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Improving HPV Vaccination Rates in Adolescents
Dissertation

Improving HPV Vaccination Rates in Adolescents

Katie Schleusner
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
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Abstract

Background: Human Papillomavirus (HPV) vaccination rates remain suboptimal among adolescents, particularly in rural populations, increasing the risk for preventable cancers. At the project site, HPV vaccination completion rates were as low as 6% among adolescents aged 12–13 years despite high uptake of other routine vaccines. Evidence-based recommendations support the use of reminder systems, including patient portal messaging and telephone outreach, as effective strategies to improve HPV vaccination initiation and completion rates among adolescents. Purpose: The purpose of this quality improvement project was to increase HPV vaccination series completion through targeted parental outreach using electronic and telephone-based reminders. Methods: This project utilized a Plan-Do-Study-Act (PDSA) framework in a rural primary care clinic. Eligible adolescents aged 12–13 years who had not initiated or completed the HPV vaccine series were identified through electronic medical record review. Parents were contacted via MyChart messages, postcards, and phone calls. Data were collected through chart audits at baseline and at multiple intervals over a six-month implementation period. Descriptive statistics and run charts were used to evaluate changes in vaccination rates. Findings: HPV vaccination completion increased from 6% at baseline to 23% at the final measurement, demonstrating a consistent upward trend over time. All identified families received outreach through at least one communication method, meeting project process goals. Discussion: Targeted, multimodal parental outreach using existing electronic health record tools was associated with improved HPV vaccination completion in a rural setting. These findings support the use of low-cost, sustainable reminder systems to reduce missed opportunities for preventive care. Future efforts should focus on long-term sustainability, improved tracking of outreach methods, and expansion of interventions to broader populations.
 HPV vaccination adolescents rural health quality improvement parental outreach immunization rates

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