LAUSR

CONTEXT Provider-based human papillomavirus (HPV) vaccine promotion interventions have been widely implemented; however, the effectiveness of these approaches is unclear. OBJECTIVES This systematic review assessed the effects and costs of provider-based interventions designed to increase HPV vaccination coverage. A meta-analysis was conducted to estimate pooled effect sizes of the interventions. DATA SOURCES We searched PubMed, Medline, Embase, and the Cochrane Library. STUDY SELECTION We identified articles on provider-based HPV vaccine promotion interventions published in English between 2007 and 2021. DATA EXTRACTION Information about the interventions' effects and costs was extracted from the studies. A meta-analysis was performed to estimate the pooled intervention effects, including changes in the HPV vaccine initiation rate, HPV vaccine completion rate, and the percentage of patients receiving the next needed dose. RESULTS We identified 32 studies of provider-based interventions to improve the HPV vaccination rate. The reported intervention strategies included provider training, provider reminders, and provider assessment and feedback. In the meta-analysis, we found significant improvements in the HPV vaccine initiation rate (3.7%) and the percentage of patients receiving the next needed dose (9.4%). LIMITATIONS Because of the limited number of studies, we were unable to compare the same outcomes between different provider-based approaches. We found the high heterogeneity across studies. The random effects method was applied to adjust for study heterogeneity, the heterogeneity remined high for certain outcomes. CONCLUSIONS Provider-based interventions were effective in improving HPV vaccination rates. Sustainability and continuous implementation are the central factors that contributed to intervention success.