Perkins 2015.

Methods	Cluster randomised trial in the USA
Participants	Participants: healthcare providers and their patients including boys and girls aged 11–21 years Number per group: 2 intervention health centres (4093 participants) and 6 control health centres (9025 participants) Total number enrolled: 13,118 participants Study population: healthcare workers (physicians, nurse practitioners, nurses, physician assistants, and medical assistants). Only physicians, nurse practitioners, and physician assistants with their own patient panels were eligible to receive personalised feedback on vaccination rates. As an incentive, physicians were eligible to receive maintenance of certification (MOC) Part IV credits, which fulfilled the requirements for maintaining board certification. Boys and girls aged 11–21 years from low‐income populations who received primary care in the Pediatric/Adolescent Departments at an intervention or control practice.
Interventions	Intervention: multi‐component performance improvement continuing medical education intervention Description: intervention included: 6–8 education visits over 12 months by an HPV physician‐educator; focused education sessions on HPV‐related topics designed to change the way providers viewed the importance of HPV vaccination and responded to parents' hesitation toward HPV vaccines; individualised feedback where providers and practices received individual reports that showed their performance compared to other providers in their practice on HPV vaccination coverage. Those practices that showed initiatives to improve systems for HPV series completion were given support; quality improvement incentives where physicians were eligible to receive MOC credits, which fulfilled requirements for maintaining board certification in paediatrics. Comparison: usual practice Description of comparison: none Duration: 2 years Vaccine target: HPV vaccines Disease targeted: HPV infection Number of doses: 3 doses
Outcomes	HPV vaccine uptake
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Selection of the practice for the intervention or control condition was random.
Allocation concealment (selection bias)	Low risk	Included centres allocated randomly.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	The outcome is an objective measure.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	The outcome is an objective measure.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Data available through a common electronic medical records' system.
Selective reporting (reporting bias)	Low risk	All practices used the same electronic medical records' system.
Other bias	Low risk	No evidence of other biases.