Annals Journal Club Selection:

Jul/Aug 2007

The Annals Journal Club is designed to encourage a learning community of those seeking to improve health care and health through enhanced primary care. Additional information is available on the Journal Club home page.

The Annals of Family Medicine encourages readers to develop the learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club, and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for: Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care, and then acting on those discussions.¹

Article for Discussion

Sussman AL, Helitzer D, Sanders M, Urquieta B, Salvador M, Ndiaye K. HPV and cervical cancer prevention counseling with younger adolescents: implications for primary care. Ann Fam Med. 2007;5(4):298-304.

Discussion Tips

This study considers how visits by adolescents and preadolescents may need to be modified to accommodate counseling about cervical cancer prevention in the era of a new HPV vaccine. Data were gathered from in-depth interviews of diverse clinicians. The article may serve as a useful springboard for clinicians, other practice members, adolescent patients, and parents to consider how counseling should be approached with different patient groups.

Discussion Questions

What are the research questions for this study? Why do the questions matter?
Is the study design appropriate for the research questions? What alternative designs (and study samples) could have been used?
Study methods—To what degree can the findings be accounted for by:

How participants were selected?
How the interview guide was prepared and how the interviews were conducted? (See the Clinician Interview Guide in Supplemental Appendix 1, available online at http://www.annfammed.org/cgi/content/full/5/4/298/DC1.)
The characteristics of the analysis team?
The analysis approach and how the data were interpreted?

Main findings—What are the main findings? Into what broader context do the findings put HPV vaccination? How do these studies advance current knowledge? How do they fit with current approaches to promoting and paying for HPV vaccine?
Generalizability—How transportable are the findings to other settings, particularly to my patients, practice, and community?
Implications—How can the information from this study inform how practices approach adolescent or preadolescent patients and their families? What are the implications for adolescent patients and their parents? How can the age at which this intervention is recommended be matched to the developmental stage of the patient? How does this study inform public policy? How should public discussion around this topic be fostered? What is the role of direct-to-consumer advertising by vaccine manufacturers?

Reference

Stange KC, Miller WL, McLellan LA, et al. Annals journal club: It’s time to get RADICAL. Ann Fam Med. 2006;4:196-197. Available at: http://annfammed.org/cgi/content/full/4/3/196.

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