In the Journals

In-office video intervention improves HPV vaccine uptake

Photo of Brian Dixon
Brian E. Dixon

Showing an informational video on a digital tablet to parents of teenagers who were unvaccinated against HPV resulted in a threefold increase in their child’s likelihood of vaccination within 2 weeks, according to research published in Pediatrics.

Brian E. Dixon, MPA, PhD, associate professor in the departments of epidemiology and biostatistics at Richard M. Fairbanks School of Public Health, Indiana University, a research scientist at the Regenstrief Institute, Inc., told Infectious Diseases in Children that one way in which this intervention was different than others was that it was targeted toward parents rather than health care providers.

“Our intervention was designed for the video to be watched in the exam room [by the parent of a young adolescent] after the nurse leaves but before the provider comes in,” he said. “Prior studies have used educational videos for college students and young adults. While these studies are important, they did not provide any evidence on whether videos would work for younger populations.”

Dixon added that during the study, it was discovered that other institutions, such as the Children’s Hospital of Philadelphia, have also been experimenting with videos related to HPV vaccination. He said that many clinics also use brochures, exam room signs and videos that play on waiting room monitors to encourage HPV vaccination.

Dixon and colleagues conducted a 7-month-long cluster randomized trial of an intervention to promote HPV vaccine uptake among adolescent patients presenting to pediatric clinics in an urban health system. The intervention included a video for parents of teens aged 11 to 17 years who were eligible for the vaccine. This video was viewed within the exam room on a digital tablet and included information on the risks and benefits of the vaccine.

The researchers then examined their child’s vaccine status 2 weeks after their visit.

Of the 1,596 teenagers eligible for an HPV vaccine dose, one-third were seen at an intervention clinic. These adolescents were more likely to be younger than those who were seen at a control clinic (11-12 years; 72.4% vs. 49.8%).

Nearly 65% of teens who were seen an intervention clinic had a change in vaccine status 2 weeks after their visit. Only 50% of teens seen at a control clinic had a reported change in vaccine status (OR = 1.82). According to the researchers, teenagers were three times more likely to receive the HPV vaccine when they attended an intervention clinic (78%; OR = 3.07; 95% CI, 1.47-6.42).

Dixon, who is also an affiliate scientist at the Veterans’ Affairs Health Services Research and Development Center for Health Information and Communication, and colleagues speculate that viewing the videos convinced parents to either request that their child should be vaccinated or that the vaccine should be discussed with their child’s provider during the visit.

“While these technologies are promising, we likely have more work to do to get them better integrated into routine practice,” Dixon said. “For example, our video targets HPV vaccination, but a pediatrician would be best served by a product that could show videos on HPV, influenza and other vaccines depending on the patient’s immunization history.”

He said that some clinics have already incorporated the use of tablets into their practices to gather information on health history from families. He suggested that one cost-effective and beneficial use of such an intervention would be to integrate videos into those devices so that the most appropriate video plays after patient history has been collected. – by Katherine Bortz

Disclosures: Dixon reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

Photo of Brian Dixon
Brian E. Dixon

Showing an informational video on a digital tablet to parents of teenagers who were unvaccinated against HPV resulted in a threefold increase in their child’s likelihood of vaccination within 2 weeks, according to research published in Pediatrics.

Brian E. Dixon, MPA, PhD, associate professor in the departments of epidemiology and biostatistics at Richard M. Fairbanks School of Public Health, Indiana University, a research scientist at the Regenstrief Institute, Inc., told Infectious Diseases in Children that one way in which this intervention was different than others was that it was targeted toward parents rather than health care providers.

“Our intervention was designed for the video to be watched in the exam room [by the parent of a young adolescent] after the nurse leaves but before the provider comes in,” he said. “Prior studies have used educational videos for college students and young adults. While these studies are important, they did not provide any evidence on whether videos would work for younger populations.”

Dixon added that during the study, it was discovered that other institutions, such as the Children’s Hospital of Philadelphia, have also been experimenting with videos related to HPV vaccination. He said that many clinics also use brochures, exam room signs and videos that play on waiting room monitors to encourage HPV vaccination.

Dixon and colleagues conducted a 7-month-long cluster randomized trial of an intervention to promote HPV vaccine uptake among adolescent patients presenting to pediatric clinics in an urban health system. The intervention included a video for parents of teens aged 11 to 17 years who were eligible for the vaccine. This video was viewed within the exam room on a digital tablet and included information on the risks and benefits of the vaccine.

The researchers then examined their child’s vaccine status 2 weeks after their visit.

Of the 1,596 teenagers eligible for an HPV vaccine dose, one-third were seen at an intervention clinic. These adolescents were more likely to be younger than those who were seen at a control clinic (11-12 years; 72.4% vs. 49.8%).

Nearly 65% of teens who were seen an intervention clinic had a change in vaccine status 2 weeks after their visit. Only 50% of teens seen at a control clinic had a reported change in vaccine status (OR = 1.82). According to the researchers, teenagers were three times more likely to receive the HPV vaccine when they attended an intervention clinic (78%; OR = 3.07; 95% CI, 1.47-6.42).

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Dixon, who is also an affiliate scientist at the Veterans’ Affairs Health Services Research and Development Center for Health Information and Communication, and colleagues speculate that viewing the videos convinced parents to either request that their child should be vaccinated or that the vaccine should be discussed with their child’s provider during the visit.

“While these technologies are promising, we likely have more work to do to get them better integrated into routine practice,” Dixon said. “For example, our video targets HPV vaccination, but a pediatrician would be best served by a product that could show videos on HPV, influenza and other vaccines depending on the patient’s immunization history.”

He said that some clinics have already incorporated the use of tablets into their practices to gather information on health history from families. He suggested that one cost-effective and beneficial use of such an intervention would be to integrate videos into those devices so that the most appropriate video plays after patient history has been collected. – by Katherine Bortz

Disclosures: Dixon reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.