Summary of findings 10. Multi‐component provider and parent intervention compared to usual practice.
| Comparison 10: multi‐component provider and parent intervention compared to usual practice | ||||||
| Population: healthcare workers and parents Setting: USA Intervention: multi‐component provider and parent interventiona Comparison: usual practice | ||||||
| Outcomes | Impact | № of participants (studies) | Certainty of the evidence (GRADE)** | |||
| Absolute effects* (95% CI) | Relative effect (95% CI) | Narrative results | ||||
| With usual practice | With multi‐faced intervention | |||||
| HPV vaccine uptake at 3 months | 25 per 1,000 | 57 per 1000 (18 to 180) |
RR 2.34 (0.75 to 7.32) |
A multi‐component intervention involving healthcare providers and parents may improve uptake of the HPV vaccine compared to usual practice. | 337
(1)b Randomised trial |
⊕⊕⊝⊝ Lowd |
| HPV vaccine uptake at 6 months | 52 per 1,000 | 73 per 1000 (65 to 83) |
RR 1.41 (1.25 to 1.59) |
25,869 (1)cNon‐randomised trial | ⊕⊕⊝⊝ Lowe | |
|
CI: confidence interval; HPV: human papillomavirus; RR: risk ratio. *The risk in the intervention group (and its 95% CI) is based on the likelihood of being vaccinated in the usual practice group and the relative effect of the intervention (and its 95% CI). **GRADE Working Group grades of evidence: High certainty: this research provides a very good indication of the likely effect. The likelihood that the effect will be substantially different† is low. Moderate certainty: this research provides a good indication of the likely effect. The likelihood that the effect will be substantially different† is moderate. Low certainty: this research provides some indication of the likely effect. However, the likelihood that it will be substantially different† is high. Very low certainty: this research does not provide a reliable indication of the likely effect. The likelihood that the effect will be substantially different† is very high. †Substantially different = a large enough difference that it might affect a decision. | ||||||
a In the randomised trial (Paskett 2016), healthcare providers received a one‐hour PowerPoint presentation and handouts on the HPV vaccine, focusing on current evidence‐based HPV vaccine information and strategies designed to assist physicians in discussing HPV vaccination with parents. In addition, parents were mailed a packet that included an educational brochure and DVD video about HPV infection and HPV vaccination as well as a CDC HPV vaccine information statement. Furthermore, health educators conducted an education session with parents about the HPV vaccine via telephone to reinforce the message in the educational materials regarding the need for the vaccine and addressed any vaccination barriers or questions.
In the non‐randomised trial (Cates 2014), the intervention included: (1) distribution of HPV vaccination posters and brochures with the risk‐related message to health departments and healthcare providers; (2) two radio public service announcements designed to raise awareness about HPV vaccine for boys among parents of preteen boys; (3) an online continuing medical education training with video demonstrating communication among providers, parents, and preteen boys available to enrolled health providers; (4) one‐page tip sheet for providers to discuss HPV vaccination with parents and boys; and (5) a website with links to credible information sources useful for both parents and providers.
bPaskett 2016 (randomised trial).
cCates 2014 (non‐randomised trial).
d Downgraded by two levels for serious imprecision and serious study limitations (unclear risk of selection bias in the included study) (Paskett 2016).
e Downgraded by two levels for non‐randomised study design (Cates 2014).