Dr. Jacobson's passion for research grew out of his nearly lifelong love for mathematical truth, public debate, and public health. The intersection of these drove his pursuit of quantitative clinical epidemiology under the tutelage of the late Alvan R. Feinstein as a Robert Wood Johnson Clinical Scholar at Yale, following his completion of a pediatric residency there. In his first years at Mayo Clinic, he directed clinical studies and trials in the immunogenetics of vaccines. Through those experiences he learned about practical matters in the conduct of research but wanted to direct his passion and his experience toward improvements in vaccine uptake. This led to his work in founding initiatives in primary care at Mayo Clinic in population health science. It was that work that led to his collaboration with Lila J Finney Rutten, Ph.D., and their shared, NCI-funded R01 titled "Less Pain, Less Fuss, Right Now! and Make It Count! Multilevel Interventions for Patient, Parent, and Practice to Enhance Provider Recommendations for HPV Vaccination."

Dr. Jacobson had firsthand experience in the conduct of pre-licensure human papillomavirus (HPV) vaccine studies. The prevalence of HPV infection became very clear. Research participant recruitment was stymied by significant proportions of otherwise eligible females who were already infected with the virus. Now, despite the availability of a very effective and safe vaccine, HPV infections by strains included in the vaccine continue to cause 30,000 cancers in the United States each year. Uptake of the HPV vaccine has been disappointingly low and lags behind other adolescent vaccines. This study seeks to test interventions targeting health care system, provider, and patient factors to improve the population uptake of the HPV vaccine. The results of this clinical trial and process evaluation will provide important evidence regarding the effectiveness of both practice-level and provider-level interventions. Specifically, outcome and process evaluation data will provide evidence showing whether practice- and provider-level interventions improve HPV vaccination rates and will offer insight into causal mechanisms and contextual factors associated with trial outcomes. Effective interventions at the practice- and provider-level may provide the major incremental boost needed to improve HPV vaccination rates in practices throughout the US. It is the under-vaccination of patients, despite the effectiveness and well-established safety of HPV vaccination, that drove Dr. Jacobson to pursue this work.