A content analysis of HPV vaccine online continuing medical education purpose statements and learning objectives

Figures & data

Table 1. Online continuing medical education characteristics and purpose statement messages.

Online Continuing Medical Education Title	Source	Purpose Statement Messages
		Delivering Recommendations^a (n = 5)	HPV Epidemiology^b (n = 1)	HPV Vaccine^c (n = 2)	Guidelines^d (n = 10)	Medical News^e (n = 4)
You are the key to HPV cancer prevention	CDC	1	0	0	1	0
Adolescent immunizations: Strong Recommending the HPV Vaccine	AAP	2	0	0	0	0
HPV Documentary-Division of Continuing Medical Education	IIC	0	0	0	0	0
You are the key to HPV cancer prevention	AHEC	0	0	0	0	0
Immunization: You call the shots- module eight-HPV, 2016	CDC	0	0	0	0	0
Don’t wait vaccinate! The prevention of HPV cancers	TMA	1	0	2	1	0
Don’t wait vaccinate! The prevention of HPV cancers (Part 2)	TMA	1	0	0	2	0
Human Papillomavirus (HPV) Vaccine Safety	CME University	0	0	0	0	0
HPV Vaccines Updates and Perspective	Medscape	0	0	0	0	0
The story of HPV: yesterday, today and tomorrow	Medscape	0	0	0	2	0
Putting HPV vaccine knowledge into practice	Medscape	0	1	0	1	0
CDC updates guideline recommendations for HPV vaccination	Medscape	0	0	0	0	1
HPV vaccine safety and efficacy	Medscape	0	0	0	1	0
Overcoming gender and socioeconomic disparities in HPV vaccination	Medscape	0	0	0	1	0
ACIP releases pediatric vaccine schedule	Medscape	0	0	0	0	1
AAP provides guidance for parents who refuse vaccination	Medscape	0	0	0	0	1
ACIP releases adult vaccine recommendations	Medscape	0	0	0	0	1
HPV vaccines: updates and clinical perspective	Medscape	0	0	0	1	0
HPV vaccination is cancer prevention (2017 update)	Boston SoM	0	0	0	0	0
Increasing adolescent immunization coverage	CME University	0	0	0	0	0
Immunization: You call the shots- module eighteen-vaccine administration	CDC	0	0	0	0	0

Note. CDC = Centers for Disease Control and Prevention. AAP = American Academy of Pediatrics. IIC = Indiana Immunization Coalition. AHEC = Area Health Education Centers. TMA = Texas Medical Association. SoM = School of Medicine.

^a Delivering recommendations included phrases about: a) delivering recommendations for HPV vaccination to decrease missed clinical opportunities, b) delivering strong recommendations for HPV vaccination, c) delivering effective recommendations for HPV vaccination, d) communicating with and/or education and/or counseling patient about HPV vaccination, e) communicating with and/or education and/or counseling parents/caregivers/family members about HPV vaccination, and f) parents’ concerns or questions about HPV vaccination.

^b HPV epidemiology included phrases about epidemiology terms regarding HPV including incidence and prevalence rates, incidence and prevalence of HPV-related cancers, causative agent and risk, and HPV-related disease.

^c HPV vaccine included phrases about: a) HPV vaccine being used as cancer prevention, b) HPV vaccination rates, and c) HPV vaccination hesitancy, vaccination refusal and barriers to parental consent.

^d Guidelines included phrases about: a) the recommended age, group (adolescents), or sex for HPV vaccination, b) administering (physically giving the HPV vaccine) the HPV vaccine to adolescents, c) locating or identifying resources, avenues, or locations aligned with current immunization guidelines administering the HPV vaccine to adolescents, and d) HPV vaccine safety.

^e Medical news included phrases about providing medical news.

Table 2. Online continuing medical education learning objective messages.

Online Continuing Medical Education Title	Source	Learning Objective Messages
		Delivering Recomm.^a (n = 10)	Strategies^b (n = 1)	HPV Epidemiology^c (n = 6)	HPV Vaccine^d (n = 11)	Guidelines^e (n = 32)	Prevention Services^f (n = 3)	HPV Vaccination Advocacy^g (n = 1)	Disparities^h (n = 4)
You are the key to HPV cancer prevention	CDC	3	0	0	1	1	1	0	0
Adolescent immunizations: Strong Recommending the HPV Vaccine	AAP	3	0	0	0	0	0	0	0
HPV Documentary-Division of Continuing Medical Education	IIC	0	0	0	0	0	0	0	0
You are the key to HPV cancer prevention	AHEC	1	0	0	1	4	0	0	0
Immunization: You call the shots-module eight-HPV, 2016	CDC	0	0	2	0	2	1	0	0
Don’t wait vaccinate! The prevention of HPV cancers	TMA	0	0	2	1	3	0	0	0
Don’t wait vaccinate! The prevention of HPV cancers (Part 2)	TMA	1	0	0	1	2	0	0	0
Human Papillomavirus (HPV) Vaccine Safety	CME University	1	0	0	0	3	0	0	0
HPV Vaccines Updates and Perspective	Medscape	0	0	0	0	1	0	0	0
The story of HPV: yesterday, today and tomorrow	Medscape	0	0	1	0	0	0	1	0
Putting HPV vaccine knowledge into practice	Medscape	0	0	0	0	0	0	0	2
CDC updates guideline recommendations for HPV vaccination	Medscape	0	0	0	0	5	0	0	0
HPV vaccine safety and efficacy	Medscape	0	0	0	0	1	0	0	0
Overcoming gender and socioeconomic disparities in HPV vaccination	Medscape	0	0	0	0	0	0	0	2
ACIP releases pediatric vaccine schedule	Medscape	0	0	0	2	0	0	0	0
AAP provides guidance for parents who refuse vaccination	Medscape	0	0	0	4	0	0	0	0
ACIP releases adult vaccine recommendations	Medscape	0	0	0	1	1	0	0	0
HPV vaccines: updates and clinical perspective	Medscape	0	0	0	0	1	0	0	0
HPV vaccination is cancer prevention (2017 update)	Boston SoM	0	1	1	0	1	0	0	0
Increasing adolescent immunization coverage	CME University	1	0	0	0	2	0	0	0
Immunization: You call the shots-module eighteen- vaccine administration	CDC	0	0	0	0	5	1	0	0

Note. CDC = Centers for Disease Control and Prevention. AAP = American Academy of Pediatrics. IIC = Indiana Immunization Coalition. AHEC = Area Health Education Centers. TMA = Texas Medical Association. SoM = School of Medicine.

^a Delivering recommendations included phrases about: a) delivering recommendations for HPV vaccination to decrease missed clinical opportunities, b) delivering strong recommendations for HPV vaccination, c) delivering effective recommendations for HPV vaccination, d) communicating with and/or education and/or counseling patient about HPV vaccination, e) communicating with and/or education and/or counseling parents/caregivers/family members about HPV vaccination, and f) parents’ concerns or questions about HPV vaccination.

^b Strategies included phrases about using evidence-based strategies to include HPV vaccination.

^c HPV epidemiology included phrases about epidemiology terms regarding HPV including incidence and prevalence rates, incidence and prevalence of HPV-related cancers, causative agent and risk, and HPV-related disease.

^d HPV vaccine included phrases about: a) HPV vaccine being used as cancer prevention, b) HPV vaccination rates, and c) HPV vaccination hesitancy, vaccination refusal and barriers to parental consent.

^e Guidelines included phrases about: a) the recommended age, group (adolescents), or sex for HPV vaccination, b) administering (physically giving the HPV vaccine) the HPV vaccine to adolescents, c) locating or identifying resources, avenues, or locations aligned with current immunization guidelines administering the HPV vaccine to adolescents, and d) HPV vaccine safety.

^f Prevention services included phrases about prevention health services (smoking cessation, weight reduction, diabetes screening, etc.).

^g HPV vaccination advocacy included phrases about advocating for the HPV vaccine.

^h Disparities included phrases about disparities in HPV vaccination.

Table 3. Assessment of learning objectives addressed within the content of CME activities.

Online Continuing Medical Education Title	Source	Objectives	Occurrence
You are the key to HPV cancer prevention	CDC	Explain in plain language, the importance of HPV vaccination for cancer prevention and the rationale for vaccinating at ages 11 or 12.	5
		Provide an effective recommendation for HPV vaccination	3
		Describe useful and compelling information about HPV vaccination to succinctly answer questions from parents and aid parents in making the decision to vaccinate their children	5
		Implement disease detection and prevention health care services (e.g., smoking cessation, weight reduction, diabetes screening, blood pressure screening, immunization services) to prevent health problems and maintain health	1
Adolescent immunizations: Strong Recommending the HPV Vaccine	AAP	No longer available for review	--
HPV Documentary-Division of Continuing Medical Education	IIC	No longer available for review	--
You are the key to HPV cancer prevention	AHEC	Define the importance of HPV vaccination for cancer prevention and the rationale for vaccinating at ages 11 or 12	1
		List the recommendations for HPV vaccine for girls and for boys.	3
		Provide useful and compelling information about HPV vaccine to parents to aid in making the decision to vaccinate	4
		Locate resources relevant to current immunization practice.	1
Immunization: You call the shots-	CDC	For HPV, describe this disease, including the causative agent.	1
module eight-HPV, 2016		For HPV, list the groups at highest risk.	2
		For HPV, identify those for whom routine immunization is recommended.	1
		For HPV, describe characteristics of the vaccine used to prevent this disease. (Characteristics may include schedule, contraindications, and/or adverse reactions.)	5
		Locate resources relevant to current immunization practice.	1
		Implement disease detection and prevention health care services (e.g., smoking cessation, weight reduction, diabetes screening, blood pressure screening, immunization services) to prevent health problems and maintain health.	0
Don’t wait vaccinate! The prevention of HPV cancers	TMA	No longer available for review	--
Don’t wait vaccinate! The prevention of HPV cancers (Part 2)	TMA	No longer available for review	--
Human Papillomavirus (HPV) Vaccine Safety	CME University	No longer available for review	--
HPV Vaccines Updates and Perspective	Medscape	Upon completion of this activity, participants will have greater competence related to apply the Advisory Committee on Immunization Practices (ACIP) recommendations for human papillomavirus (HPV) vaccination	2
The story of HPV: yesterday, today and tomorrow	Medscape	Upon completion of this activity, participants will have increased knowledge regarding the long-term data evaluating the impact of vaccination on HPV-related disease	3
		Timely and appropriate HPV vaccination	2
		Have greater competence related to: HPV vaccination advocacy	1
Putting HPV vaccine knowledge into practice	Medscape	Upon completion of this activity, participants will have increased knowledge related to identifying opportunities to decrease racial and ethnic disparities in human papillomavirus (HPV) immunization	2
CDC updates guideline recommendations for HPV vaccination	Medscape	Interpret HPV vaccination recommendations for girls and boys who begin the vaccination series at ages 9 through 14 years, based on updated guidance from the Advisory Committee on Immunization Practices (ACIP	4
		Apply HPV vaccination recommendations for persons beginning the vaccination series at ages 15 through 26 years, for immunocompromised persons, and for other groups, based on updated ACIP guidance	4
HPV vaccine safety and efficacy	Medscape	Have increased knowledge related to HPV safety and efficacy data	14
Overcoming gender and socioeconomic disparities in HPV vaccination	Medscape	Have greater competence related to identifying opportunities to decrease gender and socioeconomic disparities in HPV immunization rates	4
ACIP releases pediatric vaccine schedule	Medscape	Assess the 2017 updated schedule for child and adolescent immunizations, based on an Advisory Committee on Immunization Practices (ACIP) statement	5
		Recognize barriers that need to be overcome to complete adolescent vaccine schedules	7
AAP provides guidance for parents who refuse vaccination	Medscape	Assess the prevalence of vaccine hesitancy and dismissing pediatric patients because of vaccine refusal	1
		Analyze means to reduce vaccine hesitancy and vaccine refusal among caregivers of children and adolescents	12
ACIP releases adult vaccine	Medscape	Evaluate trends in adult vaccination in the United States	1
recommendations		Assess current recommendations for adult vaccination from the Advisory Committee on Immunization Practices	17
HPV vaccines: updates and clinical perspective	Medscape	Have greater competence related to applying the Advisory Committee on Immunization Practices (ACIP) recommendations for human papillomavirus (HPV) vaccination	3
HPV vaccination is cancer	Boston	Describe what is known about HPV disease prevalence	6
prevention (2017 update)	SoM	Explain the rationale for early vaccination	5
		Determine whether a patient should receive two or three doses based on the age of initiating the vaccine	3
		Implement an evidence-based strategy to increase HPV vaccination	6
Increasing adolescent	CME	Identify the Rights of Medication Administration for Vaccines	2
immunization coverage	University	Define the steps for proper vaccine administration	10
		Recognize the recommended routes and sites for vaccine administration	33
		Identify recommended vaccine administration best practices	15
		Describe best practices to prevent vaccine administration errors	5
		Locate resources on current immunization administration practice	2
		Implement disease detection and prevention health care services (e.g., smoking cessation, weight reduction, diabetes screening, blood pressure screening, immunization services) to prevent health problems and maintain health	7
Immunization: You call the shots- module eighteen-vaccine	CDC	Review the latest clinical data regarding the impact of HPV vaccination on relevant clinical endpoints	9
		Assess new strategies to educate and empower adolescents to become engaged in their own health as it relates to HPV vaccination	2
		Evaluate the value of concise and consistent communication to educate patients/caregivers on the importance of competing the HPV vaccination series	4

Note. CDC = Centers for Disease Control and Prevention. AAP = American Academy of Pediatrics. IIC = Indiana Immunization Coalition. AHEC = Area Health Education Centers. TMA = Texas Medical Association. SoM = School of Medicine.

Table 4. Online continuing medical education learning objective frequency.

Learning Objective Terms	Frequency N (%)
Knowledge
Identify	6 (12)
Locate	4 (8)
List	4 (8)
Define	3 (6)
Comprehension
Describe	8 (16)
Explain	3 (6)
Discuss	1 (2)
Application
Implement	5 (10)
Apply	2 (4)
Employ	1 (2)
Analysis
Recognize	2 (4)
Analyze	1 (2)
Evaluation
Assess	3 (6)
Interpret	1 (2)
Evaluate	1 (2)
Determine	1 (2)
No Verb Category
Increase Knowledge	2 (4)
Answer	1 (2)
Introduce	1 (2)
Provide	1 (2)