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Welcome Dear Culinary Connoisseurs, a.k.a. HPV vaccination experts and champions, It is our pleasure to welcome you to the January 2024 in-person meeting of the HPV Vaccination Roundtable of the Southeast hosted by the HPV Cancer Prevention Program at St. Jude Children’s Research Hospital. While the temperatures in Memphis may not be sizzling this time of year, we will be cooking up success when it comes to HPV vaccination coverage across the southeastern United States. As we gather in this vibrant city of Memphis, known for its rich history and diverse culinary heritage, we will embark on a shared journey focused on generating action plans to improve HPV vaccination coverage. This in-person meeting is the culmination of a year’s worth of planning and efforts focused on the Southeast, a region with historically low HPV vaccination coverage and high rates of HPV cancers. It is now time for harvest and the feast. In this meeting, we will all operate as sous chefs to craft a delectable menu of evidencebased and actionable strategies for collective action and elevate HPV vaccination rates across the Southeast. Throughout this meeting, our goal is to expertly curate an abundance of regionally-grown and regionally-informed strategies, carefully selecting the choicest 2-3 actions for each participant to bring back to their respective states for collective action across the region. Just as a chef expertly combines ingredients to create a winning dish, together our collaborative effort will blend these actions to craft a recipe for success in preventing HPV cancers. This in-person gathering of the HPV Vaccination Roundtable of the Southeast is more than a meeting; it’s a vibrant space – a kitchen – where we will combine our expertise and zest for change to craft the future of HPV cancer prevention in our region. This meeting aims to equip us with a pantry of essentials while we bring our key ingredients. We will engage with expert master chefs to judge our creations, serving up insights and adding unique flavors to the mix so that we come away with a winning menu. We are culinary connoisseurs of change, using our experiences and expertise to whip up impactful actions in HPV cancer prevention. You are one of the key ingredients. We encourage you to season discussions with your unique perspectives, blend ideas, and create a feast of collaborative initiatives that will tantalize the taste buds of HPV vaccination efforts in our region. Thank you for joining us on this journey to cook up success. Bon appétit!
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About the HPV Vaccination Roundtable of the Southeast The southeastern United States has historically had the lowest HPV vaccination coverage as a region – with some exceptions – and the highest rates of HPV cancers, especially cervical and oral cancers. Focusing on the Southeast allows us to galvanize existing successful efforts working in our areas, learn from each other, and further our reach and impact on improving HPV vaccination coverage. The HPV Vaccination Roundtable of the Southeast is comprised of a group of people and partners from 14 states and jurisdictions – Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, West Virginia, and Puerto Rico – and now to include Washington, DC -- working together to improve HPV vaccination coverage in their respective states and jurisdictions and in our region. Building upon previous efforts led by the ACS National HPV Vaccination Roundtable in 2019, the newly formed HPV Vaccination Roundtable of the Southeast aims to create a platform for sharing ideas and strategic action planning, implementation, and evaluation. Beginning in September 2022, select representatives of southeastern states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia) and Puerto Rico united with St. Jude Children’s Research Hospital, the American Cancer Society, and the ACS National HPV Vaccination Roundtable to discuss improving HPV vaccination in these regions to prevent HPV cancers. This group, referred to as the Planning Committee, decided unanimously to recommit to working together to take on the challenges unique to our region and similar to others facing low HPV vaccination coverage. The Southeast Roundtable focuses on current conditions surrounding HPV vaccination and HPV cancer prevention, replicating HPV vaccination success across the Southeast, overcoming challenges facing HPV vaccination, and capitalizing on opportunities to improve HPV vaccination coverage in each state and the overall region. The Southeast Roundtable also works to understand the current context and conditions, share success stories, creatively problem solve challenges, and act accordingly to take on the challenge of too many missing out on HPV cancer prevention.
The HPV Vaccination Roundtable of the Southeast consists of the following states and jurisdictions: 1. Alabama 2. Arkansas 3. District of Columbia 4. Florida
5. 6. 7. 8. 9.
Georgia Kentucky Louisiana Mississippi North Carolina
10. South Carolina 11. Tennessee 12. Virginia 13. West Virginia 14. Puerto Rico
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Compliments to the Chefs Southeast Roundtable Planning Committee Members of the Planning Committee started meeting in September 2022. Conversations explored interest in working together and what that might look like. There was much interest in working together. This powerhouse group of people committed to improving HPV vaccination coverage in their respective states and across the southeastern region have been essential to bringing the in-person meeting to fruition. There is such amazing, creative work being done and being led by those on the Planning Committee. A special thank you to them for their commitment and engagement. • • • • • • • • • • • •
Lindsay Barr, West Virginia Bob Bednarczyk, PhD, Georgia Heather Brandt, PhD, National Vivian Colon Lopez, PhD, MPH, Puerto Rico Katie Crawford, National Elaine Darling, MPH, West Virginia Gabrielle Darville-Sanders, PhD, MPH, National Amy Ellis, Mississippi Kim Hale, South Carolina Nikki Hayes, MPH, National Sherrick Hill, Virginia Pamela Hull, PhD, Kentucky
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Duha Magzoub, MPH, National Cara McCarthy, MPH, Louisiana Heather Mercer, Arkansas Jennifer Nkonga, MS, National Jill Pait, MS, North Carolina Beth Poore, South Carolina Vanessa Sheppard, PhD, Virginia Dorothy Sinard, MD, Tennessee Letitia Thompson, MPPA, National Susan Vadaparampil, PhD, MPH, Florida Francine Walton, MPH, Alabama Jennifer Young Pierce, MD, MPH, FACOG Alabama
In-person Meeting Facilitators We would like to thank the facilitators for guiding the discussions and ensuring a productive and meaningful exchange of ideas during the meeting. • • • • • • •
Katie Crawford Karlisa Cryer, MPA Amanda Ibrahim, MPH Portia Knowlton, MHRM Ashley Lach, MHA, CPHQ Kiara Long, MPH Carol Minor
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Kasia Mitchell Kaela Momtselidze, Hannah Nein Jennifer Nkonga, MS Pragya Gautam Poudel, DrPH, MPH, MSc Cristóbal Valdebenito, MA
St. Jude HPV Cancer Prevention Program In addition, for this in-person meeting, we want to thank the entire St. Jude HPV Cancer Prevention Program team and additional St. Jude support. • • • • • • 4
Heather Brandt, PhD Julia Brown, MPH Karlisa Cryer, MPA Pragya Gautam Poudel, DrPH, MPH, MSc Amanda Ibrahim, MPH Portia Knowlton, MHRM
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Ursula LeFlore Duha Magzoub, MPH Carol Minor Kasia Mitchell Andrea Stubbs, MPA Cristóbal Valdebenito, MA
Southeast Roundtable Resources
State HPV Data Profiles
Training and Technical Assistance Experiences
State Updates Meetings
Virtual Seminars
The HPV Vaccination Roundtable of the Southeast has provided programming and resources since September 2022. All resources can be found at stjude.org/southeast-roundtable. Fall 2022 Virtual Seminars St. Jude HPV Cancer Prevention Program with the American Cancer Society, National HPV Vaccination Roundtable, and Indiana Immunization Coalition held three, free virtual seminars to build skills and enhance the capacity of state teams to improve HPV vaccination coverage. The topics focused on HPV vaccination data, implementing best practices and monitoring processes and impact. February 27, 2023: Addressing HPV Vaccination Gaps in the Southeastern U.S. This seminar focused on gaps in HPV vaccination coverage in southeastern states with a focus on opportunities for action. March 30, 2023 The first of three virtual state updates meetings to reconvene southeastern states and improve HPV vaccination coverage was held on March 30 and included state updates from Mississippi, South Carolina, Tennessee, and Virginia. April 27, 2023 The second of three virtual state updates meetings to reconvene southeastern states and improve HPV vaccination coverage was held on April 27 and featured state updates from Alabama, Arkansas, Georgia, and Virginia. May 25, 2023 The last of three virtual state updates meetings to reconvene southeastern states and improve HPV vaccination coverage was held May 25 and featured state updates from Florida, Kentucky, Louisiana, North Carolina, and Puerto Rico. September 13, 2023: Digging Deeper into HPV Vaccination Data This virtual training experience focused on HPV vaccination data as a resource to guide efforts to improve coverage and prevent HPV cancers. Speakers discussed the latest available data resources, utilization, and advocacy for data that drives HPV cancer prevention efforts. November 15, 2023: Navigating Conversations: Effective Communication Strategies for HPV Vaccination in the Southeast This virtual training focused on improving HPV vaccination uptake through combatting misinformation and utilizing effective communication practices. Speakers discussed how to achieve consistency and tailor messages to improve HPV vaccination rates in the Southeast. The St. Jude HPV Cancer Prevention Program has developed state data profiles with HPV cancer and HPV vaccination data. The profiles also include tailored action steps based on the ongoing HPV vaccination efforts in each state. 5
Agenda At-A-Glance January 22, 2024 Time Topic 11:30 AM-12:15 PM
Check-in
12:15-1:00 PM
Welcome and Networking Lunch
1:00-1:30 PM
Introduction to the First HPV Vaccination Roundtable of the Southeast In-Person Meeting
1:30-2:00 PM
Gather Your Ingredients (Current State of HPV Vaccination in the Southeast)
2:00-3:15 PM
Mise en Place (Discussion of Evidence-Based Interventions for HPV Vaccination and Possible Strategies)
3:15-3:30 PM
Networking Break
3:30-5:00 PM Now We’re Cooking (Priority EBIs and Action Steps Reduced and Clarified) 5:00-5:30 PM
Closing Remarks and Plans for Next Day
5:30-6:00 PM
Networking Break
6:00-8:00 PM
Reception & Dinner Featuring HPV Cancer Survivors Panel
January 23, 2024 Time Topic 7:30-8:00 AM
Networking Breakfast
8:00-8:30 AM
Introduction
8:30-9:30 AM Turning Up the Heat: Chopped Panel Feedback on Priority EBIs and Action Steps
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9:30-9:45 AM
Networking Break
9:45-10:45 AM
The Menu (Selecting Final Strategies)
10:45-11:00 AM
Networking Break
11:00 AM-12:15 PM
Cooking Up Success (Action Planning)
12:15-12:45 PM
Working Lunch
12:45-1:30 PM
Closing the Kitchen (Next Steps and Continued Action Planning)
1:30-2:00 PM
Closing and Next Steps
Cooking Up Success HPV Vaccination Roundtable of the Southeast Meeting 2024 January 22-23, 2024
St. Jude Children’s Research Hospital ARC Building 8th Floor Memphis, Tennessee
Day 1 Monday, January 22, 2024 11:30 AM-12:15 PM Check-in Will take place at The Central Station Memphis, Curio Collection by Hilton. Registrants who arrive Monday, January 22, will check in at St. Jude Children’s Research Hospital with the HPV Cancer Prevention team at the ARC building on the 8th floor. 12:15-1:00 PM Welcome and Networking Lunch Representatives from St. Jude Children’s Research Hospital HPV Cancer Prevention Program, ACS National HPV Vaccination Roundtable, and the American Cancer Society will welcome the HPV Vaccination Roundtable attendees. Presenters: Heather Brandt, PhD, St. Jude Children’s Research Hospital Gabrielle Darville-Sanders, PhD, MPH, American Cancer Society, National HPV Vaccination Roundtable Jennifer Nkonga, MS, American Cancer Society 1:00-1:30 PM Introduction to the First HPV Vaccination Roundtable of the Southeast In-Person Meeting Ann Moenke and Yumna Ali will share the initiative goal, meeting objectives, agenda, and working agreements. Presenters: Ann Moenke and Yumna Ali, Executive Chefs, Soisson & Associates
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1:30-2:00 PM Gather Your Ingredients (Current State of HPV Vaccination in the Southeast) Welcome culinary connoisseurs! Dr. Gabrielle Darville-Sanders and Jennifer Nkonga will give presentations on the commitment of the American Cancer Society and the National HPV Vaccination Roundtable to addressing HPV vaccination coverage gaps and also the history of collaboration across southeastern states. Your host has provided you with your assignment: collectively create a three-course menu of evidencebased HPV vaccination interventions for collective impact across the Southeast. Before you begin, you must gather your ingredients. Your table should discuss ongoing HPV vaccination efforts in your respective kitchens – ahem, states – and where work remains to be done. Consider strategies that have demonstrated success and what could have been done differently. How do we close these gaps? Barriers could include issues related to awareness, accessibility, vaccine hesitancy, or any other challenges hindering effective vaccination coverage and prevention. Participants will work together to address any missed opportunities for HPV vaccination. Presenters: Gabrielle Darville-Sanders, PhD, MPH, American Cancer Society, National HPV Vaccination Roundtable Jennifer Nkonga, American Cancer Society Ann Moenke and Yumna Ali, Soisson & Associates Food for Thought: What else do you need to know today about HPV vaccination in the Southeast?
What do you think are the top three barriers to HPV vaccination coverage? In other words, what are the three barriers stopping us from improved coverage?
What do you think are the top three facilitators (or enablers) to HPV vaccination coverage? In other words, what are the three facilitators that can work for us to achieve improved coverage?
If you had to pick one action to take right now to improve HPV vaccination coverage in the Southeast, what would it be?
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What questions do you want to ask?
2:00-3:15 PM Mise en Place (Discussion of Evidence-Based Interventions for HPV Vaccination and Possible Strategies) Each table will have a designated Head Chef (meeting facilitator) responsible for leading a critique of the current menu of evidence-based HPV interventions. As a sous chef, your role involves analyzing the current menu and proposing any potential specials, or additional strategies for enhancing HPV vaccination, for consideration. The Head Chef will offer feedback on the suggested specials and assist in shaping the proposed additions to the menu for your table. Head Chefs from each table will then pitch their HPV intervention specials for addition to the menu. Presenters: Ann Moenke and Yumna Ali, Soisson & Associates Food for Thought: What are your initial reactions to the menu of EBIs?
Which EBI do you see having the most potential impact?
How can we approach the menu of EBIs to lead with equity?
What action steps are missing from the list of possible priorities?
What questions do you want to ask?
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3:15-3:30 PM Networking Break
Main Courses And now, we will start on the main course – for this meeting, the main course refers to our focus on identifying priority EBIs and action steps for the HPV Vaccination Roundtable of the Southeast to work on collectively and then focus on a detailed action plan for each of these priorities. 3:30-5:00 PM Now We’re Cooking (Priority EBIs and Action Steps Reduced and Clarified) This session is divided into two parts: reducing the current menu of HPV vaccination interventions and crafting a winning recipe for success. To begin, participants will assess the existing menu of HPV vaccination interventions, including any added specials. They will then vote on these dishes (evidencebased interventions) to establish a set menu. Once the menu is condensed, Head Chefs will guide each table through the “Developing Your Dish” template and create a presentation for evaluation by the Chopped panel on Day 2. Presenters: Ann Moenke and Yumna Ali, Soisson & Associates Food for Thought: What measures can be taken to ensure equitable access to HPV vaccines across diverse populations?
What are geographic or socioeconomic factors impacting vaccine accessibility?
What selection criteria are the most important to you as you evaluate the menu? (i.e. How feasible is this intervention for your state, jurisdiction, or community?)
How likely are your partners in your state or jurisdiction to accept the proposed EBIs?
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Which EBIs do you think will have the most impact on HPV vaccination coverage in the Southeast?
What are the potential long-term effects—both positive and negative—of these actions?
What questions do you want to ask?
5:00-5:30 PM Closing Remarks and Plans for Next Day Facilitators will complete pitches using the “Developing Your Dish” template. Pitches should be submitted to Heather Brandt, who will provide them to the mystery Chopped panel to review. Teams should designate a speaker to present their pitch to the judges on Day 2. Pitches should last no longer than 5 minutes. Presenters: Ann Moenke and Yumna Ali, Soisson & Associates 5:30-6:00 PM Networking Break 6:00-8:00 PM Reception & Dinner Featuring HPV Cancer Survivors Panel Discuss perspective of HPV cancer survivors advocating to prevent HPV cancers and increase HPV vaccination coverage. Survivors Panel: Rina “Cricket” Correa, Holly Rasumssen, Kadiana Vegee, and Joyett Wright Moderator: Julia Brown, MPH, St. Jude HPV Cancer Prevention Program
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Day 2 Tuesday, January 23, 2024 7:30-8:00 AM Networking Breakfast 8:00-8:30 AM Introduction Facilitators will introduce the goal for today’s session and provide details for the action planning outcomes. Presenters: Ann Moenke and Yumna Ali, Soisson & Associates 8:30-9:30 AM Turning Up the Heat - Chopped Panel Feedback on Priority EBIs and Action Steps The Chopped panel of mystery experts will be revealed, and teams will pitch their dishes to the virtual judges who will review and assess each team’s proposals. The panel’s expertise will come to the forefront as they provide honest critiques, valuable insights, and strategic advice on the proposed strategies. Presenters: Ann Moenke and Yumna Ali, Soisson & Associates Food for Thought: What ideas from other teams’ dishes stood out to you? Are there any you would integrate into your own implementation plan?
What do you think of the Chopped panel’s feedback on the dishes?
What changes or additions would you make to any of the dishes?
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What potential challenges were not addressed in the dishes?
Which interventions do you think have the most potential impact? Which have the least impact?
What questions do you have?
9:30-9:45 AM Networking Break 9:45-10:45 AM The Menu (Selecting Final Strategies) After hearing the Chopped panel’s feedback, you will have the opportunity to engage in table discussions to assess winning strategies against predefined criteria, focusing on their actionability and potential impact. These discussions aim to help you determine the standout strategies before casting your vote for the most favorable strategy. The top 2-3 strategies will then be unveiled. These prioritized strategies will serve as the focal points for collective impact across southeastern states in the upcoming year. The collective decision aims to drive cohesive action and maximize the strategies’ effectiveness for regional advancement in HPV vaccination efforts. Presenters: Ann Moenke and Yumna Ali, Soisson & Associates Food for Thought: What are your reactions to the top 2-3 action steps?
What EBIs or action steps that were not selected are still important to improve HPV vaccination coverage in the Southeast?
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What questions do you want to ask?
10:45-11:00 AM Networking Break 11:00 AM -12:15 PM Cooking Up Success (Action Planning) Teams will further develop their “Recipe for Success” using the Action Planning guide. This recipe will concentrate on 2-3 interventions, evaluating them against provided criteria and refining strategies through SMARTIE (Strategic, Measurable, Ambitious, Realistic, Time-bound, Inclusive, and Equitable) goals. Participants will tailor strategies to their own states, breaking down planning and implementation using the Action Planning guide. Presenters: Ann Moenke and Yumna Ali, Soisson & Associates Food for Thought: How can we ensure the sustainability of these interventions beyond their initial implementation?
How can partnerships with other organizations enhance the success of these interventions?
What potential challenges might arise from collaborative efforts, and how can they be mitigated?
What are the major benefits of these interventions?
What resources will interventions require?
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What metrics should be used to measure the success or effectiveness of these evidence-based interventions?
How will you evaluate the success of the intervention in your state?
What questions do you have?
12:15-12:45 PM Working Lunch 12:45-1:30 PM Closing the Kitchen (Next Steps and Continued Action Planning) During this session, participants will collectively assess the “Recipe for Success” action plans, delving into the timeline, benchmarks, and strategies for effectively implementing the priority initiatives across the Southeast within the next 1-3 years. Presenters: Ann Moenke and Yumna Ali, Soisson & Associates Food for Thought: Who else needs to be invited and involved in these efforts?
What ideas do you have for future programming?
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What was not discussed that we should address in the future?
What questions do you still have?
1:40-2:00 PM Closing and Next Steps Presenter: Duha Magzoub, MPH, St. Jude Children’s Research Hospital
What comes next?
Join us for virtual follow-up meetings to keep up the momentum. Following the in-person meeting, the Southeast Roundtable will host three, virtual follow-up meetings to discuss progress in realizing action steps identified during the in-person meeting. The three, virtual follow-up meetings will take place on February 24, March 20, and April 24 from 12:00 - 1:00 PM Central Time. Links to join virtual meetings will be sent to all who register to attend the in-person meeting.
We invite you to contribute to our culinary celebration of the Southeast! As part of our initiative to celebrate the diverse flavors of our region, we are curating an actual digital cookbook featuring recipes from each of the 14 states and jurisdictions in the southeast Roundtable. Do you have a cherished recipe that embodies the essence of your state? Whether it’s a traditional family dish passed down through generations or a contemporary favorite that captures the essence of your local cuisine, we’d love to include it in our collection. Use the QR code below to submit your recipe:
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Menu of Evidence-based Interventions (EBIs) From an initial list of nearly 70 evidence-based interventions, the Planning Committee meticulously assessed various criteria including potential impact, effort required, feasibility, resources required, and interest. The committee refined the selection down to a concise list of 14, aligning with the 14 states and jurisdictions within the southeastern Roundtable. Take a moment to review this list and consider the action steps discussed in the state updates meeting shared earlier. The breadth of opportunities presents us with an optimal chance to act decisively and maximize our collective impact. 1. 2. 3. 4. 5. 6. 7.
“Every visit is a vaccine visit” to reduce missed opportunities Centralized IIS-system-based reminder recall Communication campaign and messages HPV vaccination champions training program Learning collaboratives Parent/caregiver education Partner-driven efforts, such as building capacity of coalitions and community-based organizations 8. Provider and entire office team education 9. Provider recommendation 10. Provider assessment and feedback 11. Provider reminder and recall 12. School-based HPV vaccination education and delivery 13. Standing orders 14. Start HPV vaccination at age 9
Selection Criteria Impact: Quantity of people and/or populations the intervention will affect and likelihood of increasing HPV vaccination rates. Interest: Quantity of collaborators (state representatives, partners, providers, etc.) enthusiastic about adoption and implementation of the intervention. Feasibility: The degree to which the intervention can realistically be accomplished. Resources available: The degree to which the intervention can realistically be accomplished with the available funds, workforce, etc. Effort required: The degree to which the intervention will stretch or expend the available workforce. 17
Action Steps The following action steps were identified as part of the state update meetings held by the HPV Vaccination Roundtable of the Southeast in March, April, and May 2023. The action steps prioritize HPV-focused work in southeastern states, offering more services in rural areas, and aim to shift the focus from prevention to the elimination of HPV cancers, beginning with cervical cancer as a public health problem.
Data • • •
Conduct data “deep dives” to investigate how multiple data sources may be analyzed and used to inform geographic responses to low HPV vaccination coverage. Identify top examples of HPV vaccination and HPV cancer data sources for replication in other states. Leverage IIS as a tool to support vaccination and enhance data.
Communication • • • • • •
Address misinformation, disinformation, and malinformation through educational approaches to all key audiences and decision makers. Address vaccination hesitancy. Change the focus from prevention to elimination of HPV cancers as a public health problem, beginning with cervical cancer. Create HPV vaccination social media campaigns. Implement education and outreach strategies to encourage provider recommendation and parental acceptance of vaccination at age 9. Increase legislative advocacy and implementation of policies supporting HPV vaccination.
Promote Equity in HPV Vaccination • • • • • • •
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Increase equity in HPV vaccinations while utilizing trusted messengers and nontraditional partners. Advance HPV vaccination through advocacy to close access gaps between communities and vaccination. Explore innovative approaches to reach key populations, such as mobile units, roadshows, and communication campaigns. Prioritize efforts and populations where vaccine coverage lags, such as rural communities. Prioritize HPV focused work through southeastern state comprehensive cancer programs to address disparities in HPV vaccination coverage rates in each state. Provide more information and services in rural areas. Strategic activities result from strategic partnerships by engaging key groups.
Notes
Evaluation We hope you enjoyed this meeting, and we would like to ask for your feedback on the meeting format, content, and overall experience. Please take a few minutes to complete a brief evaluation that you will receive via email at the conclusion of the meeting.
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stjude.org/southeast-roundtable 20