Methods: We conducted 11 focus groups with a total of 28 students, averaging 3 per group. Using an inductive approach, we hand-coded focus group transcripts, developed a coding structure, and discussed themes as they emerged from the data.
Results: Although more than half of the students had never heard of the HPV vaccine, students generally held positive views about vaccines. Barriers to receiving the HPV vaccine included lack of awareness and knowledge about the HPV vaccine, as well as lack of perceived need for the vaccine. When asked about the most important information that they needed in order to make an informed decision about whether or not to get the vaccine, participants mentioned the following: 1) prevalence of HPV, 2) HPV-related diseases, 3) what the HPV vaccine protects against, 4) HPV vaccine safety, 5) HPV vaccine efficacy, and 6) how they can access the vaccine. Participants differed in their preferences for types of health education, from an in-person informative lecture, to YouTube videos, to posters placed in dorms or in bathrooms. They preferred the conveyor of this information to be a trustworthy source; they identified healthcare providers, professors/researchers, and other students who have received the vaccine as credible sources. In terms of message appeal, many students described wanting the facts, statistics about HPV prevalence and the vaccine as well as narratives from students who have been diagnosed with HPV and those who have experience receiving the vaccine.
Conclusions: Although this cancer prevention resource has been commercially available since 2006, college students still a lack of awareness and perceived need for the HPV vaccine. Future health education efforts should utilize participants’ recommendations to increase students’ understanding of HPV and the HPV vaccine and, therefore, impact their perceived susceptibility to HPV, the benefits of the vaccine to their health, and therefore increase utilization of this resource. Strategies to increase vaccination should include health education and vaccine implementation strategies, as well as strategies to reduce the cost of the vaccine for college students, thereby increasing the accessibility of the vaccine for this population.
Harald zur Hausen studied viruses and discovered that certain strains of the human papilloma virus (HPV), a sexually transmitted disease, can cause cervical cancer, in Europe during the twentieth and twenty-first centuries. Zur Hausen spent his research career identifying the viruses that cause diseases, particularly cancer-causing viruses (oncoviruses). He primarily focused on HPV and cervical cancer. Zur Hausen hypothesized that HPV was cancerous and discovered that two strains, HPV 16 and 18, caused cervical cancer. That discovery led to improved diagnosis of cervical cancer and the later development of the HPV vaccines, Gardasil and Cervarix. In 2008, zur Hausen won the Nobel Prize in Physiology or Medicine.
From 1977 to 1987, Harald zur Hausen led a team of researchers across several institutions in Germany to investigate whether the human papillomavirus (HPV) caused cervical cancer. Zur Hausen's first experiment tested the hypothesis that HPV caused cervical cancer rather than herpes simplex virus type 2 (HSV-2), the then accepted cause. His second and third experiments detailed methods to identify two previously unidentified HPV strains, HPV 16 and HPV 18, in cervical cancer tumor samples. The experiments showed that HPV 16 and 18 DNA were present in cervical tumor samples. Zur Hausen concluded that HPV, not HSV-2, caused cervical cancer, which enabled researchers to develop preventions, such as the HPV vaccine.
The Human Papillomavirus (HPV) strains 16 and 18 are the two most common HPV strains that lead to cases of genital cancer. HPV is the most commonly sexually transmitted disease, resulting in more than fourteen million cases per year in the United States alone. When left untreated, HPV leads to high risks of cervical, vaginal, vulvar, anal, and penile cancers. In 1983 and 1984 in Germany, physician Harald zur Hausen found that two HPV strains, HPV-16 and HPV-18, caused cervical cancer in women. In the early twenty first century, pharmaceutical companies Merck & Co. and GlaxoSmithKline created HPV vaccines protecting against HPV-16 and HPV-18, which have reduced the number of HPV infections by fifty-six percent in the US. Discovering HPV strains 16 and 18 allowed physicians to test for those cancer-causing cell populations using Pap smears, a diagnostic tool that collects cells from the woman's cervix to identify cancerous cases of HPV infection. By identifying the cancerous strains of HPV-16 and HPV-18 and utilizing preventative measures such as the Pap smear and HPV vaccines, the rates of cervical cancer and other HPV-related cancers have reduced.
Human Papillomavirus, or HPV, is a viral pathogen that most commonly spreads through sexual contact. HPV strains 6 and 11 normally cause genital warts, while HPV strains 16 and 18 commonly cause cervical cancer, which causes cancerous cells to spread in the cervix. Physicians can detect those HPV strains, using a Pap smear, which is a diagnostic test that collects cells from the female cervix.
Study Design: Ten health care providers from Vaccines for Children (VFC) clinics in New Mexico were included in this pretest/posttest study. Providers were given a questionnaire adapted from the Determinants of Intent to Vaccinate (DIVA) questionnaire. Only two subscales were utilized for this project (total of 10 items): Adaptation to the Patient’s Profile and General Practitioner’s Commitment to the Vaccine Approach. Martinez et al. (2016) suggest that PCP’s commitment to the vaccination approach” can be used as a stand-alone tool with a Cronbach’s alpha > .70. Following the pretest, which served as consent, providers viewed a short, four video series addressing common barriers to the HPV vaccine, followed by the same questionnaire. First and second dose rates of the HPV vaccine were measured prior to the intervention and three months post intervention using the New Mexico Immunization Information System (NMSIIS).
Results: A Wilcoxon Ranks test was used for statistical analysis of the survey responses. Alpha was set at ≤ .10. Four of the 10 questions were statistically significant for increasing provider intent to vaccinate. HPV first dose rates increased in all three clinics and second dose rates increased in two out of the three clinics.
Conclusions: Web-based education is a successful intervention for increasing
provider intent to vaccinate and first and second dose HPV administration rates. Not only can the intervention be used for the HPV vaccine, but to help increase administration rates of all other vaccines.
The human papillomavirus (HPV) is the most commonly spread sexually transmitted infection in the United States. Although the HPV vaccine protects against transmission of the most common strains of HPV that cause genital warts and numerous urogenital cancers, uptake in the United States remains suboptimal. Failure to vaccinate leaves individuals vulnerable to the virus and subsequent complications of transmission. The evidence demonstrates that provider recommendation alone increases rates of vaccine uptake. The literature does not suggest a specific method for provider recommendation delivery; however, best practice alerts (BPAs) were correlated with increased vaccination rates.
These findings have directed a proposed project that includes an electronic health record (EHR) change prompting internal medicine, family practice and women’s health providers to educate and recommend the HPV vaccine at a Federally Qualified Health Center (FQHC) in the Southwest United States. The project demonstrates that after the implementation of a practice change of a HPV BPA in the EHR, HPV vaccination rates increased. Practice settings pre and post were similar, making the increase clinically significant.
The strengths of this project include an increase in HPV vaccination rates, a sustainable intervention, and an intervention that can easily be replicated into other health maintenance tasks. There were some limitations including the BPA alert only catching the HPV 9 vaccine series and the BPA did not always capturing historical data. Despite these technical barriers the HPV BPA delivered an increase in the HPV vaccine to protect more individuals from the HPV virus, increased provider adherence to national guidelines, and provides a platform for BPAs to be utilized for other vaccines.
The human papillomavirus (HPV) is a sexually transmitted infection (STI) that is associated with several types of cancer and genital warts. No cure exists for those currently infected with HPV, but a vaccine is available that can prevent the virus and development of cancers associated with HPV. Military servicemembers are at a high risk for contracting HPV; it is one of the most common STIs among active duty service members. The health consequences of HPV can impact a servicemember’s military readiness. The HPV vaccine is not required for military servicemembers, but it is offered free of charge. HPV vaccination rates among military service members remain relatively low.
The purpose of this evidence-based project was to increase the level of knowledge about HPV, improve health beliefs regarding HPV, increase HPV vaccine intention, recommendation, and uptake. Using the Health Belief Model as an organizing framework, a population targeted eight-minute education video on HPV and HPV vaccination was developed. It was implemented at an outpatient military treatment facility located in the southwest United States over a 6-week period, to newly reported service members. Participants included 116 military service members aged 18 to 45. A pretest and posttest questionnaire were used to assess the impact of the intervention. HPV level of knowledge increased significantly from pretest to posttest mean scores were 3.00 to 4.39 respectively (p < .001). HPV vaccine intention increased from 62% to 66% (p = .739). HPV vaccine recommendation increased from 62% to 85% (p < .001).
Human papillomavirus (HPV) is a prevalent sexually transmitted infection that affects many adolescents and adults worldwide. The consequences of contracting HPV have proven to be devastating, potentially leading to a variety of life-threatening genitourinary and oral cancers. As such, prevention via vaccination is critical. HPV vaccination is recommended for all adolescents beginning at 11 years of age. Although the immunization has proven to be safe and effective, HPV vaccination rates are substantially below target goals worldwide.
A literature review of evidence from the last five years was conducted to examine barriers and facilitators to HPV vaccine uptake. The most commonly cited barriers to vaccination included lack of knowledge about the vaccine and inadequate provider recommendation. Current evidence regarding interventions to increase HPV vaccine uptake reveal that best practices are multi-factorial and should include a combination of provider education and recommendation training. These findings led to the proposal of an evidence-based intervention aimed to increase adolescent HPV vaccination rates.
A one-hour educational program was conducted at a local pediatric primary care facility. Five healthcare providers participated in the program, which consisted of a PowerPoint presentation outlining the benefits of HPV vaccination and use of an interactive application from the CDC. The app taught participants how to offer a strong recommendation for the vaccine through active participation. Pre and posttests were administered to determine the providers’ intent to vaccinate and vaccination rates were monitored. Analysis of the data collected revealed a statistically significant rise in vaccination rates. These results reveal that provider education can improve recommendation techniques and therefore increase vaccine coverage. Further research is needed to see if one-time education is sustainable.