1. The Effects of a Media Campaign on Human Papillomavirus Vaccine Coverage Rates in Alaska Lyndsey “Sarah” Mixson Public Health Associate Office for State, Tribal, Local and Territorial Support Centers for Disease Control and Prevention 2015 PHAP Class Summer Seminar May 17, 2016 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support

2. Significance of Human Papillomavirus to Public Health  Every year in the United States 27,000 people are diagnosed with a cancer caused by HPV  That’s one case every 20 minutes http://www.cdc.gov/cancer/hpv/statistics/cases.htmhttp://www.cdc.gov/cancer/hpv/statistics/cases.htm, http://dhss.alaska.gov/dph/Epi/iz/Pages/hpv/default.aspxhttp://dhss.alaska.gov/dph/Epi/iz/Pages/hpv/default.aspx

3. Background  Alaska Immunization Program  Utilized Prevention and Public Health Fund grant funding to increase HPV Vaccination rates Initial Period: 15 Months (August 2014- October 2015) o No-cost extension granted to complete activities by June 2016 http://dhss.alaska.gov/dph/Epi/iz/Pages/hpv/default.aspx

4. 2013 and 2014 PPHF HPV Immunization Awardees 2013 Awardees Minnesota Massachusetts New York New York City Philadelphia District of Columbia Ohio Chicago Georgia Utah Arizona Abbreviations: PPHF = Prevention and Public Health Fund; HPV = Human papillomavirus 2014 Awardees Washington North Dakota Michigan Wisconsin Rhode Island Illinois Iowa Kentucky Kansas Nevada Alaska

5. Alaska Stakeholders  Alaska Native Tribal Health Consortium  Anchorage Neighborhood Health Center  Arctic Investigations Program, CDC  State of Alaska Division of Public Health Cancer Prevention & Control Programs Immunization Program Public Information Office Public Health Nursing Women, Children, Family Health (Adolescent and School Nurse Program)  Municipality of Anchorage Health Department  American Academy of Pediatrics- AK Chapter  Anchorage School District Health Services Div.  Vaccinate Alaska Coalition

6. Three-Phased Approach  First Phase  Implement strategies targeted to immunization providers  Second Phase  Implement a comprehensive communication campaign targeted to the public  Third Phase  Implement immunization information system (IIS)-based reminder/recall for adolescents aged 11-18 years;

7. Three-Phased Approach  First Phase  Implement strategies targeted to immunization providers  Second Phase  Implement a comprehensive communication campaign targeted to the public  Third Phase  Implement immunization information system (IIS)-based reminder/recall for adolescents aged 11-18 years;

8. Media Campaign  Goal: Reach young people and their parents via traditional mass media to promote the HPV vaccine and initiate behavior change  Primary target: “Household decision makers” women 30-45 with children  Secondary target: Adults 30-45, pre-teens and teenage children, grandparents  Reach: Statewide, major urban areas, rural areas  Campaign schedule: 12 weeks (July-September)  Mediums: Video PSA’s, Radio ads, internet ads

9. Commercial https://vimeo.com/129940096

10. Alaska: the Last Frontier  Alaska’s Population: 736,732 people  Anchorage : 300,950  Juneau : 32,660  Fairbanks : 32, 324  Media Market  TV  Cable  Radio www.usmarshals.gov/district/ak/general/information.htmwww.usmarshals.gov/district/ak/general/information.htm, www.quickfacts.census.govwww.quickfacts.census.gov

11. Methods  Alaska Immunization Information System (VacTrAK)  December 2013, all health care providers required to report administered immunizations to VacTrAK within 14 days  VacTrAK records were assessed for percent change in vaccination rate amongst targeted age groups  Females and males  Age 13 through 18 years old  Before (April 31) and after campaign (December 31)  Initiated (one dose) and Completed (three doses) vaccine series

12. Results: Female  Before Campaign  Female 42% (n= 9,781) initiated 30% (n= 6,993) completed

13. Results: Female  Before Campaign  Female 42% (n= 9,781) initiated 30% (n= 6,993) completed  After Campaign  Female 51% (n=12,009) initiated 32 % (n=7,604) completed

15. Results: Male  Before Campaign  Male 29% (n=7,039) initiated 16% (n=3,763) completed

16. Results: Male  Before Campaign  Male 29% (n=7,039) initiated 16% (n=3,763) completed  After Campaign  Male 42% (n=10,377) initiated 21% (n=5,038) completed

18. Conclusion  Human papillomavirus vaccination among targeted age groups increased in Alaska following a statewide media campaign  Causation could not be determined without a formal media campaign evaluation. http://www.ncbi.nlm.nih.gov/pubmed/21050999

19.  Social Media Campaign and Internet Ads  Alaska Dispatch News, KTUU, Facebook  Reminder-recall will be implemented to ensure that those who initiated the HPV vaccine series complete it.  Children 11-18 years of age due for at least one dose of HPV vaccine Looking Forward

20. For more information, please contact CDC’s Office for State, Tribal, Local and Territorial Support 4770 Buford Highway NE, Mailstop E-70, Atlanta, GA 30341 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: OSTLTSfeedback@cdc.govWeb: http://www.cdc.gov/stltpublichealthOSTLTSfeedback@cdc.govhttp://www.cdc.gov/stltpublichealth The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Lyndsey “Sarah” Mixson, BS Public Health Associate CDC/OSTLTS/PHAP 3601 C Street, Suite 540 Anchorage, AK 99503 (907) 334-0856 kzv0@cdc.gov Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support