A framework-based guide for adapting and implementing primary care–based pediatric interventions to the pediatric oncology setting: HPV PROTECT as an exemplar

Abstract

Pediatric oncology providers can help childhood cancer survivors protect their health by ensuring they receive routine preventive services. Management of these services by survivorship providers is necessary due to patients’ suboptimal rates of re-engaging with pediatric primary care after treatment completion. This is especially the case with cancer prevention interventions, like human papillomavirus (HPV) vaccination, as survivors have greater confidence in the recommendations offered by their oncology versus primary care providers when counseling of this nature occurs. As these preventive pediatric interventions have traditionally been tested and delivered in primary care, they may lack appropriate tailoring or adaptation to the pediatric oncology setting. This article serves as a guide for using a best practice (ADAPT) framework for adapting and implementing a provider-focused intervention to increase the uptake of HPV vaccination in the pediatric oncology setting. Once the rationale and guiding principles for engaging in this process are presented, the intervention adaptation processes are illustrated via descriptions of assessment, planning, piloting, evaluation, implementation, and maintenance. Additional considerations specific to the pediatric oncology setting are also provided. By applying ADAPT or other appropriate frameworks when adapting and implementing pediatric interventions in the cancer survivorship setting, progress will be made toward establishing a gold standard in approaching these tasks. Ultimately, these collective efforts will maximize the likelihood of effective intervention delivery and reduce health risk in this vulnerable population.