# Project 2: Testing Multi-Level Interventions to Improve HPV Vaccination

> **NIH NIH P01** · OHIO STATE UNIVERSITY · 2021 · $330,265

## Abstract

Prior research has demonstrated that health care provider recommendation is the most influential factor affecting
HPV vaccine uptake and completion among adolescents and young adults. However, many providers are not
recommending the vaccine at opportunistic times such as the targeted ages of 11-12 when most children receive
Tdap and meningococcal vaccines. To improve the uptake of the HPV vaccine among 11-12 year olds – the age
group of focus for the Centers for Disease Control and Prevention (CDC) – a multi-disciplinary research team
across four Appalachian states will test the effectiveness of a health system-based intervention, as part of an
integrated clinic-based cervical cancer prevention program (with Projects 1 and 3), that is directed to three levels
of influence – clinic, provider, and patient. Using a delayed intervention design in a group randomized
implementation trial, we will examine outcomes of effectiveness, acceptability, and sustainability along the
Implementation Science Framework. We will also test in a secondary aim whether interventions targeted to the
13-26 year olds increases catch-up vaccination. This study is part of the Program Project, “Improving Uptake of
Cervical Cancer Prevention Services in Appalachia,” and as such, is intricately integrated with the Cores of the
Program. The interventions to be tested have been developed in conjunction with community partners, address
multi-level factors within the Social Determinants of Health that impact disparities in HPV-related disease, and
have been piloted in Appalachian populations. Specific aims are to: 1) Primary Outcome: Test the effectiveness
of a multi-level intervention directed at clinics, providers, and patients (parents of children aged 11-12) to improve
HPV vaccine initiation and completion in health systems in four Appalachian states (KY, OH, WV, and VA) among
children aged 11-12, and assess the effectiveness of the intervention program among subgroups, e.g., females
vs males; 2) Secondary Outcomes: Assess: a) sustainability of the intervention; b) cost impacts of the
intervention; c) changes in clinic practices that occur as a result of the intervention in terms of staff responsibilities
for the vaccination process and reducing missed opportunities for vaccination; and d) whether interventions
directed to 13-26 year olds increases catch-up vaccination; and 3) Secondary Outcomes: Examine: a) changes
in knowledge and attitudes of providers via educational session pre-post surveys and b) satisfaction with the
intervention at the multiple levels. If effective, this multi-level intervention will be disseminated to our clinical and
community partners as well as other partners throughout Appalachia to facilitate the uptake of effective
interventions throughout health systems and clinics in Appalachia to help reduce the burden of HPV-preventable
diseases.

## Key facts

- **NIH application ID:** 10268465
- **Project number:** 5P01CA229143-03
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** ELECTRA D. PASKETT
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $330,265
- **Award type:** 5
- **Project period:** 2019-04-11 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10268465

## Citation

> US National Institutes of Health, RePORTER application 10268465, Project 2: Testing Multi-Level Interventions to Improve HPV Vaccination (5P01CA229143-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10268465. Licensed CC0.

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