Date Available

4-18-2021

Year of Publication

2021

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Karen Stefaniak

Committee Member

Dr. Morgan Chojnacki

Committee Member

Dr. Emily Messerli

Co-Director of Graduate Studies

Dr. Mandakini Sadhir

Abstract

Background: The Human Papillomavirus (HPV) is a significant factor associated with the development of HPV-associated cancers in the United States. The administration of the HPV vaccination is a critical prevention strategy in reducing HPV-related cancers in the United States. The state of Kentucky has lower than average HPV vaccination rates compared to the national average. There is a significant amount of evidence exploring barriers and facilitators of the HPV vaccination administration. There are several multi-level barriers associated with low uptake of the HPV vaccination in adolescents. Multiple sources of evidence have indicated that parents who receive a provider recommendation are much more likely to receive the HPV vaccination.

Purpose: The purpose of this project is to assess the effectiveness of an educational intervention on health care provider’s understanding of the importance of their own vaccine recommendations to adolescent families to improve HPV vaccination rates.

Methods: This is a quasi-experimental pretest–posttest design. The sample includes medical providers and clinical staff of the University of Kentucky Adolescent Medicine Clinic. Participants completed a pre-survey, an educational quality improvement (QI) session, and post-survey derived from an evidence-based HPV IQ toolkit from the University of North Carolina Gillings School of Public Health. Likert scales were used to analyze provider and clinic staff attitudes before and after the session, perceived importance of components of the session, and to evaluate the change in provider attitudes before and after the session. A paired t-test was used to compare provider attitudes before and after the QI session. Clinic HPV immunization rates of 13-year-old males and females were collected from the Kentucky Immunization Registry before the project implementation and three months following the QI session.

Results: A total of 13 participants completed the pre-survey and the QI education session in November of 2020. A total of 11 participants completed the post-survey. During the post-survey, participants completed an evaluation of the QI program, which demonstrated overall positive attitudes of providers and clinic staff surrounding the HPV vaccination before the session and improved attitudes after the session. In the three months following the educational intervention, completion of at least one HPV vaccination documented improved from 81% to 86% of UK Adolescent Medicine 13-year-old patients.

Conclusion: A gap exists between national recommendations and HPV vaccination completion rates in adolescents due to multiple factors in the United States. Following a QI session, improvement was observed of 13-year-old male and females HPV rates and strength of attitudes of medical staff strength within UK Adolescent Medicine. Although results lacked statistical significance, this study highlights an individual clinic’s ability to obtain tools necessary to set goals, implement evidence-based practices, and improve patient outcomes. Further large participant multi-level evidence-based interventions are recommended.

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