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The 2017 HPV Vaccine
Is Cancer Prevention Champion Award winners have been selected! This
award program is a joint initiative between the Centers for Disease Control and
Prevention, Association of American Cancer Institutes, and the American Cancer
Society that recognizes clinicians, clinics, practices, groups, and health
systems effectively working to protect their adolescent patients against HPV
cancers by achieving high HPV vaccination rates.
This year, the award
program honored one Champion from each of the 10 U.S. Department of Health and
Human Services (HHS) regions. Read all about our 2017 Champions below:
 Region
1
Maine Medical Partners
Scarborough, Maine
Maine Medical Partners (MMP) provides care for more than
15,000 children in the most economically and culturally diverse community in
its state. Recognizing the importance of vaccinating against a cancer-causing
virus, MMP implements evidence-based strategies to improve HPV vaccine
completion rates. They take this work very seriously!
MMP
providers educate patients and parents on the importance of HPV
vaccination—ensuring they understand who should be vaccinated and when.
Furthermore, MMP takes every opportunity to vaccinate patients by offering
vaccines at both well and acute visits. This helps them avoid any missed
opportunities for HPV vaccine.
Recruiting
and retaining a highly trained clinical staff who appreciate the importance of
vaccines is just the first step in MMP’s impressive work with HPV vaccination.
Providers and medical assistants also participate in ongoing trainings that
focus on improving the effectiveness of vaccine conversations with parents.
Additionally, MMP works closely with the Population Health Department for
outreach to the community about HPV vaccine and participates in the Main
Quality Counts Statewide HPV Vaccine Learning Collaborative. All of these
activities helped MMP achieve impressive HPV vaccine series completion rates of
72%. Maine Medical Partners is the 2017 HHS Region 1 HPV
Vaccine Is Cancer Prevention Champion!
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Region 2
Jacobi Medical Center
Children's Health Center
Bronx, New York
The Children's Health Center (CHC) is a large urban practice
servicing an underserved community. A training site for 45 residents
and students from the Albert Einstein College of Medicine, CHC employs 10
full-time attending physicians in the ambulatory care setting.
Working
hard to increase HPV vaccination series completion rates for several years, CHC
realized this significant undertaking would involve focus on educating its
staff, physicians, and patient population. To start with, CHC accesses
information from the Citywide Immunization Registry (CIR) for every well and
acute visit. Nursing staff print, review, update, and brief physicians with CIR
reports regularly. Focusing on avoiding missed opportunities, CHC offers
walk-in immunizations, schedules follow-up vaccine appointments before patients
leave, and uses standing orders for vaccines so RNs can independently
vaccinate. CHC also tracks HPV completion rates as performance indicators for
the practice and now uses a reminder system in the CIR to text patients missing
vaccines. CHC has an HPV vaccine series completion rate of 70.3%. Children's
Health Center is the 2017 HHS Region 2 HPV Vaccine Is Cancer Prevention
Champion!
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Region 3
Office of Sein Win
Falls Church, Virginia
The Office of Sein Win is a small family-owned pediatric
practice that opened in 2011. With a total staff of 3, they treat approximately
600 children each year.
The office is committed to maintaining complete Immunization
Information System (IIS) records for each child and regularly reporting
immunization in Virginia’s IIS. The office systematically schedules adolescent
well visits, promptly reschedules missed visits, utilizes standing orders for
all adolescent vaccines, and includes education as a significant part of all
patient care. Furthermore, parents and patients receive a bundled
recommendation—staff recommend HPV vaccination the same way and same day as
other immunizations. Using a reminder/recall process and an immunization
manager (who reviews vaccination histories, calls patients who are overdue for
vaccines, and oversees that all immunization records are up to date) are two
quality improvement measures that collectively improved vaccine coverage levels.
These initiatives, as well as the strong relationship built on trust between
staff and patients, result in an HPV vaccine Series Completion Rate of 72%. The Office of Sein Win is the 2017
HHS Region 3 HPV Vaccine Is Cancer Prevention Champion!
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Region 4
Department of Health
Collier Immokalee Site Clinic
Immokalee, Florida
Department of Health Collier Immokalee Clinic works with
adults and children from a farm community in southwest Florida. Within the past
4 years, the Clinic took on the massive challenge of improving HPV vaccination
rates. This journey to impressive rates began with tracking and offering HPV
vaccine to all eligible children.
The Clinic dedicated their focus to making sure all staff
with any contact with clients are knowledgeable advocates for HPV vaccine and
armed with the knowledge of its importance in cancer prevention. Providers
recognized that cultural norms in the community they serve meant that
discussing “sexual contact” was uncomfortable when parents asked about HPV
vaccine. Therefore, staff refocused their conversations about HPV vaccine from
being for an STI to cancer prevention. This also helped frame the conversation
in a way that was helpful for both staff and providers. The Clinic then
rephrased their intake questionnaire, since it seemed misleading by suggesting
that vaccines not required for school entry, like HPV vaccine, were not
important. As a response to these efforts, coverage rates steadily improved for
HPV vaccine. Series completion rates of
76.2% for 13 to 15 year olds, makes the Department of Health Collier
Immokalee Site Clinic the 2017 HHS Region 4 HPV Vaccine Is Cancer Prevention
Champion!
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Region 5
Jane Goleman MD, FAAP
Columbus, Ohio
Dr. Jane Goleman works in primary care at Nationwide Children’s
Primary Care Network and has for over 25 years. She is a founding member of the
Pediatric Health Equity Collaborative and leads the HPV Quality Improvement
initiative to decrease HPV-related cancers and limit disparities in health
outcomes for cervical cancer.
Dr. Goleman formed a quality improvement (QI) project to
improve HPV vaccination rates. This QI project started with a small team of
clinical staff that learned more about how to discuss HPV vaccine with parents,
created an educational handout about HPV vaccine, distributed reminder magnets
for return visits, and called patients overdue for their third vaccine. Dr.
Goleman worked with the staff to refocus the discussion about the vaccine on
cancer prevention and changed the Electronic Medical Records (EMR) Health
Maintenance Alerts for HPV vaccine to 9 rather than 11 years of age. This
change in the EMR spread HPV vaccine quality improvement work to all 13 clinic
sites and updates physicians and nurse practitioners on their HPV vaccine rates
every six months. Training providers and residents on the Announcement Approach
(starting vaccine discussions with “Your child needs the following
vaccines …. We’ll be giving them at the end of the visit today”) and providing immunization rates
to each clinic site helped increase rates significantly. Additionally, awarding
performance-based incentives to clinics also helped increase HPV vaccination
rates. Dr. Goleman spreads the word about these successful HPV vaccine initiatives
to increase rates and why it matters through lectures to the local community
and her peers. In 2016, she presented “HPV-associated Cancers and Vaccination
in Ohio: The Problem and How to Address Disparities” and “Increasing HPV
Vaccination in the U.S.: A Collaboration
of NCI-Funded Cancer Centers.” All of this dedication results in a series completion rate of 81.7%, making Dr.
Jane Goleman the 2017 HHS Region 5 HPV Vaccine Is Cancer Prevention
Champion!
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Region 6
St. Anthony Pediatrics
Anthony, New Mexico
St.
Anthony Pediatrics is a large pediatric practice in southern New Mexico, 2
miles from Texas and 20 miles from Mexico. Staff realized that patients often
missed scheduled appointments and, as a result, adopted a successful no-appointment
clinic. All visits are walk-in, same-day visits, and staff screen clients for
needed immunizations status at the time of their visit.
When
patients receive the first dose of HPV vaccine, they receive a reminder card informing
them when they need to return to the office for the follow-up doses. In the clinic
waiting and triage areas, educational posters are prominently displayed to emphasize
the importance of HPV vaccine. When parents have questions about the vaccine,
they receive informative reading material so that they can prepare their
questions while they wait to see by the provider. Providers in this clinic
actively counsel clients on the importance of HPV vaccine and how it protects
them. St. Anthony Pediatrics participates in the New Mexico Statewide
Immunization Information System (NMSIIS), entering all immunizations
administered into NMSIIS through manual data entry. They utilize the NMSIIS
patient rosters to track their active population, and they inactivate clients
in NMSIIS when they are no longer seen by the clinic. With a series completion rate of 72%, St.
Anthony Pediatrics is the 2017 HHS Region 6 HPV
Vaccine Is Cancer Prevention Champion!
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Region 7
Ozarks Community Hospital- Noel Clinic
Noel, Missouri
The Ozarks
Community Hospital (OCH) Noel Clinic is a family practice rural health clinic
located in extreme southwest Missouri near the border of Missouri and Arkansas.
The OCH Noel Clinic services include primary care to children and adults. The
population of patients is incredibly diverse and encompasses many
nationalities. The range of cultures and languages presents unique
communication barriers. Nonetheless, the clinic works hard to ensure quality
access to comprehensive primary care services to those individuals who are
traditionally underserved.
The clinic
has a Vaccines for Children (VFC) coordinator who keeps track of the VFC
program for Noel Clinic, including HPV vaccination for adolescent patients. The
coordinator’s approach at the clinic is personal and consistent. For example,
she reaches out to VFC patients and their families by sending reminder cards in
the mail and follows up with phone calls for any overdue immunizations. She is
determined to get to know all of her patients and develop a relationship with
them and their families. She educates
each one carefully about HPV vaccine, ensuring she addresses their questions.
The OCH Noel clinic is proud to have such experience and focus on quality
patient care. This dedication results in HPV vaccine series completion rate of
86%, making the Ozarks Community Hospital- Noel Clinic the 2017 HHS Region 7 HPV Vaccine Is
Cancer Prevention Champion!
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Region 8
Billings Area Indian Health Service Facilities:
Wind River Service
Unit Ft Washakie
Arapahoe, Wyoming
Wind River Service Unit is a tribally-run clinic serving
approximately 11,000 members of the Native American Eastern
Shoshone and Northern Arapahoe tribes.
Staff at the clinic developed an innovative approach to parental
acceptance for HPV vaccine that draws upon buy-in from patients, parents, and
at times the local high school, to collaborate in the completion of the vaccine
series for all of their patients. For example, when a patient eligible for HPV
vaccine comes to the clinic, the parent or guardian receives HPV vaccine
Information Statement (VIS) to prepare them for a conversation with their
provider. Parents can direct their questions about HPV vaccine to the nursing
staff trained to educate parents and patients on HPV vaccine and its role in
cancer prevention. To avoid any future missed opportunities, the staff asks
parents or guardians to complete a consent form for all doses in the series at
the initial dose of the vaccine. Staff developed this innovative approach, in
part, after they encountered parents refusing remaining doses of the vaccine in
the series—often due to patients complaining about the painful shots or parents
stating they did not consent to the initial dose. This also avoids missed
opportunities in case someone else accompanies the patient at future visits to
complete the vaccine series.
If the clinic does not have a consent for the
vaccine on file, staff scan it into the electronic
health record and send an HPV vaccine consent form, along with the teen clinic
consent, to the Wyoming Indian High School. The school includes this form in
registration packets for parents and guardians to complete. Eligible patients
can elect to receive HPV vaccine series at any of the weekly teen clinics held
throughout the school year. This dedication results in HPV vaccine series
completion rate of 78.8% making the Wind River Service Unit the 2017 HHS Region
8 HPV Vaccine Is Cancer
Prevention Champion!
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Region 9
Chinle
Service Unit, Navajo Area Indian Health Service
Chinle, Arizona
Chinle Service Unit (CSU), Navajo Area Indian Health
Service, part of a federally operated health care system, is the sole health
care provider for over 35,000 people in the central region of the Navajo Nation
in northeastern Arizona. Ten health care providers (physicians and nurse
practitioners) provide pediatric primary care services, as well as inpatient
care, and an emergency department.
Through standing orders for nursing staff, CSU offers HPV vaccine
to all eligible patients at primary care or school-based clinics. Taking the
initiative to track immunizations through a registry incorporated into the
electronic health record, reminds nurses to check immunization status and
incorporate this information in notes for providers. CSU relies on the
electronic health records and the immunization registry, especially the
school-based health clinics. Furthermore, the registry links with the state
registry so data on all immunizations given throughout the state is up to date.
Initially faced with some parental refusal for HPV vaccine, patient
and family education staff worked together to find a way to communicate the
health benefits of the series. CSU worked closely with the native medicine
department to develop a culturally appropriate brochure on HPV vaccine that integrates
cultural teachings. This significantly helps with HPV vaccine acceptance. The
school-based health clinic staff also oversees the vaccination status of
students, closely working with schools and parents to complete the series at
school.
With a series
completion rate of 82.7%, Chinle Service Unit,
Navajo Area Indian Health Service is the
2017 HHS Region 9 HPV Vaccine Is Cancer Prevention Champion!
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Region 10
International
Community Health Services
Seattle, Washington
International Community Health Services (ICHS) is an
integral part of the some of the most populous and vibrant communities in the
region. Specifically, it is the largest Asian Pacific Islander non-profit
community health center in Washington. ICHS patients speak close to 50
languages and represent numerous cultures.
ICHS generates the “missing immunization” report monthly
through the Washington State Immunization Information System (WAIIS). Based on
the information staff find through the WAIIS, they contact parents or patients
to schedule appointments for overdue immunizations. Staff diligently update patients’
immunizations in WAIIS at every visit (well child exam visit, problem visit,
nurse visit, etc.). Staff use a bundled recommendation (recommending HPV
vaccine with Tdap, MCV4, and flu shot) and are equipped to discuss HPV vaccine
and how it can help prevent cancer. To educate and inform parents about HPV
vaccines, staff offer them the “Plain Talk” immunization booklet.
ICHS acknowledges that maintaining these rates requires continuity
and commitment: “It’s not just an individual goal. It requires a cooperation
from the whole care team.” This hard work led to a series completion rate of 84%. International
Community Health Services is the
2017 HHS Region 10 HPV Vaccine Is Cancer Prevention Champion!
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#HowIRecommend
is a new video series that
highlights real clinicians responding to a variety of questions about HPV vaccine that they hear
in their own practices. In these short videos, watch clinicians make an
effective HPV vaccine recommendation, answer the questions parents have about
HPV vaccine and explain
how their office helps empower and educate parents. Right now, you can see Dr. Alix Casler and Dr.
Sharon Humiston answering the most common questions they hear about HPV
vaccination. More
videos in this series are in production and will be posted in the upcoming
months.
If you missed our #PreteenVaxScene webinar on
July 13th, you can now view it
online. In this webinar,
representatives from partner organizations highlight their newest HPV vaccine
resources and where they can be found. Partner organizations include American
Academy of Pediatrics (AAP), Academic Pediatric Association (APA), American
Cancer Society for the HPV Vaccination Roundtable, American Cancer Society VACs
Project, National AHEC Organization (NAO) and National Association of County
& City Health Officials (NACCHO). Check it out now.
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