going to show HPV the door AIM Call to Action February 18, 2014 Heather Hirsch Denise Dunn

Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Joint letter from Minnesota Cancer Alliance and Minnesota Department of Health Sent to 253 clinics identified via VFC ordering records Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback Enclosures

Minnesota Cancer Alliance Strategy: HPV Vaccine added to Cancer Plan HPV Vaccine was added to the Policy Agenda (2011) HPV was identified as an MCA Steering Committee priority 2011/12 The workgroup chartered by the steering committee is developing a work plan aimed at changing the message around HPV; moving away from HPV as an STD and framing the conversation around cancer prevention. Strategy includes recruiting physicians to: -Write editorials in provider publications -Host provider education webinars -Conduct clinic visits Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback About Minnesota Community Measurement Mandatory per state law Results reported to public Measures chosen by committee Arguments for an HPV measure Similar to HEDIS measure but would include males Easy to measure via IIS Likely an indicator of other best practices Current status Minnesota Cancer Alliance (MCA) advocated for a measure in 2011, but was not selected MCA has drafted a letter outlining the measure and is recruiting support from member organizations Letter will be submitted to the Division of Health Policy in April 2014

Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback Prevent Cancer Foundation grant -MCA received $10,000 grant -Project began in January 2014 Partners: American Indian Cancer Foundation, Fond du Lac Comprehensive Cancer Control Program, MN WI Intertribal Cancer Council Purpose -develop and test culturally specific mailing and educational materials for HPV vaccinations to be used in MN American Indian populations -distribute the educational materials and reminder mailings, through clinics and AI serving organizations -Working with IHS to get data on HPV vaccination rates from tribal clinics

Old Minnesota State High School League physical assessment form: New language (adds MCV4 and HPV): Newer language (no distinction between recommended and required): Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback Adolescent assessment summary report Measures: Tdap MCV4 (1 st & booster) HPV (1 st, 3 rd, series completion) Missed opportunities (to be added) Tdap, MCV4, and HPV client followup capacity added to IIS

Reminder-recall project participants Suburban pediatric practice Greater Minnesota family practice Combined adolescent cohort ~19,000 Status One first round complete, one nearly complete Challenges Data quality Clinic staff turnover Lessons so far Patients respond enthusiastically Clinics are willing to use IIS reminder-recall tools after demonstrations Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback Goals Increase providers comfort in recommending HPV Suggest easy, realistic responses to common questions/hesitations Show, not tell Model CASE method Use in PPHF provider education project Status Shooting footage this week Considering editing strategies Panel of pediatrician & family physician reviewers

Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Statewide reminders Parents of 11- and 12-year-olds (~123,000) Addresses from IIS with Westlaw updates Regional reminders To adolescents due for any dose of HPV 2 more rounds to 11- and 12-year-olds 3 rounds to 13- through 17-year-olds Message is about full adolescent platform In 2 out of 7 IIS administration regions Addresses updated via Westlaw Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Digital displays at high school sports events 29 metro-area high schools (high attendance games) Look and feel of postcards Minnesota State High School League 2014 state tournaments: boys & girls basketball, boys & girls hockey, wrestling, football Program print ads, exhibits, PA announcements PSAs during TV broadcasts of tournament games Close the Door to Cancer (CDC) Banner ads on TV station website Diverse media placements Radio PSAs in Hmong, Khmer, Vietnamese, Oromo, Somali, Amharic, Spanish, and Tagalog Print materials for American Indian, Spanish- speaking, Hmong, African-American, and African-born (Somali, Liberian, Ethiopian) audiences Often get more than we pay for Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Digital displays at high school sports events 29 metro-area high schools (high attendance games) Look and feel of postcards Minnesota State High School League 2014 state tournaments: boys & girls basketball, boys & girls hockey, wrestling, football Program print ads, exhibits, PA announcements PSAs during TV broadcasts of tournament games Close the Door to Cancer (CDC) Banner ads on TV station website Diverse media placements Radio PSAs in Hmong, Khmer, Vietnamese, Oromo, Somali, Amharic, Spanish, and Tagalog Print materials for American Indian, Spanish- speaking, Hmong, African-American, and African-born (Somali, Liberian, Ethiopian) audiences Often get more than we pay for Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Provider education On-demand webcast, 5 lectures, 10 clinic visits CME credit available Assessment & feedback Quality improvement planning at clinic visits Webinar followup after adolescent AFIX visits Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback

Contact Denise Dunn (651) MDH Immunization Program Heather Hirsch (651) MDH Comprehensive Cancer Control Program Lisa Randall (651) MDH Immunization Program Symposium presentation Joint letters Provider framing campaign Minnesota Community Measure Culturally appropriate educational materials Athletic physical form Adolescent reminder- recall Provider videos PPHF grant Stakeholder engagement Reminder-recall Public awareness Provider education Assessment & feedback