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

> **NIH NIH P01** · OHIO STATE UNIVERSITY · 2022 · $243,289

## Abstract

PROJECT SUMMARY – PROJECT 2 
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:** 10381631
- **Project number:** 5P01CA229143-04
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** ELECTRA D. PASKETT
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $243,289
- **Award type:** 5
- **Project period:** 2019-04-11 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10381631

## Citation

> US National Institutes of Health, RePORTER application 10381631, Project 2: Testing Multi-Level Interventions to Improve HPV Vaccination (5P01CA229143-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10381631. Licensed CC0.

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