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