Abstract
Occupational and environmental health nurses play a critical role in educating the public about human papillomavirus (HPV). With HPV vaccination rates remaining low, creative educational models should be explored.
According to the Centers for Disease Control and Prevention (2016), human papillomavirus (HPV) vaccination rates remain low in the United States and are very low relative to other vaccines. Historically, HPV vaccination education focused on the virus’ association with sexual health and preventing the infection in women. However, this educational model failed to focus on the long-term effects of HPV infections in both men and women, and the cancer-preventing benefits of the HPV vaccine (White & Waldrop, 2013).
Occupational and environmental health nurses play a critical role in improving public health by designing programs to reduce the risk of disease and implementing preventive strategies to keep workers healthy and productive (American Association of Occupational Health Nurses, n.d.). These nurses can make an impact by providing vaccine information and educating workers, parents, and students about the cancer-preventing effects of the HPV vaccine (Beavis & Levinson, 2016).
To assess the effectiveness of HPV education, the research team selected underserved middle school students to pilot the HPV education program. Over a 2-day period, school administrators and staff allowed 25 minutes of class time in all life science courses for HPV education. All middle school students of ages 11 to 14 in attendance during the life science courses received the education. Pre- and posteducation surveys were used to evaluate participant HPV knowledge, vaccine accessibility, interest in vaccination, and willingness to discuss the HPV vaccine with a parent or guardian. The Washington State University Institutional Review Board determined that the study was exempt. All survey data were compiled and analyzed using the chi-square test with two endpoints and Kruskal–Wallis test for data with three endpoints.
In comparing the postsurvey with presurvey data, the responses significantly reversed upon receiving the educational material with 69% (305/444) of respondents stating they would not discuss the vaccine with their parents and 27% (118/453) stating they would (p ≤ .001). Although the difference was not statistically significant, more respondents (n = 21, p = .107) were open to receiving HPV vaccine after the basic HPV educational presentation emphasizing that the cancer-causing virus affects both males and females. Postsurvey data revealed 15% (67/444) of the participants would receive the vaccine, 23% (104/444) would not receive the vaccine, and 61% (269/444) remained undecided. A significant barrier to HPV vaccination is willingness to discuss the vaccine with a parent or guardian; this may be due to the sexual transmission of the virus. Another barrier to increasing HPV immunization rates is the perception among parents that receiving HPV vaccine will increase students’ sexual activity (Beavis & Levinson, 2016). A limitation of the study was the varied health literacy and reading levels among respondents, which may have created inconsistent and incomplete survey data.
Providing education about the HPV, transmission, and vaccine prevention directly to middle school students did not improve their willingness to discuss these topics with a parent or guardian. This information may be useful to occupational health nurses who provide HPV education to workers. Occupational health nurses should consider the health literacy of their workforces in providing any health education programs. The advantages of the HPV vaccination including the cancer-preventing benefits should be emphasized, and data demonstrating that no correlation exists between the vaccination and increased sexual activity should be provided (Bailey et al., 2016; Bednarczyk, Davis, Ault, Orenstein, & Omer, 2012).
Footnotes
Acknowledgements
The authors thank student pharmacists Hope Tran and Courtney Mayo for their assistance with the project. They also acknowledge Ross Bindler, PharmD, for his statistical analysis of the survey findings.
The author(s) declared no potential conflicts of interest and received no financial support with respect to the research, authorship, and/or publication of this article.