Clinical Protocol Development: Targeted Educational Intervention for Acceptance of HPV Vaccine

Tuesday, 13 July 2010

Brenda L. Cassidy, RN, MSN, CPNP-PC
Elizabeth A. Schlenk, PhD, RN
School of Nursing, University of Pittsburgh, Pittsburgh, PA

Learning Objective 1: describe the effects of educational strategies on parental acceptance rates of HPV vaccine as reported in the literature.

Learning Objective 2: describe the implications of use of an evidence-based educational fact sheet on parental acceptance of the HPV vaccine.

Significance
Cervical cancer is the third leading cause of death in women worldwide (Alexander, Block, Ault, Derkay, & Ferris, 2008).  Human Papilloma Virus (HPV) is a sexually transmitted infection that causes 70% of cervical cancer.  The HPV vaccine prevents infection when vaccinated prior to coital debut (Center for Disease Control and Prevention, 2006).  Hispanic and non-Hispanic black women have a higher incidence of cervical cancer than non-Hispanic white women (Barnholtz-Sloan, Patel, Rollison, Kortepeter, MacKinnon, & Giuliano, 2009).  Use of culturally sensitive evidence-based targeted educational interventions can promote parental acceptance of the HPV vaccine and reduce cervical cancer rates and racial disparities in cervical cancer.
Objectives
The clinical question is:  In parents of girls 11-12 years of age, what is the effect of an evidence-based educational fact sheet on parental acceptance of the HPV vaccine?
Literature
A literature search was conducted using the following databases:  PubMed, CINAHL, MEDLINE, PsycInfo, and Cochrane Database of Systematic Reviews.  Keywords used in the search were:  HPV/human papilloma virus, parent/mother, knowledge/education, vaccine/HPV vaccine, acceptance, adolescent/child, health promotion, pamphlets, educational strategies, awareness, willingness.  Seven articles were selected that investigated educational strategies to promote parental acceptance of the HPV vaccine.
Evidence Evaluation
A review of randomized controlled trials and quasi-experimental studies regarding parental acceptance after targeted education about the HPV vaccine revealed that 37%-63% of parents were more likely to accept HPV vaccine after receiving targeted education.
Project Evaluation
An evidence table was constructed to evaluate the evidence supporting the clinical question, and an overall evidence grade was assigned, according to Agency for Healthcare Research and Quality criteria.
Implications
The results will be used to develop a culturally sensitive targeted educational intervention that can be easily translated into clinical practice to increase acceptance of the HPV vaccine, thus reducing cervical cancer rates and racial disparities in cervical cancer.