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J Pediatr Health Care. 2014 Mar-Apr;28(2):155-64. doi: 10.1016/j.pedhc.2013.01.002. Epub 2013 Mar 20.

A quality improvement initiative to increase HPV vaccine rates using an educational and reminder strategy with parents of preteen girls.



A quality improvement project was undertaken to determine if an evidence-based educational brochure and reminder system can increase human papillomavirus (HPV) vaccine uptake and dose completion rates.


Development of a brochure to promote HPV vaccine uptake was based on predictors of parental acceptance and Health Belief Model concepts. Electronic alerts prompted telephone reminders for dose completion. This quality improvement project utilized a quasi-experimental design with 24 parents of preteen girls from a private pediatric practice and a historical control group of 29 parents. HPV vaccine rates were compared between the groups.


A significant difference in HPV vaccine uptake (χ(2) = 11.668, P = .001; odds ratio [OR] = 9.429, 95% confidence interval [CI] = 2.686-33.101) and dose completion (χ(2) = 16.171, P < .001; OR = 22.500, 95% CI = 4.291-117.990) rates were found between the historical control and intervention groups. Parents who received the clinical protocol were 9.4 times and 22.5 times more likely to have HPV vaccine uptake and dose completion, respectively.


Low national HPV vaccine rates demonstrate the need for theory-based vaccine delivery programs. These results show that an evidence-based educational brochure and reminder system appeared to improve HPV vaccine uptake and dose completion rates at this private pediatric practice.


HPV vaccine; health promotion; patient education; reminder systems

[Indexed for MEDLINE]

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