This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
When new clinical practice guidelines come out, it can be hard for doctors to change their practices. For example, guidelines now recommend that doctors use the test for human papilloma virus, or HPV, as the primary test to screen for cervical cancer, either alone or with the Pap test, for many women. But despite this guidance, doctors don’t always use the HPV test.
In this study, the research team is comparing two ways the Kaiser Permanente Southern California healthcare system, or KPSC, is using to try to increase doctors’ use of primary HPV screening. The first way is called a guided local-tailored approach. In this approach, clinics create a local project team that identifies barriers to doctors’ use of primary HPV screening. Then the team selects and applies strategies from an existing list to address those barriers. The second way is called a hybrid usual care approach. This approach involves standard education from KPSC followed by the clinic’s usual process for adopting new guidelines.
Who can this research help?
Results may help healthcare systems when considering ways to change care to reflect new guidelines or evidence.
What is the research team doing?
The research team is assigning 12 KPSC clinics by chance to either the guided local-tailored or hybrid usual care approach. The team is looking at health records for women ages 30–65 to see how often doctors order cervical cancer screening with primary HPV testing. Also, the team is asking doctors, nurses, and patients about their experiences switching to primary HPV testing.
Patients and providers are helping to choose study outcomes and design ways to collect data.
Research methods at a glance
|Population||12 KPSC medical centers with 1,400 providers and 10,000 patients|
Primary: provider-level uptake of primary HPV screening
Secondary: patient and provider knowledge of HPV test, patient and provider satisfaction with transition to primary HPV testing for routine cervical cancer screening, patient emotional reaction to HPV test and positive HPV test results, provider delivery of education, provider resistance to the new screening test
|2-month follow-up for primary outcome|