Abstract B047: PC TEACH, a cancer prevention intervention: Assessing the implementation and adoption of evidence-based strategies to increase human papillomavirus (HPV) vaccination delivery in rural primary care settings

Abstract Background: In the United States, the incidence of HPV associated cancers has been increasing disproportionately in rural compared to urban areas, which is also where HPV vaccination (HPVV) rates remain significantly low among adolescents. There are effective evidence-based strategies to improve HPVV in clinical practice; however, few interventions have targeted community-based primary care private practices serving rural populations. To address this gap, we developed an implementation science focused intervention to increase adolescent HPVV (PC TEACH) that considers community, culture, and health systems as upstream factors using a practice facilitation approach. Methods: Community-based primary care practices located in Central and Western New York that administer adolescent vaccines and were willing to share aggregate practice and patient-level data were randomly recruited into a stepped-wedge design with 4 waves of implementation of PC TEACH, a customizable practice-level intervention. Mixed-methods approaches including in situ observations, monthly structured calls, and visits with the office champion using audit and feedback, as well as clinical coaching interaction notes over a 12-month period, were used to evaluate implementation and adoption of PC TEACH strategies. PC TEACH strategies include T (team huddles); E (execute standing orders); A (adolescent girls and boys recommended HPV vaccination starting at age 9); C (cancer prevention approach); H (HPV vaccine, same way, same day). Document analysis of routinely collected process materials was conducted to assess the adoption of PC TEACH strategies. Descriptive statistics were calculated to assess and compare frequency and distribution of intervention strategies implemented by practices across the waves as well as to describe practice level characteristics. Results: Our recruitment goal to enroll 16 practice sites across the 4 waves with 4 practices in each wave was met. As of February 2025, the study team has conducted baseline visits for all 16 enrolled practices and upward of 115 follow-up visits. In addition, we have collected 193 provider and staff surveys, and 120 visual office surveys. Preliminary findings from practices enrolled in waves 1 and 2 show that all practice sites implemented the A (Adolescent girls and boys recommended HPV vaccination starting at age 9), C (Cancer prevention educational brochures provided for families), and H (HPV vaccine, same way, same day) strategies. There was variability across practices in the implementation of the T (team huddles) and E (execution of standing orders) strategies. Conclusions: A structured approach to collect mixed-methods data from participating practice sites supports and allows for the rigorous evaluation of implementation and adoption of PC TEACH strategies by community-based primary care private practices. This data provides us with detailed process information on barriers to implementation of practice-based HPVV strategies and inform future dissemination. Citation Format: Elisa M. Rodriguez, Emily Foschio, Tunazzina Kaijar, Ann M. Abdella, Kayla Catalfamo, Kathryn Glaser, Dennis Z. Kuo, Jill A. Marsteller, Michael Pease, Nicolas F. Schlecht. PC TEACH, a cancer prevention intervention: Assessing the implementation and adoption of evidence-based strategies to increase human papillomavirus (HPV) vaccination delivery in rural primary care settings [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B047.