Sam Wakim, Rina Ramirez
Background: There is a quiet epidemic in the cancer world. It is oral cancer in middle-aged men. [1,2]. The cases of oropharyngeal cancer linked to human papillomavirus (HPV) infection are steadily rising, and outpacing the rate of HPV infection-related cervical cancer . HPV is the most prevalent sexually-transmitted infection (STI), affecting 79 million Americans, most in their late teens and early twenties. HPV can be prevented with a series of vaccines administered to male and female children, starting as early as age nine [4-7]. Preventing HPV may also result in preventing up to six types of HPV-related cancer, including oral cancer [8-10].
Methods: Zufall Health Center’s Project Aim integrated dental and medical teams for a collaborative program to prevent oral cancers by increasing the HPV vaccination rates of our young patients. Working with an original medical/dental cohort of 900 male and female patients ages nine to eighteen, our project goal was to improve our immunization rate 10% by January 1, 2020.
Zufall’s Project Aim was implemented by eight Community Dental Health Coordinators (CDHCs) using the PDSA improvement model. Project objectives included engaging patients using Motivational Interviewing; communicating oral cancer risk to families; improving HPV vaccination completion rates; enhancing patient follow-up; monitoring and reporting immunization rates; improving operational performance; and maintaining process improvements.
Results: Project Aim exceeded its program goal, significantly improving the Centers’ immunization rate: from 12% at project start to 31.08% by January 2020.
Conclusion: To our knowledge, we accomplished a first-of-its-kind project. There has been no data that showed improvement on HPV vaccination rates as a result of dental interventions. By changing our workflow, integrating our medical and dental homes, and empowering our CDHCs to lead the integrated effort and promote vaccination, we achieved significant improvement in HPV immunization rates in our young patients.View pdf