Trial Outcomes & Findings for HPV Vaccine Communication ECHO for Primary Care Clinics (NCT NCT04587167)
NCT ID: NCT04587167
Last Updated: 2026-02-24
Results Overview
Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
30 participants
Primary outcome timeframe
Twelve months
Results posted on
2026-02-24
Participant Flow
Clinics were recruited using existing professional contacts, purchasing of professional listservs, and participation as an exhibitor at state-wide conferences. The study team employed multiple outreach methods, including personalized mailings, individualized electronic messages, and mass email communications.
Clinics were randomized using covariate-constrained randomization to ensure balance among the 3 arms with respect to clinic size, clinic type (academic vs non-academic), rurality (defined using RUCC), and initial HPV vaccination rates. Our outcomes were evaluated on the clinic-level. Each clinic reported aggregate immunization data on patients 11-17 years of age. Patients reported in the aggregate data are from the clinics, parents and patients were not enrolled. Only clinic staff were enrolled.
Unit of analysis: Clinics
Participant milestones
| Measure |
HPV ECHO
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 8 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
To assess the primary outcome of HPV vaccine uptake, participating clinics will consent to providing aggregate patient immunization data at baseline, 3-, 6-, 9-, and 12-month follow-up throughout the study period. This aggregate data will be reported as it is essential to the study.
|
HPV ECHO+
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 10 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via mail.
To assess the primary outcome of HPV vaccine uptake, participating clinics consent to providing aggregate patient immunization data at baseline, 3-, 6-, 9-, and 12-month follow-up throughout the study.
|
Control
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 10 primary care clinics in Pennsylvania.
To assess the primary outcome of HPV vaccine uptake, participating clinics consent to providing aggregate patient immunization data at baseline, 3-, 6-, 9-, and 12-month follow-up throughout the study period. This aggregate data will be reported as it is essential to the study.
|
|---|---|---|---|
|
Overall Study
STARTED
|
11477 10
|
10401 10
|
9387 10
|
|
Overall Study
Aggregate Immunization Data for 11-14 year olds - Started
|
6538 9
|
5895 9
|
5379 9
|
|
Overall Study
Aggregate Immunization Data for 15-17 year olds - Started
|
4888 9
|
4461 9
|
3969 9
|
|
Overall Study
Clinical Staff Enrolled in Study - Started
|
51 10
|
45 10
|
39 10
|
|
Overall Study
Clinical Staff Enrolled in Study - Completed
|
46 9
|
36 9
|
36 9
|
|
Overall Study
Aggregate Immunization Data for 11-14 year olds - Completed
|
6537 9
|
5901 9
|
5410 9
|
|
Overall Study
Aggregate Immunization Data for 15-17 year olds - Completed
|
4890 9
|
4464 9
|
3936 9
|
|
Overall Study
COMPLETED
|
11473 9
|
10401 9
|
9382 9
|
|
Overall Study
NOT COMPLETED
|
4 1
|
0 1
|
5 1
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
Baseline characteristics by cohort
| Measure |
HPV ECHO
n=11426 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 8 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=10356 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 10 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via mail.
|
Control
n=9348 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 10 primary care clinics in Pennsylvania.
|
Total
n=31130 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Age, Customized
Aggregate Patient Immunization Data · 11-14 year olds
|
6538 Participants
n=11426 Participants • Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
|
5895 Participants
n=10356 Participants • Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
|
5379 Participants
n=9348 Participants • Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
|
17812 Participants
n=31130 Participants • Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
|
|
Age, Customized
Aggregate Patient Immunization Data · 15-17 year olds
|
4888 Participants
n=11426 Participants • Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
|
4461 Participants
n=10356 Participants • Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
|
3969 Participants
n=9348 Participants • Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
|
13318 Participants
n=31130 Participants • Our outcomes were based upon aggregate HPV vaccine initiation and completion counts as reported by our enrolled primary care clinics.
|
|
Sex/Gender, Customized
Gender · Female
|
45 Participants
n=51 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
38 Participants
n=45 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
30 Participants
n=39 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
113 Participants
n=135 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
|
Sex/Gender, Customized
Gender · Male
|
4 Participants
n=51 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
4 Participants
n=45 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
6 Participants
n=39 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
14 Participants
n=135 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
|
Sex/Gender, Customized
Gender · Not reported
|
2 Participants
n=51 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
3 Participants
n=45 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
3 Participants
n=39 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
8 Participants
n=135 Participants • Clinical staff (n=135) from each clinic enrolled in the study.
|
|
Sex: Female, Male
11-14 year olds · Female
|
3211 Participants
n=6538 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
2881 Participants
n=5895 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
2615 Participants
n=5379 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
8707 Participants
n=17812 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
|
Sex: Female, Male
11-14 year olds · Male
|
3327 Participants
n=6538 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
3014 Participants
n=5895 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
2764 Participants
n=5379 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
9105 Participants
n=17812 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
|
Sex: Female, Male
15-17 year olds · Female
|
2417 Participants
n=4888 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
2209 Participants
n=4461 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
1959 Participants
n=3969 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
6585 Participants
n=13318 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
|
Sex: Female, Male
15-17 year olds · Male
|
2471 Participants
n=4888 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
2252 Participants
n=4461 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
2010 Participants
n=3969 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
6733 Participants
n=13318 Participants • The two different age groups are reported separately to show the sex distribution within each age group.
|
|
Race and Ethnicity Not Collected
|
—
|
—
|
—
|
0 Participants
Race and Ethnicity were not collected from any participant.
|
|
Region of Enrollment
United States
|
11426 patients
n=11426 Participants • Data reported represent the aggregate patient data reported from clinics enrolled in the cluster RCT.
|
10356 patients
n=10356 Participants • Data reported represent the aggregate patient data reported from clinics enrolled in the cluster RCT.
|
9348 patients
n=9348 Participants • Data reported represent the aggregate patient data reported from clinics enrolled in the cluster RCT.
|
31130 patients
n=31130 Participants • Data reported represent the aggregate patient data reported from clinics enrolled in the cluster RCT.
|
PRIMARY outcome
Timeframe: Twelve monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period.
Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6537 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=5901 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5410 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months
|
3189 Participants
2
|
3833 Participants
2
|
4260 Participants
2
|
SECONDARY outcome
Timeframe: Three monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 3 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6538 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=3319 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5403 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 11-14 Year Olds at 3 Months
|
2483 Participants
|
1759 Participants
|
4083 Participants
|
SECONDARY outcome
Timeframe: Six monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period.
Coverage change from baseline to 6 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6538 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=3319 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5395 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 11-14 Year Olds at 6 Months
|
2584 Participants
|
1831 Participants
|
4177 Participants
|
SECONDARY outcome
Timeframe: Nine monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period.
Coverage change from baseline to 9 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6538 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=3319 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5346 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 11-14 Year Olds at 9 Months
|
2744 Participants
|
1888 Participants
|
4102 Participants
|
SECONDARY outcome
Timeframe: Three monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period.
Coverage change from baseline to 3 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6538 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=3319 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5403 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (Completion), 11-14 Year Olds at 3 Months
|
1517 Participants
|
1063 Participants
|
3075 Participants
|
SECONDARY outcome
Timeframe: Six monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in minor variations in total counts across the reporting period.
Coverage change from baseline to 6 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6538 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=3319 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5395 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (Completion), 11-14 Year Olds at 6 Months
|
1655 Participants
|
1156 Participants
|
3249 Participants
|
SECONDARY outcome
Timeframe: Nine monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 9 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6538 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=3319 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5346 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (Completion), 11-14 Year Olds at 9 Months
|
1817 Participants
|
1232 Participants
|
3180 Participants
|
SECONDARY outcome
Timeframe: Twelve monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 12 months in HPV vaccine completion (according to the Advisory Committee on Immunization Practices (ACIP) guidelines), among 11- to 14- year-old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6537 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=5901 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5410 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (Completion), 11-14 Year Olds at 12 Months
|
1984 Participants
|
1946 Participants
|
3432 Participants
|
SECONDARY outcome
Timeframe: Three monthsPopulation: These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 3 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=4888 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=2447 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=3971 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 15-17 Year Olds at 3 Months
|
1965 Participants
|
1801 Participants
|
3182 Participants
|
SECONDARY outcome
Timeframe: Six monthsPopulation: These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 6 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=4888 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=2447 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=3932 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 15-17 Year Olds at 6 Months
|
1976 Participants
|
1805 Participants
|
3158 Participants
|
SECONDARY outcome
Timeframe: Nine monthsPopulation: These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 9 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=4888 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=2447 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=3969 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 15-17 Year Olds at 9 Months
|
1997 Participants
|
1812 Participants
|
3185 Participants
|
SECONDARY outcome
Timeframe: Twelve monthsPopulation: These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=4890 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=4464 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=3936 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months
|
2397 Participants
|
3684 Participants
|
3176 Participants
|
SECONDARY outcome
Timeframe: Twelve monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 11- to 14- year old patients by sex, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6537 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=5901 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5410 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months by Sex
Female - Initiated HPV vaccine
|
1628 Participants
|
1860 Participants
|
2079 Participants
|
|
HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months by Sex
Male - Initiated HPV vaccine
|
1561 Participants
|
1973 Participants
|
2181 Participants
|
|
HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months by Sex
Female - Not initiated
|
1582 Participants
|
1022 Participants
|
539 Participants
|
|
HPV Vaccination (≥1 Dose), 11-14 Year Olds at 12 Months by Sex
Male - Not initiated
|
1766 Participants
|
1046 Participants
|
611 Participants
|
SECONDARY outcome
Timeframe: Twelve monthsPopulation: These numbers reflect only patients 15-17 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 12 months in HPV vaccine initiation (≥1 dose), among 15- to 17- year old patients by sex, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=4890 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=4464 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=3936 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months by Sex
Female - Initiated HPV vaccine
|
1210 Participants
|
1846 Participants
|
1585 Participants
|
|
HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months by Sex
Male - Initiated HPV vaccine
|
1187 Participants
|
1838 Participants
|
1591 Participants
|
|
HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months by Sex
Female - Not initiated
|
1208 Participants
|
364 Participants
|
363 Participants
|
|
HPV Vaccination (≥1 Dose), 15-17 Year Olds at 12 Months by Sex
Male - Not initiated
|
1285 Participants
|
416 Participants
|
397 Participants
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Twelve monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 12 months in Tdap vaccination among 11- to 14-year-old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6537 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=5901 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5410 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
Tetanus, Diphtheria, and Acellular Pertussis (Tdap) Vaccination, 11-14 Year Olds
|
4083 Participants
|
5487 Participants
|
4061 Participants
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Twelve monthsPopulation: These numbers reflect only patients 11-14 years of age to align with the outcome measure. Enrolled clinics were instructed to follow the same cohort of active patients defined at baseline. However, limitations in EHR reporting and data support led to inconsistencies in data submission, resulting in variations in total counts across the reporting period.
Coverage change from baseline to 12 months in meningococcal vaccination (≥1 dose), among 11- to 14-year-old patients, as measured by clinics' records
Outcome measures
| Measure |
HPV ECHO
n=6537 Participants
Clinics randomly assigned to this arm will receive the intervention via real-time, interactive videoconferencing using Zoom at no cost to participants. The intervention has a curriculum of 10 sessions focused on the evidence-based Announcement Approach. Sessions will be 60 minutes in duration and held every other weekly for 4 months at regularly scheduled times.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
|
HPV ECHO+
n=5901 Participants
Clinics randomly assigned to this arm will receive the HPV ECHO intervention plus a systems communication strategy to deliver recall notices to parents who initially decline HPV vaccination. This arm includes 12 primary care clinics in Pennsylvania.
Project ECHO: Using proven adult learning techniques and interactive video technology, the ECHO Model promotes knowledge exchange between experts or specialists at centers of excellence ("the hub") and primary care providers (the "spokes), typically located in rural settings. Through regular real-time collaborative sessions, the spokes connect with the hub and with other spokes to discuss 1) best practices in care and 2) complex cases managed within their practice.
Announcement Approach Training: Train physicians and their clinic staff to make strong HPV vaccine recommendations by using presumptive announcements. If parents show vaccine hesitancy, the Training train physicians a 3-step approach (Connect, Clarify, Counsel) to share effective, evidence-based messages about HPV vaccine.
Recall notices: Notify parents that their child is behind for HPV vaccination. Recall notices will include research-tested messages to specifically address parent concerns. Recall notices will be sent to parents via patient portal or email communication.
|
Control
n=5410 Participants
Clinics randomly assigned to this arm will receive no ECHO interventions. This arm includes 12 primary care clinics in Pennsylvania.
|
|---|---|---|---|
|
Meningococcal Vaccination (≥1 Dose), 11-14 Year Olds
|
3422 Participants
|
5408 Participants
|
3882 Participants
|
Adverse Events
HPV ECHO
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
HPV ECHO+
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Control
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place