378 - Changes in Reported Clinician Communication Practices and Confidence Following the CCOM HPV Vaccine Communication Intervention

Publication Number: 2367.378

David Higgins, University of Colorado School of Medicine, Centennial, CO, United States; Jessica Cataldi, University of Colorado School of Medicine, Denver, CO, United States; Gretchen Homan, University of Kansas School of Medicine, Wichita, KS, United States; Delwyn Catley, San Diego State University, San Diego, CA, United States; Laura Helmkamp, University of Colorado School of Medicine, Aurora, CO, United States; English Evelyn, University of Colorado Anschutz, Chicago, IL, United States; Xinyu Zhang, KUMC, Wichita, KS, United States; Cathryn Perreira, University of Colorado School of Medicine, Aurora, CO, United States; Christine Spina, University of Colorado at Anschutz Medical Campus, Denver, CO, United States; Kathryn L. Colborn, University of Colorado Anschutz, Aurora, CO, United States; Christina Studts, University of Colorado School of Medicine, Aurora, CO, United States; Sean T. O'Leary, University of Colorado School of Medicine, Denver, CO, United States

Background: HPV vaccination gaps persist, partly due to clinicians’ discomfort with vaccine conversations and parental hesitancy. The Clinician Communication about HPV Vaccine 2.0 (CCOM) intervention is an adaptation of the in-person Physician Communication about HPV Vaccine (PCOM) intervention, shown to improve clinician HPV vaccine communication and uptake. CCOM is being tested to determine whether virtual delivery achieves comparable improvements in HPV vaccine uptake compared to in-person delivery.

Objective: To describe pre- to post-intervention changes in clinicians’ reported HPV vaccine communication practices and confidence following receipt of the CCOM training.

Design/Methods: Pre- and post-intervention surveys were administered to clinicians in the 22 clinics participating in the CCOM trial (virtual and in-person delivery arms combined). Of the 104 clinicians who completed the pre-intervention survey, 91 (88%) also completed the post-intervention survey and were included in this analysis. Exact McNemar tests and Bowker’s symmetry tests for paired categorical comparisons were used. Analyses combined clinicians across arms.

Results: Among clinicians (N=91) who completed both surveys (Table 1), the proportion strongly recommending the HPV vaccine for 11-12-year-old males increased significantly from 84% to 92% (p=.04) following the CCOM training and remained stable for 11-12-year old females (88% to 92%, p=.34) (Table 2). Following CCOM training, use of a presumptive introduction of the HPV vaccine conversation increased from 11% to 63% (p <.01). When parents were hesitant to vaccinate, clinicians reporting use of MI-based skills following CCOM training increased from 34% to 81% (p <.01), with significant increases in the use of supportive statements (22% to 33%, p<.01), reflective listening (23% to 34%, p<.01), and asking permission before sharing information (20% to 39%, p<.01) (Table 3). Clinicians who strongly agreed they are “influential in parents’ decisions” increased from 22% to 44% (p < 0.01) (Table 4).

Conclusion(s): Receipt of the CCOM training was associated with substantial improvements in clinicians’ self-reported communication practices and perceived influence on parents' decisions to vaccinate, across both in-person and virtual delivery arms. These findings provide early evidence of perceived behavior change among clinicians participating in the CCOM trial. Primary trial outcomes, including arm-level comparisons of observed communication behaviors and vaccine uptake, will be reported upon completion of the trial.

Tables 1 and 2: Clinician Demographic and Changes in Clinicians’ Reported HPV Vaccine Recommendation Strength and Communication Approach
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Table 3: Changes in Reported Use of Key Motivational Interviewing Skills
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Table 4: Changes in Clinicians’ Perceived Influence on Parental HPV Vaccination Decisions
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