{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:43:56Z","timestamp":1777859036425,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"University of Texas M.D. Anderson Cancer Center HPV Vaccination Initiative"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Strengthening provider recommendation is an effective strategy in increasing the human papillomavirus (HPV) vaccine uptake. A quality improvement (QI) initiative called \u201cCommunicating about HPV to Adults and Teens\u201d (HPV CHAT) was initiated to support providers with communication tools to discuss HPV vaccination with parents and patients. We described lessons learned for implementation of a clinic-based provider training for HPV vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>HPV CHAT was implemented in safety-net hospital clinics, practice-based research clinics, and federally qualified health centers between September 2021 and August 2023. Guided by the Plan-Do-Study-Act (PDSA) model, we retrospectively evaluated process improvements across 2 implementation cycles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall, 318 providers participated across the 2 cycles. Key activities in the first cycle included identification of clinic needs, development of asynchronous virtual training, advisory board feedback, recruitment communications via practice and clinic managers, and provider participation monitoring. Barriers included slow response to participation (58.3% response rate) and high turnover rate in some clinics. Results from the first cycle informed activities implemented in the second cycle. In the second cycle, participation rate was 60.6% and varied across settings due to strength of clinic collaborations and prior knowledge of the implementation process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The success of HPV CHAT underscores the need to proactively tailor interventions for clinical settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319261428038","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T04:47:06Z","timestamp":1773895626000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lessons Learned From the Implementation of a Clinic-Focused HPV Vaccination Initiative"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2993-2939","authenticated-orcid":false,"given":"Idara N.","family":"Akpan","sequence":"first","affiliation":[{"name":"University of North Texas Health Science Center, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2757-0877","authenticated-orcid":false,"given":"Grace","family":"Maynard","sequence":"additional","affiliation":[{"name":"University of North Texas Health Science Center, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6949-4932","authenticated-orcid":false,"given":"Rachel J.","family":"Meadows","sequence":"additional","affiliation":[{"name":"JPS Health Network, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5096-2983","authenticated-orcid":false,"given":"Kimberly G.","family":"Fulda","sequence":"additional","affiliation":[{"name":"University of North Texas Health Science Center, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5316-121X","authenticated-orcid":false,"given":"Divya A.","family":"Patel","sequence":"additional","affiliation":[{"name":"UTHealth Houston School of Public Health in Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2018-8501","authenticated-orcid":false,"given":"Aaron W.","family":"Gehr","sequence":"additional","affiliation":[{"name":"JPS Health Network, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3639-6647","authenticated-orcid":false,"given":"Yan","family":"Lu","sequence":"additional","affiliation":[{"name":"JPS Health Network, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0991-7361","authenticated-orcid":false,"given":"Sarah","family":"Matches","sequence":"additional","affiliation":[{"name":"University of North Texas Health Science Center, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Espinoza","sequence":"additional","affiliation":[{"name":"University of North Texas Health Science Center, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7115-0001","authenticated-orcid":false,"given":"Erika L.","family":"Thompson","sequence":"additional","affiliation":[{"name":"The University of Texas at San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000193"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.05208-11"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31821-4"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7012a2"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6832a3"},{"key":"e_1_3_3_7_2","unstructured":"Meites E Gee J Unger E Markowitz L. 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