Using an implementation research framework to identify potential facilitators and barriers of an intervention to increase HPV vaccine uptake

Rebecca Selove, Maya Foster, Raquel Mack, Maureen Sanderson, Pamela C. Hull

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: Although the incidence of cervical cancer has been decreasing in the United States over the last decade, Hispanic and African American women have substantially higher rates than Caucasian women. The human papillomavirus (HPV) is a necessary, although insufficient, cause of cervical cancer. In the United States in 2013, only 37.6% of girls 13 to 17 years of age received the recommended 3 doses of a vaccine that is almost 100% efficacious for preventing infection with viruses that are responsible for 70% of cervical cancers. Implementation research has been underutilized in interventions for increasing vaccine uptake. The Consolidated Framework for Implementation Research (CFIR), an approach for designing effective implementation strategies, integrates 5 domains that may include barriers and facilitators of HPV vaccination. These include the innovative practice (Intervention), communities where youth and parents live (Outer Setting), agencies offering vaccination (Inner Setting), health care staff (Providers), and planned execution and evaluation of intervention delivery (Implementation Process). Methods: Secondary qualitative analysis of transcripts of interviews with 30 community health care providers was conducted using the CFIR to code potential barriers and facilitators of HPV vaccination implementation. Results: All CFIR domains except Implementation Process were well represented in providers' statements about challenges and supports for HPV vaccination. Conclusion: A comprehensive implementation framework for promoting HPV vaccination may increase vaccination rates in ethnically diverse communities. This study suggests that the CFIR can be used to guide clinicians in planning implementation of new approaches to increasing HPV vaccine uptake in their settings. Further research is needed to determine whether identifying implementation barriers and facilitators in all 5 CFIR domains as part of developing an intervention contributes to improved HPV vaccination rates.

Original languageEnglish
Pages (from-to)e1-e9
JournalJournal of Public Health Management and Practice
Volume23
Issue number3
DOIs
StatePublished - 2017

Bibliographical note

Funding Information:
This research was supported by grant # U54 CA153708 from the National Cancer Institute. Selove and Foster received support for their work on this project from grant # U54 CA163066 from the National Cancer Institute.

Publisher Copyright:
© 2017 Wolters Kluwer Health, Inc.

Keywords

  • Community intervention
  • HPV vaccine
  • Implementation research
  • Minority health

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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