Local Health Department Interest in Implementation of a Jail-Based Human Papillomavirus Vaccination Program in Kansas, Iowa, Missouri, and Nebraska

J Public Health Manag Pract. 2020 Mar/Apr;26(2):168-175. doi: 10.1097/PHH.0000000000001021.

Abstract

Context: Local health departments (LHDs) play a vital role in community vaccination programs for human papillomavirus (HPV) infection, but little research has been done to assess LHD interest in cross-sectoral partnerships to vaccinate high-risk groups, specifically incarcerated persons.

Objective: To describe factors associated with interest in a novel implementation strategy linking LHDs with jails in 4 Midwestern states to deliver HPV vaccine.

Design: Survey based on the Consolidated Framework for Implementation Research (CFIR) model given to LHD administrators. A modified Poisson relative risk regression was used to assess the relationship between independent variables and LHD interest in implementation of a jail-based HPV vaccination program.

Setting: LHDs in Kansas, Missouri, Iowa, and Nebraska.

Participants: From September 2017 to April 2018, two-thirds (237/344) of invited LHD administrators from the 4 states responded to the survey.

Main outcome measure: LHD interest in implementation of a jail-based HPV vaccination program.

Results: Forty-five percent of LHDs were interested in learning more about implementing a jail-based HPV vaccination program, and 2% already offered or had plans to offer HPV vaccine in their jails. Barriers to implementation were cost (66%), inmates' short incarcerations (47%), and availability of medical staffing (43%). LHD characteristics associated with interest in implementation of a jail-based HPV vaccination program included "inner setting" CFIR variables, which capture the structural and cultural context for program implementation: 7 or more employees (odds ratio [OR] = 2.22; 95% confidence interval [CI], 1.24-3.95), perception of importance to provide HPV vaccine in jails (OR = 3.70; 95% CI, 2.00-6.84), and already providing any vaccines in jails (OR = 2.62; 95% CI, 1.18-5.80).

Conclusions: Nearly half of LHDs in the region expressed interest in partnering with local entities to meet HPV vaccination needs of high-risk groups. Research on cross-sectoral partnerships and what these collaborations look like in practice is needed for public health impact.

MeSH terms

  • Cross-Sectional Studies
  • Humans
  • Iowa
  • Kansas
  • Local Government*
  • Missouri
  • Nebraska
  • Papillomavirus Infections / prevention & control
  • Papillomavirus Vaccines / administration & dosage
  • Papillomavirus Vaccines / therapeutic use*
  • Prisons / statistics & numerical data*
  • Public Health / methods*
  • Public Health / statistics & numerical data

Substances

  • Papillomavirus Vaccines