Quality of Web-Based Educational Interventions for Clinicians on Human Papillomavirus Vaccine: Content and Usability Assessment

Abstract

BackgroundHuman papillomavirus (HPV) vaccination rates fall far short of Healthy People 2020 objectives. A leading reason is that clinicians do not recommend the vaccine consistently and strongly to girls and boys in the age group recommended for vaccination. Although Web-based HPV vaccine educational interventions for clinicians have been created to promote vaccination recommendations, rigorous evaluations of these interventions have not been conducted. Such evaluations are important to maximize the efficacy of educational interventions in promoting clinician recommendations for HPV vaccination.ObjectiveThe objectives of our study were (1) to expand previous research by systematically identifying HPV vaccine Web-based educational interventions developed for clinicians and (2) to evaluate the quality of these Web-based educational interventions as defined by access, content, design, user evaluation, interactivity, and use of theory or models to create the interventions.MethodsCurrent HPV vaccine Web-based educational interventions were identified from general search engines (ie, Google), continuing medical education search engines, health department websites, and professional organization websites. Web-based educational interventions were included if they were created for clinicians (defined as individuals qualified to deliver health care services, such as physicians, clinical nurses, and school nurses, to patients aged 9 to 26 years), delivered information about the HPV vaccine and how to increase vaccination rates, and provided continuing education credits. The interventions’ content and usability were analyzed using 6 key indicators: access, content, design, evaluation, interactivity, and use of theory or models.ResultsA total of 21 interventions were identified, out of which 7 (33%) were webinars, 7 (33%) were videos or lectures, and 7 (33%) were other (eg, text articles, website modules). Of the 21 interventions, 17 (81%) identified the purpose of the intervention, 12 (57%) provided the date that the information had been updated (7 of these were updated within the last 6 months), 14 (67%) provided the participants with the opportunity to provide feedback on the intervention, and 5 (24%) provided an interactive component. None of the educational interventions explicitly stated that a theory or model was used to develop the intervention.ConclusionsThis analysis demonstrates that a substantial proportion of Web-based HPV vaccine educational interventions has not been developed using established health education and design principles. Interventions designed using these principles may increase strong and consistent HPV vaccination recommendations by clinicians.

Quality Evaluation Tool for Clinician Online Continuing Medical Education

“…The existence and use of a quality evaluation tool for online interventions aimed at CME for clinicians could increase confidence and cost-effectiveness in these interventions to meet minimum health communication and design principles to enhance clinicians' practices and communication with patients, as well as identify the strengths and weaknesses of online CME. While this tool does not provide assessment information on the unintended consequences or whether the learners' needs were met, the tool is a starting point to evaluate, at a minimum, costeffectiveness, strengths, and weaknesses (Rosen et al, 2018). By shedding light on the absence of these principles and creating a tool to evaluate online interventions, a stronger push can be made for CME developers to utilize these principles to develop quality continuing education opportunities.…”

“…This coefficient provides information on the reliability of variables by counting pairs of scale points assigned by coders, treating coders as freely volatile, and delivering robust calculations not impacted by sample size, multiple coders, or missing data (Hayes & Krippendorff, 2007). Two independent coders (two of the authors) used the first draft of the tool to code a sample of CME interventions focused on HPV and HPV vaccination (further details about how these interventions were selected can be found at (Rosen, Bishop, McDonald, Kahn, & Kreps, 2018). Thirteen of the twenty-three subindicators were considered internally reliable with K-alpha coefficients > 90%.…”

“…Two subindicators were considered to be irrelevant after the first round of coding and were removed from the tool (e.g., evaluation sub-indicator, "Statement on how the program is evaluated for effectiveness"). After the tool was revised, the two independent coders conducted another round of coding with an additional sample of interventions (Rosen et al, 2018). After calculating Kalpha coefficients for the second round of coding, the evaluation tool was considered to be internally reliable given all indicator scores were above .80, which is considered the norm for acceptable reliability (De Swert, 2012).…”

Quality Assessment of Websites Providing Information on Human Papillomavirus Vaccines in Thailand

“…There are various approaches that can be used to determine the quality of websites (Craigie et al, 2002;Hargrave et al, 2006;Tozzi et al, 2010;Irwin et al, 2011, Rosen et al, 2018. This study applied the criteria proposed by the WHO GACVS as a tool for evaluating the quality of the retrieved websites, which is an internationally accepted standard for assessing the quality of websites that provide information related to vaccination.…”

“…Several strategies for assessing the quality of the websites providing healthcare information have been proposed in several previous studies (Craigie et al, 2002;Hargrave et al, 2006;Tozzi et al, 2010;Irwin et al, 2011, Rosen et al, 2018. The World Health Organization (WHO) has concerned the quality of the website in providing health information which can influence the success of health promotion strategies, particularly with regard to vaccination programs.…”