Great news for the ACTION Health Cancer Task Force: in the April 2009 issue of the CDC’s electronic peer-reviewed journal, Preventing Chronic Disease, you will find the published result of years of cutting-edge hard work on HPV & Cervical Cancer.
Published under the rather vanilla (at least in my view) title “HPV Vaccine Attitudes and Practices Among Primary Care Providers in Appalachian Pennsylvania” are the results and conclusions of ACTION Health’s 2006-07 population-based provider survey. You can either click the link above to go to the full text, or see the polished up version (*.pdf) here.
Pretty much everything is covered in the article, so you should probably go to the actual article to gain a full understanding, but here are some key excerpts. From the introduction:
From 2003 through 2005, 45 cases of invasive cervical cancer were reported in the 5-county ACTION Health area. According to the Pennsylvania Cancer Registry, 31 cases were expected during this period (11). Also during this period, 12% of women aged 18 to 64 were uninsured and 17% did not have a regular physician (11,12).
Because of the apparent increased risk of cervical cancer in this area, these women may benefit from HPV vaccination. We surveyed primary care practices to determine HPV vaccine-related practices and recommendations in the ACTION Health area. The study was the first of its kind in the ACTION Health service area and the northern Appalachian region overall.
Woo hoo! Cutting edge stuff. That’s probably why this study was published. However the methodology was also sound:
In December 2006, ACTION Health conducted an initial survey of all primary care practices (n = 65), defined as family medicine, pediatric, and gynecology practices, including public clinics and university health centers, in the ACTION Health area. We identified practices by reviewing telephone listings and hospital Web sites and by querying coalition members. We initially contacted practices by telephone, and then we faxed them a 1-page survey (Appendix) that took less than 5 minutes to complete. We asked the person in the practice who was most knowledgeable about the HPV vaccine to complete and return the instrument.
In May 2007, a second survey was faxed to the people who returned the initial instrument (n = 55) because we wanted to develop a strategy for a future intervention (Appendix). The second instrument took approximately 5 minutes to complete. We did not collect data on the training or position of the person who completed either instrument. We calculated prevalence estimates and 95% confidence intervals (CIs) for all results. The institutional review board of The Pennsylvania State University determined this study to be exempt from review.
And some findings:
Of the 65 primary care practices, 55 returned a completed initial instrument (response rate, 85%). Of these, 44 (80%; 95% CI, 69%-91%) offered the vaccine to their patients.
Not too shabby. That means that advocacy isn’t as important as the Task Force initially thought it might be. Therefore, targeting parents and college-age populations will be doubly effective in vaccinating the eligible populations.
We conclude that most practices in this area of Appalachian Pennsylvania recommend the HPV vaccine or provide it if patients request it. Future community education interventions should target women and girls in the appropriate age range to increase their knowledge of cervical cancer and the risks and benefits of HPV vaccination.
Congratulations, Cancer Task Force!
