Strategies to Bridge Equitable Implementation of Telehealth.

During the COVID-19 pandemic, the rapid scaling of telehealth limited the extent to which proactive planning for equitable implementation was possible. The deployment of telehealth will persist in the postpandemic era, given patient preferences, advances in technologies, growing acceptance of telehealth, and the potential to overcome barriers to serve populations with limited access to high-quality in-person care. However, aspects and unintended consequences of telehealth may leave some groups underserved or unserved, and corrective implementation plans that address equitable access will be needed. The purposes of this paper are to (1) describe equitable implementation in telehealth and (2) integrate an equity lens into actionable equitable implementation.

Adolescents Who Have Undergone Human Papillomavirus Vaccination Are More Likely to Get a COVID-19 Vaccine.

PURPOSE: Human papillomavirus (HPV) and COVID-19 vaccination are both recommended for adolescents of ages 12-17. In May 2021, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices allowed the two vaccines to be administered concurrently. METHODS: We identified adolescents of ages 12-17 using electronic health records from a large integrated delivery system. We assessed associations between socio-demographic characteristics and uptake of HPV vaccination and COVID-19 vaccination, as well as the cumulative proportion of adolescents who obtained a COVID-19 vaccine over time by HPV vaccination status. RESULTS: We identified 40,819 adolescents; 65% had received any COVID-19 vaccination, and 79% had received any HPV vaccination. Adolescents who had initiated HPV vaccination had about 4-fold greater odds of having obtained a COVID-19 vaccine than those who had not (odds ratio = 4.02, 95% confidence interval = 3.81, 4.24). DISCUSSION: Patterns of vaccination uptake suggest possible advantages to co-promotion of adolescent vaccines.

Successful Multi-Level HPV Vaccination Intervention at a Rural Healthcare Center in the Era of COVID-19.

Objectives: To develop and test a human papillomavirus (HPV) vaccination intervention that includes healthcare team training activities and patient reminders to reduce missed opportunities and improves the rate of appointment scheduling for HPV vaccination in a rural medical clinic in the United States. Methods: The multi-level and multi-component intervention included healthcare team training activities and the distribution of patient education materials along with technology-based patient HPV vaccination reminders for parents/caregivers and young adult patients. Missed vaccination opportunities were assessed pre- and post-intervention (n = 402 and n = 99, respectively) by retrospective chart review and compared using Pearson χ2. The patient parent/caregiver and young adult patient population (n = 80) was surveyed following the reminder messages and penalized logistic regression quantified unadjusted odds of scheduling a visit. Results: Missed opportunities for HPV vaccination declined significantly from the pre-intervention to the post-intervention period (21.6 vs. 8.1%, respectively, p = 0.002). Participants who recalled receipt of a vaccination reminder had 7.0 (95% CI 2.4-22.8) times higher unadjusted odds of scheduling a visit compared with those who did not recall receiving a reminder. The unadjusted odds of confirming that they had scheduled or were intending to schedule a follow-up appointment to receive the HPV vaccine was 4.9 (95% CI 1.51-20.59) times greater among those who had not received the vaccine for themselves or for their child. Conclusions: Results from this intervention are promising and suggest that vaccination interventions consisting of provider and support staff education and parent/caregiver and patient education materials, and reminders can reduce missed opportunities for vaccinations in rural settings.