1. Name(s): Michael Fetters | |||||
2. Research topic: HPV vaccination | |||||
3. Clinicalstory: In our clinic serving Japanese and Asian patients in the USA, many parents refuse HPV vaccination for their children. | |||||
4. Six practical approaches | Problem | Information needed | Type of intervention | Implementation strategy | Evaluate and plan the next steps |
Survey | Immunisations of girls aged 11–12 years old or less on team 3. | What is literature on parent/child attitudes about HPV vaccination? | Develop or adapt existing survey for self-administration? | Distribute throughout the clinic system. | Examine practices in best and worst centres. |
Qualitative interviews | Fewer Japanese families accepting HPV vaccine? | What is literature on HPV vaccination in Japan? Cultural issues and HPV? | Interview mother, daughters, physicians. | Conduct interviews in the practice. | Adapt materials, adjust consent, community article. |
Quality improvement | Administration seeks 80% vaccine uptake in those aged 11–12 years old. | What is my clinic's HPV vaccination rates? What is literature on QI and HPV? | Organise clinic focus on HPV vaccine, posters, prompts and so on. | Implement PDSA process (Plan, Do See, Act). | Reassess in 3 months, cyclically, make further changes. |
Curriculum development | GP residents need training on how to discuss vaccines. | What is the current curriculum? Deficits? Problems? Examples? | Teach knowledge and skills in giving, and communication skills. | Assess baseline, intervene, assess if improved. | Change components of curriculum not effective/popular. |
Clinical policy analysis | Should boys 11–12 receive HPV vaccination? | Policy of government, other countries, WHO speciality organisation. | Critique policy. | Examine assumptions, make persuasive argument. | Disseminate to government, specialty organisations. |
Case study | Responding to Japanese parents’ culturally driven HPV vaccine concerns. | Literature on cultural adaptations to make programme acceptable. | Review clinic rates, interview staff, parents, current media. | Develop culturally adapted programme and assess effectiveness. | Assess rates after intervention, disseminate results. |
5. Research title: Improving (HPV vaccination of eligible adolescents) in (a family medicine clinic serving overseas Japanese patients): a (quality improvement) study. | |||||
6. Nextsteps: (1) identify current HPV vaccination rates; (2) discuss with staff members a strategy to improve; (3) search the literature for other similar experiences. |
GP, general practice; HPV, human papillomavirus; QI, quality improvement; WHO, World Health Organization.