Table 3 Post-implementation findings by facilitators and barriers with supporting excerpts from user organizations
Facilitators | Barriers | |
|---|---|---|
Primary care clinics | • Approach broadly fit within clinic existing workflows “I think it worked well in the workflow just having the packet right in front of you and then just taking it and, as you're handing it to the patient, just mentioning it. Like, you could even do it on your walk to the room. It wasn’t anything that was difficult.” - Medical assistant • Targeting adolescents who were due for HPV vaccines "The most success in that I feel like was when you were doing a well-child check and you needed an HPV vaccine. So it was just sort of like, oh, this makes perfect sense. Like, I would like to learn more about it in lay terms…” - Medical assistant | • Time constraints limited the amount of engagement with patients “Like, the two instances where I had a little bit of time to talk with the patient I felt like that was the most useful, and I wish I had more people that I could've done that with. But I would say that anything more than that, like if my provider was ready for me to do something with a different patient, I didn’t have time to actually chat with the patient about the website and bring it up with them and like show them together.” - Provider • Staff turnover “I do think that the short staffing in the beginning and training all of our new people that was definitely a hindrance […] A lot of times you're training like three or four brand-new staff too, and I'm fairly new to be honest.” - Provider • Uncertainty about patient engagement with website and behavior change “And I don't know if you guys kept track of how many people visit the website or not and so I don't know if just directing patients that there is a website about it, directing people and parents or not since I’m not sure if whoever, how many people access the website.” - Provider |
School-based clinics | • Easy to put up posters and distribute handouts within existing workflows and priorities “Giving the paper out, not a problem […] I think it flowed well to be able to talk to the patients.” - Provider | • Students not interested in HPV education when not the reason for visit “I mean, how do you get teenagers excited about health topics, you know? I mean, until it’s like right in their face…because even we do a fair deal of birth control, let’s say. But I could talk to them until I’m blue in the face one day, and if they’re not having sex that day, they have no interest in what I’m saying. And then it could be the next day that they’re in my clinic saying, oh, I need birth control. So I don’t know. Like how do you inspire kids to pay attention to something that’s not right in their face and causing them a problem?” - Provider • Students did not want paper handouts “Kids just don’t want to take papers from the clinic, even like our patient instructions and the things that are really relevant to their visit and they still don’t want that. They tend to leave the papers sitting on their chair when they walk out the door.” - Provider • Uncertainty about patient engagement with website and behavior change “I mean, we know how many shots we give, but I do not know what it would take [to measure the impact of the website on HPV vaccine uptake]. I don’t often times see them back again from the ones I gave [the website materials] to them.” - Provider |
School health educators | • Smooth integration within curriculum as a supplemental resource “I used the website more as a supplement to my big project. And so it was kind of like […] okay, so now we’re going to go get information and a resource from outside of school, so this just reinforces what you guys have learned in the first part…” - Health educator • Hmong students appreciated seeing their culture in the materials and/or people they knew “[I remember the kids saying] ‘I recognize that actor,’ you know. And so one of the people in there […], he did the guy part, and some of the students said ‘hey, we know [him].’” - Health educator • Addressed a need: at one school, kids developed a report using old textbooks that did not include vaccine information “I know that some of the things that they didn’t know about were the vaccines, because in the books and the research that we did that we had, a lot of the kids just said your body can get rid of it naturally […] And so I think some of the kids who did the research before, they were not aware that oh, there are vaccines. And so that was kind of interesting to them.” - Health educator | • Charter school policy limits conversations about sex “And so that’s why just even talking about sex is…I try not to. So we just learn about the diseases. And that’s what I tell my administration. What we’re going to do is we’re going to learn about these diseases, and that’s pretty much it.” - Health educator • Limited time/energy to expand outside of classroom “Because we have so many other projects that we do, once we’re done, we’re done. I don’t go back to it. But I think having this for the kids, maybe offering incentives for them to come back and look at it or something like that could potentially…then you can get the parents involved or whatnot.” - Health educator |