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Table 1 Summary of distinguishing factors for completion of HPV vaccine series by 13th birthday characterized using the CFIR(1)

From: Theory-based development of an implementation intervention to increase HPV vaccination in pediatric primary care practices

CFIR domain Construct Effect
Intervention characteristics Relative advantage—at age 11–12 (increased immunogenicity, completion of series before risk, access to at-risk population) Facilitator
Adaptability—use older age of initiation Barrier
Outer setting Patient needs and resources—optional as not mandated by school Barrier
Peer pressure Barrier
External policy and incentives—financial incentives for series completion, e.g., meaningful use Facilitator
Inner setting Networks and communication—communication to coordinate implementation of 3 doses across staff and providers Facilitator
Readiness for implementation—leadership engagement in system level improvements and use of available resources, e.g., EMR alerts, outreach calls Facilitator
Characteristics of individuals Knowledge and beliefs—perceive value to completing by age 13 Facilitator
Knowledge and beliefs—perceive value to bundling Facilitator
Self-efficacy—confident to strongly recommend vaccine and to convince hesitant parents Facilitator
Self-efficacy—enthusiastic about HPV vaccine Facilitator
Readiness to change—has made personal efforts for improvement Facilitator
Process Planning—discuss/implement changes for increased vaccine use Facilitator
Engaging—involve staff in meaningful problem-solving Facilitator
Executing—strong recommendation, routinely provide at age 11/12, bundle 3 vaccines Facilitator
Reflecting and evaluating—with a view to making changes Facilitator
  1. CFIR Consolidated Framework for Implementation Research