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Table 4 Interventions categorized by discrete implementation strategies in the expert recommendations for implementing change (ERIC)

From: Differences in stakeholder-reported barriers and implementation strategies between counties with high, middle, and low HPV vaccine initiation rates: a mixed methods study

Discrete implementation strategies

Quadrant

Highest rates

Middle rates

Lowest rates

Facilitate relay of clinical data to clinicians

Higher feasibility and higher importance (I)

   

 Keep records/check state immunization registry

X

X

X

Identify and prepare champions

   

 School nurses as HPV vaccine champions

X

X

X

 Survivor of HPV-related cancer

X

  

Conduct ongoing training

   

 Train pediatricians and clinic staff to communicate with parents

X

X

 

 Training school nurses to educate students

 

X

X

Distribute educational materials to stakeholders

   

 Utilize local library to pass out information about the vaccine

X

  

 Sending education materials to local vaccine health care clinicians

X

X

 

Prepare patients/consumers to be active participants

Lower feasibility and higher importance (IV)

   

 Deliver information to parents via schools

X

X

X

 Health educator at school talks to students

X

 

X

 HPV discussed in public school sex education

X

  

 Digital clinic waiting room sign information

X

X

 

 School nurses focus vaccine messaging on cancer prevention

 

X

X

Intervene with patients/consumers to enhance uptake and adherence

   

 Health fairs

X

X

X

 Promotional items and financial incentives

X

X

X

 Dentists educate patients on the links between HPV and oral cancer

X

X

X

 Reminder text message to parents

X

X

 

 School events with vaccines available

X

X

 

 Vaccines at family planning clinics

X

X

 

 Offering bus passes to patients

X

X

 

 Discuss vaccine at all health appointments

 

X

X

Alter patient/consumer fees

Lower feasibility and lower importance (III)

   

 Discount, sliding scale, or free

X

X

X

Use of mass media

   

 National TV advertisements from Merck

X

X

X

 Local advertising campaigns (e.g., newspaper, radio advertisements)

X

X

X