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AIM Adolescent Immunization Resource Guide

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Overview of activity
The Alaska Immunization Program formed a new HPV joint initiative workgroup to provide input on HPV PPHF grant activities and increase collaboration across partners related to increasing HPV immunization rates.

Background/impetus for the activity
The Alaska Immunization Program was awarded a 2-year HPV-specific PPHF grant (2014-2016) to increase HPV vaccination coverage among adolescents. As part of the activities specified in the grant, the Immunization Program initiated an HPV-focused stakeholder group.

Description of activity
The CDC grant materials provided suggestions for partners to invite when forming an HPV-focused stakeholder group, and the Immunization Program also included specific state and local agencies to address the unique needs of its jurisdiction.

Several meetings were held during the grant period, mainly by telephone, and the stakeholder group provided input and feedback on the content and format of several HPV-related activities including:
- Educational materials targeting immunization providers —
- A public media campaign, which included CDC materials that were adapted to the specific needs of the Alaska Immunization Program- and two videos with Alaskan residents
- A reminder/recall postcard (focused on HPV vaccine but including Tdap and MCV as well)

Role of Immunization Program and other agencies/groups involved

Partners in the stakeholder group include: the Alaska Native Tribal Health Consortium; the CDC Arctic Investigations Program; internal partners in the division of public health (cancer control and prevention, public information office, public health nursing, adolescent health, and school health); the Anchorage Health Department; the state chapter of the AAP, the Anchorage School District Health Services Division; the Vaccinate Alaska Coalition; the Alaska Area Health Education Center; the state chapter of the American Cancer Society; and Let Every Woman Know, a nonprofit gynecologic cancer group.

Alaska’s vast geographic area and signifcant Alaska Native/American Indian population bring unique immunization challenges. A few state-specifc and local partners on the stakeholder group help to address these challenges: 
- Anchorage School District: the largest school district in the state; administers vaccines and conducts special projects related to adolescent immunization (eg, offering vaccines to students during parent-teacher meeting times).
- Municipality of Anchorage Health Department: Anchorage is the largest population center in Alaska and is the only borough in the state with independent health powers.

- Alaska Native Tribal Health Consortium: a nonprofit tribal health organization that partners with the 13 tribes and tribal health organizations in the Alaska Native Health Care System to provide health care to the Alaska Native/American Indian population throughout the state, especially in the widespread rural areas. 
- Public Health Nursing: the services provided by this program, which is within the division of public health, include staffing a network of public health centers and offices in 16 communities and providing nurse visits to approximately 280 additional small communities and villages.

The Alaska Immunization Program has provided project update presentations at events run by stakeholder partners. This has resulted in increased awareness of resources among relevant partners. For example, the Alaska Cancer Prevention and Control Program recently asked permission to include some of the Immunization Program materials in its cervical cancer screening awareness efforts to combine the messages of screening and vaccination.

Intersection with other program activities
As noted above, the HPV stakeholder group provided input on materials developed for other HPV-related activities undertaken by the Immunization Program (public media campaign, reminder/recall effort, and provider education materials). Using the provider materials that were developed, the program distributed HPV vaccination toolkits to health care providers who administer the HPV vaccine.

The stakeholder initiative was supported by an HPV PPHF grant. The grant has ended, but continued support will come through the Immunization Program’s CDC cooperative agreement.

The joint workgroup currently has one full-time staff member – the education and training manager – whose time is dedicated to providing support to the workgroup. Initially, the program also had a public health advisor, but his position has been eliminated.

Implementation status
Though the HPV PPHF grant has ended, the Immunization Program plans to continue operating the HPV stakeholder group. The initial focus of the group was to provide input on PPHF grant activities, but will now shift slightly to focus on keeping each other informed and working together on future activities. The Immunization Program will remain the administrator of the group, but will not necessarily be the impetus for all of the group’s activities.

- Establishing the HPV stakeholder group was particularly helpful in raising awareness of each other’s activities across all of the cancer-related partner groups. 
- Through this stakeholder group, the Immunization Program developed new relationships with the American Cancer Society, Alaska Division of Public Health Cancer Prevention and Control, Alaska = Adolescent Health Program, and Let Every Woman Know. 
- Working with the Alaska Area Health Education Center was a relatively new and valuable collaboration. 
- Overall communication among partners increased outside of workgroup activities. 
- In keeping with the trend to do more with less, this group helped partners combine activities and identify potential redundancies. For example, both the Alaska Immunization Program and the Chronic Disease Prevention and Health Promotion Program were preparing guidance on the change in HPV vaccine dosing schedule and will now combine these efforts.

- Given competing priorities among all involved partners, it is challenging to coordinate in-person meetings for the stakeholder group, resulting in less frequent meetings than originally planned. The program utilizes informal communication by email and generally holds meetings via conference call.

Lessons learned/Advice to other programs
Forming a stakeholder group requires significant, focused effort in the beginning to launch the group and initiate activities. 
- Though it would depend on what an immunization program is trying to accomplish, it would be difficult for a truly effective stakeholder group to operate with anything less than one part-time employee (ie, 20 hours/week). Once the group achieves some momentum, a staff member is necessary to keep the group organized and maintain the activities. However, the responsibilities can have significant overlap with other programmatic activities. Partners not yet involved in the Alaska Immunization Program’s HPV stakeholder group that should be considered include:
» dental providers
» pharmacists (they don’t participate in VFC in Alaska, but older adolescents are a population they might potentially serve)
» representatives from private practice (the group has good representation of service areas that reach out to the public in Alaska, but not much on the private side).

For More Information
Contact Sarah Aho, Alaska Immunization Program education and training manager, at (907) 269-8000 or


Alaska Resources: HPV Stakeholder Group

Item Name Posted By Date Posted
HPV campaign materials developed w/ stakeholders Link Administration 12/18/2017
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