage in a three-month intervention period (February – April 2023) to improve vaccination rates. After three months of change, teams will measure outcomes against their baseline rates and determine an action plan for continued improvement.

After participating in the three-month program, participants will be able to:
  • Understand the necessity of implementing interventions to improve HPV vaccination rates in adolescents.
  • Describe best practices for team-based approaches to care.
  • Perform an assessment in the practice to identify opportunities for improvement HPV vaccination rates.
  • Select and implement a quality improvement plan (QIP) based on identified opportunities for improvement in HPV vaccination rates.
  • Perform a post-assessment to measure improvement produced by implementation of a QIP for improving HPV vaccination rates.
  • Streamline office protocols, build stronger team comradery, and better understand the importance that patient engagement has on individual and community health.
Selected Practices Must
  • Participate in a welcome kick-off Zoom call to review the outline of the program, clinical background, and expectations. This call will be held in mid-January 2023. As many team members as possible are encouraged to attend, but at least one team member must join.
  • Review four pre-recorded educational webinars at a time most convenient for them (access will be provided to registered teams on a password protected portion of the OAFP site).
  • Submit baseline and outcomes data for the following measures:
    • Percentage of patients age 11 – 26 with at least 1 HPV vaccine.
    • Percentage of patients age 11 – 26 with completed HPV vaccine series.
    • Percentage of patients with completed HPV vaccination series by age 13 (NQF 1407, MIPS #394, HEDIS measure), if possible.
    • Baseline data will be due in early February and outcomes data will be due in early May.
  • Require at least one team member to participate in a check-in Zoom call in March.
  • Complete a post-program evaluation.
  • Complete a physician attestation form for American Academy of Family Physicians (AAFP) and American Board of Family Medicine (ABFM) credit. Note: each physician team member requesting credit will need to submit this form but can use the same data for baseline and outcomes.
Participating Practices Will Receive
  • ABFM Family Medicine Certification (FMC) Performance Improvement (PI) Activity points, fulfilling an ABFM PI requirement and earning 20 ABFM points.
  • AAFP Performance Improvement Continuing Medical Education (PICME) credits.
  • Continuing medical education (CME) credits for watching the recorded educational webinars.
  • A $500 stipend (provided to practice once outcomes data, program evaluation, and physician attestation form(s) are submitted).

At the conclusion of the three-month program, the OAFP will launch an EasyPI HPV Vaccination track. Watch for details this summer!

CME and Family Medicine Certification

This program has been submitted to the AAFP for PI CME credit and ABFM FMC points. Determination of credit is pending. It is anticipated that participants in the program will earn up to 20 PI Prescribed credits through the AAFP and up to 20 PI points in the ABFM FMC program. Plus additional CME credit for watching the recorded webinars.

Non-physician members of the care team can also claim CME credit for completion of this program, as all credits are transferable to most national organizations. 

Questions

If you have questions regarding this QI program, please contact Deputy Executive Vice President Kaitlin McGuffie or call 800.742.7327. 

There are over 35,000 cancers caused by HPV in the United States each year.  These cancers include cervical cancer, oropharyngeal cancer, anal cancer, vulvar and vaginal cancer, and penile cancer.  More than 90% of these cancers can be prevented by vaccination for HPV.1

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) guidelines on HPV vaccination state:

HPV vaccination is routinely recommended at age 11 or 12 years; vaccination can be given starting at age 9 years. Catch-up HPV vaccination is recommended for all persons through age 26 years who are not adequately vaccinated.2

Even though the guidelines for HPV vaccination are clear, the rates of HPV vaccination in the United States remain much lower than that of most other vaccines. In 2018, only 39.9% of adults age 18-26 had received one or more doses for HPV vaccination while 21.5% received the complete series. Vaccination rates are even lower for individuals who are Black (36.7%) and Hispanic (36.7%).  Males are vaccinated at about half the rate of women.3 In 2019, 71.5% of adolescents 13-17 received at least 1 dose of HPV vaccine, while 54.2% had the complete series. This compares to 88.9% of adolescents who received vaccination for meningitis and 90.2% vaccinated for tetanus/diphtheria/pertussis. More than 90% of adolescents have vaccination for measles/mumps/rubella vaccine, hepatitis B vaccine, and varicella.4

An average of 479 new cases of cervical cancer were diagnosed each year in Ohio in 2014-18. Cervical cancer incidence rates were highest for white women (8%), followed by Black (7.8%), Hispanic (6.6%), and Asian/Pacific Islander (3.2%) women. An average of 157 women died from cervical cancer each year in Ohio in 2014-18. Cervical cancer death rates in Ohio were stable from 2010-19. Cervical cancer death rates were 36% higher and five-year relative survival was 5% lower for Black women than for white women.5

HPV vaccination among 13- to 17-year-olds in Ohio in 2020 was:
  • 7% of girls had been vaccinated compared with 61.4% in the United States
  • 5% of boys have been vaccinated, compared with 56% in the United States.5
Finally, the Ohio Partners for Cancer Control published the Ohio Comprehensive Cancer Control Plan 2021-20306 with specific goals related to vaccines for cancer prevention/HPV-associated cancers that this project will help address.
  • Objective 20: Increase the percentage of adolescents 13 to 17 years of age who are up-to-date with HPV vaccine, especially among groups experiencing disproportionate effects residing in non-metropolitan (rural) areas of the state, from 58.2% to 70% in 2025 and 80% in 2030 (baseline: 2018 National Immunization Survey – Teen Survey).
  • Objective 21: Increase the percentage of young adults 18 to 26 years of age who are up-to-date with HPV vaccine from 25.1% to 50% in 2025 and 80% in 2030 (baseline: 2018 National Center for Health Statistics).
  • Objective 22: By 2030, decrease the HPV-associated cancer incidence rate in Appalachian Ohio (14.3 per 100,000) to the rate in non-Appalachian Ohio (12.4 per 100,000) to eliminate the disparity between Appalachian and non-Appalachian Ohio (baseline: 2017 OCISS).

This quality improvement project will assist practices and physicians to improve HPV immunization rates in adolescents while meeting ongoing board certification requirements. 

References
  1. HPV | HPV Cancers are Preventable | CDC.  Accessed November 6, 2020.
  2. Meites E, Szilagyi PG, Chesson HW, Unger ER, Romero JR, Markowitz LE. Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68(32):698-702. doi:10.15585/mmwr.mm6832a3
  3. Boersma P, Black LI. Human Papillomavirus Vaccination Among Adults Aged 18−26, 2013−2018 Key Findings Data from the National Health Interview Survey.; 2013. Accessed November 6, 2020.
  4. Elam-Evans LD, Yankey D, Singleton JA, et al. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2019. MMWR Morb Mortal Wkly Rep. 2020;69(33):1109-1116. doi:10.15585/mmwr.mm6933a1
  5. Ohio Cancer Incidence Surveillance System, Bureau of Vital Statistics, Ohio Behavioral Risk Factor Surveillance System, Ohio Department of Health, 2021; TeenVaxView (2020).
  6. Ohio Partners for Cancer Control, The Ohio Comprehensive Cancer Control Plan 2021-2030.

This QI initiative is supported by a grant provided by the Ohio Department of Health (ODH) Bureau of Health Improvement & Wellness, Breast and Cervical Cancer Project (BCCP) through financial support from the Centers for Disease Control and Prevention (CDC) under Cooperative Agreement NU58DP007097.