Minnesota Department of Health

Partners and Programs in the Spotlight

Even before becoming a Prevention and Public Health Fund (PPHF) awardee, the Minnesota Department of Health (MDH) used several low-cost strategies to improve HPV vaccination rates.

Using ordering data from the Vaccines for Children (VFC) program, MDH identified practices with low ordering rates and sent letters to these practices with strategies for increasing HPV vaccine uptake. The MDH Comprehensive Cancer Control Program matched funds to provide a stipend to clinics participating in MDH’s adolescent reminder/recall project. Working with the Minnesota State High School League allowed them to change exam forms for physicals to include HPV and meningococcal vaccines.

“Our approach to improving HPV vaccine coverage has stayed the same, but PPHF funding has allowed us to expand our activities,” said Denise Dunn, head of the MDH immunization program’s Education and Partnerships Unit.

Minnesota uses a five-pronged approach to improve HPV vaccination rates. They have formed a stakeholder group with cancer groups, local public health agencies, tribal health organizations, and other partners; launched a public awareness campaign; implemented clinician education; used assessment and feedback to alert practices of their low HPV vaccination rates; and employed reminder-recall systems.

MDH’s public awareness campaign uses a combination of traditional face-to-face interaction and innovative digital marketing tactics. MDH set up tables at the Minnesota State Fair and at state high school sports tournaments to interact with adolescents and their families and educate them on the importance of getting HPV vaccine at the recommended ages.

They are running digital ads through the Star Tribune, Minnesota’s largest newspaper, which employs cutting-edge web analytics to allow for more effective targeting. MDH has also used culturally and ethnically diverse media outlets to place ads, PSAs (including CDC PSAs), and articles about HPV and other adolescent vaccines.

“It’s important to normalize HPV vaccine,” said Dunn. “Parents are more receptive to getting the HPV vaccine for the child when it’s presented as a routine vaccine that prevents a serious disease, much like Tdap and meningococcal vaccines.”

They use a similar pattern for clinician outreach with a combination of lecture tours for an in-person experience and an online webinar to reach a broader audience. One of the more unique aspects of the clinician education component is that MDH has developed a humorous, educational video distinguishing an effective recommendation from an ineffective recommendation.

“We thought this video would be a fun and instructive way to educate clinicians on how to recommend HPV vaccine,” said Lisa Randall, a policy specialist at MDH. “The video offers realistic scenarios to show how easy a recommendation for HPV vaccine can be.”

Clinicians are the most trusted source of health information for parents. Research has shown that a strong recommendation from a healthcare professional is crucial to whether or not parents get HPV vaccine for their son or daughter.

Assessment, Feedback, Incentives, eXchange, more commonly known as AFIX, allows MDH to show practices the data on their HPV vaccination rates and suggest methods for raising those rates.

As part of their reminder-recall project, MDH has sent postcards to the families of all 11- and 12-year-olds in Minnesota informing them of the importance of adolescent vaccines. In some parts of the state, they also sent personalized letters to parents of teens, providing more detailed information on the importance of preteen vaccines and listing each teen’s immunization needs. In other areas, they sent autodialed phone reminders.

Regardless of the channel or format, MDH hopes to convey the same message: HPV vaccine is cancer prevention.

More information on MDH’s adolescent immunization initiative.