PPHF 2016: Increasing HPV Vaccine Coverage by Strengthening Adolescent AFIX Activities, Financed in Part by 2016 Prevention and Public Health Funds

AFIX (Assessment, Feedback, Incentives, and eXchange) is a continuous quality improvement process informed by research and used for improving immunization rates and practices at the immunization provider level.

A key component of AFIX is a face-to-face interaction between AFIX staff and the provider

staff who are involved in immunization activities.

This interaction is important and unique in that it offers an opportunity for education, outreach, and consensus toward achieving improved immunization service delivery using quality improvement (QI) methods.

The AFIX process, once understood and implemented by providers, can assist practices in meeting immunization coverage goals for a variety of standards such as Healthy People 2020 and HEDIS (Healthcare Effectiveness Data and Information Set) measures, for example.

There is strong evidence that assessment and feedback, along with other elements such as incentives and exchange, are effective in increasing vaccination rates.

In 2008, the Task Force on Community Preventive Services updated its original 1999 literature review on the topic and reaffirmed its earlier recommendation of using assessment and feedback “based on strong evidence of its effectiveness across a range of settings and populations.” In addition, the task force recommends assessment and feedback in improving immunization rates in adults and children when used alone or with additional components (such as incentives).

This same review is cited in CDC’s Advisory Committee on Immunization Practices (ACIP) 2011 General Recommendations in its endorsement of assessment and feedback.

Adolescent HPV coverage rates remain unacceptably low, and adolescent-focused AFIX is underutilized.

Therefore, this is an opportunity to not only improve the number of visits but improve the quality of the intervention as well.

Preliminary results from the PPHF-funded HPV vaccination awardees, in addition to other recent AFIX activities, suggest that AFIX can be used to raise HPV vaccination coverage rates.

This current funding request will provide the opportunity for the AFIX process to work toward achieving both higher adolescent coverage rates and the Healthy People 2020 goals among the provider sites receiving an AFIX visit.

This funding request will ensure all AFIX visits are conducted as specified in the AFIX Policies and Procedures Guide; focus on low adolescent coverage rates which may include large health networks or individual sites with large patient populations to maximize impact; expand the rollout of existing adolescent AFIX strategies or implement new ones; increase the number of adolescent AFIX visits implemented and completed; and provide information as specified to evaluate both the process and outcome of selected AFIX activities via progress reports, online data, check-in calls, etc.

in an effort to improve the overall AFIX strategy.

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Additional Information of Eligibility:
Eligibility is limited to the current Immunization Program awardees under CDC-RFA-IP13-1301 "Immunization and Vaccines for Children Program" and that receive Vaccines For Children (VFC) funding.

Full Opportunity Web Address:

Aaron Borrellizvt3@cdc.gov

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Edited by: Michael Saunders

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