By: Ashley Lach, MHA, CPHQ  and Christina Turpin

Nearly 20% of the U.S. population—equating to 57 million Americans—live in rural communities, where they may face significant barriers to accessing health care and experience poorer health outcomes. One area of concern is the higher incidence of HPV cancers in these communities. HPV vaccination is key to making change. However, historically, rural areas have lagged urban counterparts by about 10% in the uptake of the HPV vaccination series.

The American Cancer Society (ACS) and the ACS National HPV Vaccination Roundtable (HPVRT) have long collaborated with rural communities to address this issue. Their efforts include a three-year project in the Mountain West, participation in the St. Jude rural think tank engagement, the creation of a rural advisory group, and the establishment of the Rural HPV Vaccination Learning Community.

In response to the rural HPV vaccination gap, in March 2024 we launched the Rural HPV Vaccination Learning Community—a virtual, peer-based series stemmed from quality improvement (QI) and evidence-based interventions (EBI). The goal is to increase knowledge, prioritize HPV vaccination, and equip rural health care systems with the tools to implement best practices.

Our model includes concise presentations with technical assistance, panels featuring rural partners who share their experiences and challenges, and small breakout sessions to address questions and issues in each topic area. The curriculum is designed to build upon itself, emphasizing the use of vaccination data, goal setting, gap analysis, exploring EBIs, overcoming challenges, and creating lasting change. Past session recordings are available for public viewing.

In its first year, participation was strong, with 332 unique participants from 223 organizations representing 32 states across the U.S. Notably, states such as California, Wisconsin, Texas, Nevada, and Virginia had high representation—some with the largest adolescent populations and others with predominantly rural settings. The patient impact was significant, with over 373,000 children aged 9-13 potentially eligible to initiate or complete their HPV vaccination series.

The early results are encouraging: 61.5% of participants who attended the HPV vaccination-at-age-9 session, recognized as a promising practice, reported feeling inspired to integrate the information into their everyday work. Even more exciting, 100% of those involved in the EBI discussion are not just planning but committed to putting HPV vaccination EBIs into action within the next six months. It is clear change is possible, and this work will help impact Healthy People 2030 goals and beyond.

Registration for the 2025 Rural Learning Community is now open and will begin on March 12. We are committed to protecting children today from HPV infections, pre-cancers, and cancers in the future. Join us in making this critical change for rural America’s health.

About the authors

Christina Turpin is the Director for the National HPV Vaccination Roundtable with the American Cancer Society (ACS). Along with the ACS National HPV Vaccination Roundtable team, she leads nationwide efforts to raise HPV vaccination rates and prevent HPV cancers with the ultimate vision of ending vaccine-preventable HPV cancers as a public health problem. Christina has been with ACS for 14 years and started her career with ACS in Baltimore, Maryland before relocating home to Idaho. Prior to her current position, she focused on advancing priorities around cancer screening and prevention, HPV vaccination, quality of life, survivorship, access to care, and health equity. Christina is a graduate of Pennsylvania State University. She resides in Boise, Idaho and enjoys spending time with her family out in the woods, on the lake, or cheering on Penn State Football. 

Ashley Lach, MHA, CPHQ, joined the American Cancer Society in 2009 as an Income Development Specialist. In 2014, she transitioned out of development and into a role within the patient support pillar where she led the goals of the American Cancer Society’s mission through comprehensive, prioritized partnerships with health care systems, payors, clinics, providers, and state agencies. In 2021, Ashley transitioned to a grant funded position working on the Interventions & Implementation team where she is a program manager working on reducing HPV disparities. Ashley received her Bachelor of Arts in Communication from DePaul University and her Master of Health Administration from Ohio University. Ashley holds a basic certification of quality and safety from the Institute for Healthcare Improvement (IHI) and is a Certified Professional in Health care Quality (CPHQ) which is the gold standard from the National Association for Health care Quality.