Measurement of provider fidelity to immunization guidelines: a mixed-methods study on the feasibility of documenting patient refusals of the human papillomavirus vaccine

Table 2 Proportion of well visits with documented patient refusals among the seven adopter practices during Baseline Phase and Implementation Phase

Study phase	Proportion of Well Visits with Documented Refusals						p-value^a
	Overall n = 7 Practices		Coach-Based Arm n = 4 Practices		Web-Based Arm n = 3 Practices
	Refusals / Well Visits	%	Refusals / Well Visits	%	Refusals / Well Visits	%
Baseline phase^b
Quarter 1	8/1282	0.62	0/1010	0.00	8/272	2.90	< 0.001
Quarter 2	17/2797	0.61	3/2252	0.13	14/545	2.60	< 0.001
Quarter 3	14/2278	0.61	2/1764	0.01	12/514	2.30	< 0.001
Quarter 4	28/1183	2.40	11/919	1.20	17/264	6.40	< 0.001
Implementation phase
QI Project 1^b
Quarter 5	182/1283	14.20	150/977	15.40	32/306	10.50	0.04
Quarter 6	580/2865	20.20	519/2292	22.60	61/573	10.60	< 0.001
QI Project 2^b
Quarter 7	623/2591	24.00	558/2094	26.60	65/497	13.10	< 0.001
Quarter 8	317/1681	18.80	290/1399	20.70	27/282	9.60	< 0.001
Overall for Implementation Phase	1472/8082	18.20	1517/6762	22.40	185/1658	11.10	< 0.001

QI Quality Improvement
^aP-value represents the Pearson Chi-square test with Yates’ continuity correction comparing proportion of documented refusals between the coach-based and web-based arms
^bEach quarter represents 3 months
Boldface indicates p < 0.05

ISSN: 1472-6947