A new five-year project, led by a professor at UCLA Fielding School of Public Health, could help to inform national efforts to improve HPV vaccination in underserved populations.
Dr. Roshan Bastani, in the department of health policy and management, will lead a $6.6 million research study awarded by the Patient-Centered Outcomes Research Institute (PCORI) to investigate the comparative effectiveness of strategies designed to increase receipt of the human papillomavirus (HPV) vaccine among adolescents. By advancing the understanding of which health system interventions are most effective and efficient, the research has the potential to dramatically increase HPV vaccination and prevent HPV-related cancers nationwide.
For this study, the UCLA Jonsson Comprehensive Cancer Center and the UCLA Fielding School of Public Health are partnering with the Northeast Valley Health Corporation (NEVHC), a multi-site Federally Qualified Health Center (FQHC) that provides much needed health care to a primarily uninsured or publicly insured, low-income, Latino population in Los Angeles County.
The UCLA-NEVHC study is one of three studies selected for funding through PCORI’s Pragmatic Clinical Studies Initiative, an effort to produce results that are broadly applicable to a diverse range of patients and health care settings and can be more quickly adopted in routine clinical practice.
As well as being a professor at the UCLA Fielding School, Dr. Bastani is director of disparities and community engagement at the UCLA Jonsson Comprehensive Cancer Center, and director of the UCLA Kaiser Permanente Center for Health Equity. The UCLA team includes Dr. Beth Glenn, associate professor of health policy and management, Dr. Alison Herrmann, associate director of the UCLA Kaiser Permanente Center for Health Equity, and Dr. Catherine Crespi associate professor-in-residence in biostatistics and also affiliated with the Center for Cancer Prevention and Control Research. The NEVHC team will be led by Ms. Debra Rosen, director of quality and health education, and Dr. Christine Park, chief medical officer.
The discovery of HPV as a major cause of many cancers (including cervical, anal, oropharyngeal, vaginal, vulvar and penile) and the subsequent development of prophylactic HPV vaccines was a revolution in cancer prevention. However, ten years after the vaccine’s introduction, HPV vaccination rates among U.S. adolescents remain unacceptably low. HPV-related cancers disproportionately affect ethnic minority and low-income groups in the United States, such as the patients served by NEVHC.
For the five-year research project, Bastani’s team will assess system-level strategies for increasing receipt of the HPV vaccine among the largely Latino population receiving care in FQHCs, where HPV vaccination rates are much lower than in the general population. The study will compare three strategies: a multi-level, multi-component point-of-care (clinic-based) approach that targets physicians, staff, patients as well as clinic-level policies, procedures and practices; text message or mailed reminders sent to parents of NEVHC adolescent patients who are due for a dose of the HPV vaccine; and a combined clinic-based and parent-reminder approach.
More than 17,000 adolescents eligible for the HPV vaccine are expected to receive services at a participating NEVHC clinic during the project period, Dr. Bastani said.
“We are very excited to receive this award from the Patient-Centered Outcomes Research Institute,” Dr. Bastani said. “By determining the comparative effectiveness and efficiency of our intervention strategies for increasing HPV vaccination in the NEVHC adolescent population, we have tremendous potential to improve the prevention of HPV-related cancers in other low resource clinical settings across the country. We greatly look forward to implementing this study and sharing its results.”
The UCLA-NEVHC study was selected through a highly competitive review process in which patients, caregivers and other stakeholders joined scientists to evaluate the proposals. PCORI’s Board has approved this award pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.
The Patient-Centered Outcomes Research Institute is an independent, nonprofit organization authorized by Congress in 2010 to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions.