IMPACT Project 4 – Budget impact, cost-effectiveness, and population outcomes of interventions to improve HPV vaccine communication and uptake in rural and nonrural communities

ABSTRACT ? Project 4 Human papillomavirus (HPV) cancers are preventable through vaccination.

Yet HPV vaccine coverage is well below the national goal of 80%, especially in rural areas where HPV cancers are more common. HPV vaccine communication interventions are a promising approach to address low uptake. As part of the P01 Program Project, ?Improving Provider Announcement Communication Training (IMPACT),?

Projects 1-3 will test novel enhancements of the Announcement Approach Training (AAT) intervention in healthcare systems to improve primary care team members' HPV vaccine communication.

The overall objective of Project 4 is to facilitate decision makers' selection and adoption of AAT and other effective HPV vaccination interventions, by quantifying tradeoffs in their comparative cost and health impact in rural and nonrural areas.

Aim 1 is to identify differences in contextual factors in rural and nonrural clinical settings that may influence the implementation and effectiveness of enhanced AAT interventions.

Using a mixed-methods approach, we will conduct semi-structured interviews in rural (n=20) and nonrural areas (n=20) among primary care team members, quality improvement decision makers, and health administrators, as well as survey a national sample of primary care team members (n=2,500) to examine contextual differences across rural and nonrural clinical settings.

Aim 2 is to evaluate the budget impact, cost-effectiveness, and population outcomes of HPV vaccine communication and other evidence-based interventions in rural and nonrural clinical settings, including the enhanced AAT interventions studied in Projects 1-3, to facilitate comparisons for decision making.

We will develop a national county-specific HPV microsimulation model that overlays interventions onto populations reflecting patterns of baseline HPV vaccination, HPV transmission, and progression to HPV cancers to project the anticipated budget impact, cost-effectiveness, and population outcomes of HPV vaccine interventions in rural and nonrural clinical settings.

Aim 3 is to aid stakeholder implementation planning by developing a web-based interactive decision support tool illustrating the value and implementation outcomes of HPV vaccine interventions in rural and nonrural clinical settings.

We will engage stakeholders to evaluate the usability of the decision support tool for decision making and add to the AAT Intervention Package.

Project 4 addresses the IMPACT Program Project theme of amplifying HPV vaccine communication interventions' impact in healthcare systems.

Our project findings will translate the health impact and cost of interventions tested in Projects 1-3 in rural and nonrural areas into a dissemination format well-suited to the needs of decision makers in healthcare systems to accelerate the adoption of promising HPV vaccine communication interventions to prevent cancer in diverse geographic contexts.