(P167) Examination of Current Implementation Research Evidence Supporting HPV Vaccination Starting at Age 9

Project: Assessing evidence-based interventions to promote human papillomavirus (HPV) vaccination starting at age 9.

Issue: On-time HPV vaccination by the 13th birthday has proven to be effective in preventing HPV cancers and pre-cancers. However, HPV vaccination coverage rates in the United States (U.S.) continue to lag behind other routinely recommended vaccinations for adolescents. Endorsed by the American Academy of Pediatrics and American Cancer Society, starting HPV vaccination at age 9 could help improve coverage rates by allowing additional time to complete vaccination series by the 13^th birthday and a more concentrated focus on cancer prevention messaging. However, the lack of empirically tested interventions to improve HPV vaccination initiation and completion among 9–10-year-olds present an opportunity to examine how existing evidence-based interventions can be adapted and tested to ensure they remain effective in promoting uptake at earlier ages.

Results: The two most widely utilized repositories by program planners and practitioners, of evidence-based intervention for various cancer prevention and control programs are limited regarding HPV vaccination interventions. The National Cancer Institute Evidence-based Cancer Control Programs include six interventions. Most of these interventions focus on adolescent females, two include a focus on males, and none include 9–10-year-olds. The Guide to Community Preventive Services is a collection of the evidence-based strategies or approaches for general vaccination uptake, including enhancing access to vaccination services, increasing community demand for vaccinations, and provider- or system focused interventions. None of the strategies suggested are specific to HPV vaccination among 9-10-year-olds. Implementation science, with a specific focus on adapting interventions and strategies to improve uptake of healthcare services can provide the theoretical guidance to modify existing interventions and strategies for 9-10-year-olds while simultaneously documenting the key drivers for implementing interventions to be maximally effective. One such framework is the Framework for Reporting Adaptations and Modification (Expanded & Implementation Strategies).

Lessons Learned: Starting HPV vaccination at age 9-years-old could help improve HPV vaccination coverage rates. However, current evidence-based interventions and strategies focus on older adolescents. Implementation science could be beneficial in adapting current interventions to meet the needs of 9-10-year-olds, ultimately improving vaccination coverage thereby contributing to cancer prevention efforts.