The Vaccine Champion Intervention (old)

Our intervention is designed to improve HPV vaccine communication and coverage by engaging healthcare systems’ own vaccine champions. Our intervention trains vaccine champions to deliver the Announcement Approach Training (AAT) to primary care clinics in their system, while also helping them leverage other QI resources to increase HPV vaccination rates.

Benefits of the Vaccine Champion Intervention

Vaccine champions offer a readily available resource to scale up the AAT. The benefits of our intervention’s assets-based approach are to:

Include a diversity of healthcare system staff

Vaccine champions can be found throughout healthcare systems and often include clinical staff with a range of training. Advanced Practice Providers, nurses and Medical Assistants, as well as QI staff and physicians, can be very effective champions and can represent the staff and patients of the clinics they work with.

Increase healthcare system capacity

Our intervention helps healthcare systems identify and invest in their existing vaccine champions to increase their capacity to improve vaccination services.

Improve HPV vaccine uptake

As healthcare system “insiders,” vaccine champions are well-positioned to deliver the AAT and other evidence-based interventions to primary care clinics in their system. They can use their knowledge of the local context to optimize intervention acceptability and participation.

Maximize sustainability

Unlike external facilitators, vaccine champions remain in their healthcare system after the formal intervention period is over to provide continued support.

Evidence for Vaccine Champion Intervention

Vaccine champions are healthcare professionals known for helping improve vaccination rates by influencing their colleagues’ attitudes, beliefs, and behaviors.

Success story:

“The project was a really great success within [our health system]. We had great staff engagement, and the communication approach taught in the training was very easy for our staff to use. It didn’t slow down the rooming process and fit in with the workflow. Since the trainings, we’ve been seeing improvements in HPV vaccination rates that add up to an additional 250-350 vaccines per month.”

Our research shows that vaccine champions can be an effective resource for increasing HPV vaccination. Vaccine champions:

Are common in primary care. Most primary care professionals with a role in adolescent vaccination work with at least one champion. Some work with many more! (Brewington et al., 2024)
Work in a variety of roles. Vaccine champions can be physicians, nurses, advanced practice providers or medical assistants. A champion’s professional degree is less important than their interest in improving adolescent vaccination and their close working relationship with colleagues. (Heisler-MacKinnon et al., 2024)
Support their colleagues. Primary care professionals help their colleagues improve in different ways. Some take a more active role in leading quality improvement (QI) projects to improve vaccination rates. Other champions facilitate improvement by sharing information, encouragement, and vaccination data with their team. (Kennedy et al., in the works)
Have relevant experience and a passion for improvement. Primary care professionals report that the most effective vaccine champions have clinical experience and use many different strategies to improve vaccination rates. (Heisler-MacKinnon et al., 2024)

Identifying Vaccine Champions

Look for staff who:

have clinical experience.
work closely with many people on the team or across teams.
are passionate about improving vaccination.
are known in the clinic or healthcare system for working on vaccine improvement.
work in different roles within clinics and the healthcare system (for example, nurses, advance practice providers, QI specialists, and physician leads).
have the time to devote to vaccine improvement projects.

Program Format

Virtual planning meetings with vaccine champions, AAT workshops in primary care clinics, and materials to support outreach and follow up with clinics.

Components

Preparation

Meetings with healthcare system leaders to build relationships, recruit clinics, and identify champions.
Facilitator orientation sessions to teach champions how to lead AAT workshops.
Champion debriefing meeting to review the role of a vaccine champion and talk through logistics of facilitating AAT workshops.

Champion-led AAT workshops

AAT workshop planning and preparation to schedule workshops and invite clinical staff.
AAT workshops in clinics to teach clinical staff the communication technique.
Optional AAT follow-up meeting led by champions to review the steps of the Announcement Approach and talk with clinic staff about barriers and supports to improving HPV vaccination.

Sustainability planning

Debriefing with champions about AAT workshops and discuss resources and barriers to HPV vaccine improvement in the healthcare system.
Setting goals with champions for sustained improvements.

Provided Materials

What makes the champion intervention a highly scalable strategy is that it requires few materials and resources. All of the needed materials have already been developed and are available to you at no-cost. Materials for this intervention include:

Healthcare system recruitment materials

Project information one-pager

sample description text

Project pitch slide deck

AAT Materials

AAT slide deck and script

AAT flyer

AAT presentation resources

Other Champion Meeting Materials

Planning logistics slide deck

Calendar invite template

Staff invitation email template

AAT workshop information flyer

QI resources in the healthcare system slide deck

AAT follow-up meeting slide deck (optional)

Sustaining improvements slide deck

Fidelity checklist

Needed Resources

The most important resource needed for the champion intervention is protected time and support for champions. Champions will need time to:

meet with project staff 4 times.
attend a facilitator orientation session.
practice delivering the AAT.
schedule workshops and invite clinic staff.
lead AAT workshops.
host optional follow-up meetings with clinics.

Additionally, clinics will need meeting space and AV equipment (such as a projector and screen to show the AAT slides) to host a training. Champions may also need technical assistance and support to manage AV equipment during AAT workshops. Clinic staff need protected time to attend AAT workshops and support for using the AAT communication approach.

Methods to Implement the Vaccine Champion Intervention

Recruit systems and clinics

Recruit healthcare systems through professional networks and adolescent vaccination related events, using the project information one pager and the project pitch slide deck.
Secure buy-in from system leaders, using the project pitch slide deck.
Recruit clinics to participate in AAT workshops. Health system and QI leaders identify target clinics and secure buy-in from clinic managers. They may want to use the project one-pager or pitch slide deck.

Identify and prepare champions

Identify champions who will lead AAT workshops. QI and health system leaders identify who will coordinate with project staff and who will be trained to facilitate AAT workshops.
Train champions in an AAT facilitator orientation session. Champions learn how to lead AAT workshops in their own clinics, using the facilitator orientation slides and script and presentation resources.
Project staff meet with champions to debrief about the facilitator orientation, answer questions, and discuss logistics, using the planning logistics slide deck.
Champions practice delivering the AAT at least twice, using the AAT slides and script.

Host AAT workshops

Schedule AAT workshops in primary care clinics. Project staff work together with champions to schedule workshops at a time convenient for most clinical staff to attend.
Invite clinical staff to attend workshops using the calendar invite template, staff email template, and AAT workshop flier.
Champions lead AAT workshops in clinics, using AAT slides, script, handouts, and presentation resources, with support from a training assistant.
Conduct evaluations with clinical staff attending AAT workshops. Clinical staff complete pre- and post-workshop evaluation surveys so they can claim continuing education credits. Healthcare systems may also want to use the workshops as part of a Maintenance of Certification (MOC) project.

Plan for sustained improvement

Project staff meet with champions to debrief about AAT workshops and talk about QI resources within the healthcare system, using the QI resources in the healthcare system slide deck.
Champions optionally meet with clinics 4-6 weeks after the AAT workshop to talk about overcoming barriers to using the Announcement Approach and ways to support changes in the clinic, using the AAT follow-up meeting slide deck.
Project staff meet with champions to talk about sustaining HPV vaccine improvements in the healthcare system, using the sustaining improvements slide deck.
Conduct follow-up evaluations with clinical staff who attended AAT workshops two months later to measure changes in HPV vaccine attitudes, intentions, and use of presumptive announcements. Champions may also choose to evaluate changes in HPV vaccination rates in participating clinics.

Ways to Maximize Success

Secure protected time for champions’ work. Vaccine champions are busy professionals who juggle many competing demands in the fast-paced and unpredictable environment of primary care. Even the most passionate champions may decline to participate in HPV vaccine QI efforts if they do not have institutional support in the form of protected time for their work.
Engage multiple types of vaccine champion. Our intervention first requires leadership buy-in from an administrative champion who is authorized to agree to the project and commit staff time and other organizational support. Next, operational champions familiar with clinics’ day-to-day operations are needed to schedule and deliver AAT workshops. Ideally, frontline champions are also available within participating clinics to offer support or deliver AAT workshops.
Plan for staff turnover, burnout, and disruptions. Interventions that seek to engage champions can navigate these challenges by planning intervention activities in the late winter when flu season is winding down, engaging teams of champions to allow for some redundancy in roles and making intervention activities as positive and efficient as possible to respect champions’ time and contributions.
Provide ongoing technical assistance. Our vaccine champions have expressed appreciation for technical assistance, including AAT practice sessions, FAQ guides and tip sheets, and check-in meetings.
Develop collaborative partnerships. Partnering with organizations to meet project goals and fill gaps in expertise can be crucial to success. We partnered with a large state-wide quality collaborative that maintains close relationships with member healthcare systems to recruit systems and connect to decision makers. Other potential partners could be national organizations or state-wide vaccination coalitions that have existing relationships with healthcare systems.