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Increasing Human Papillomavirus Immunization in Pediatric Cancer Survivors for Population Health: A Quality Improvement Approach

Kent, Debra A
http://rave.ohiolink.edu/etdc/view?acc_num=xavier1524824560677099

Abstract Details

2018, Doctor of Nursing Practice Degree Program in Population Health Leadership DNP, Xavier University, Nursing.
Background: Human papillomavirus (HPV), the most common sexually transmitted infection in the United States, results in significant morbidity and mortality. Pediatric and adolescent cancer survivors’ vulnerability to second malignancies leaves this under-immunized population at increased risk. Methods: Guided by the Health Belief Model (HBM) and using quality improvement methodology, a HPV Cancer Prevention video was created and implemented during a routine survivorship appointment. The purpose was to 1) explore feasibility of a video implementation process, 2) improve provider recommendation/endorsement of HPV vaccine, 3) explore satisfaction, knowledge gain, and rationale for immunization and 4) measure initiation and completion rates. Results: The HPV Cancer Prevention video supplemented provider education and endorsement, successfully increasing HPV initiation and completion rates in a vulnerable survivorship population. Eighty percent of survivors and 73% of parents either strongly agreed or agreed that the video provided them with new information about HPV. Satisfaction rates for receiving HPV information in video format were similarly high, with 90% of survivors and 87% of parents satisfied, or very satisfied. Provider endorsement of immunization, a strong predictor of immunization, improved over historical baseline to 95% of the population. Immunization initiation and completion rates of 68% and 40.4% (respectively) were higher in this cohort of 59 survivors (33 males, 26 females) than for other cancer survivor populations. The most commonly reported rationale for uptake related to perceived susceptibility, reported as “cancer prevention”; cues to action such as provider recommendations and familial experience with HPV associated cancers were important; lack of perceived susceptibility featured themes about the lack of sexual activity. Other rationale included lack of research about the vaccine and religious justification. The decline to vaccinate rate was 32%. Conclusions: Capitalizing on oncology survivorship visits provides additional opportunities for discussion about HPV, and for immunization. Video education, a useful supplement to provider endorsement, and a feasible strategy for increasing uptake, requires an HPV champion for sustainability. Strategies to increase cancer survivors’ lower HPV immunization completion rates are necessary. Cancer survivor refusal rates are concerning in a population at heightened risk, and require further study.
Susan Allen, PhD, RN-BC (Committee Chair)
Patricia McMahon, DNP, NP-C, RN (Committee Member)
137 p.
Health; Health Care; Public Health
Human papillomavirus immunization; Human papillomavirus uptake; HPV immunization uptake in cancer survivors; HPV immunization interventions

Recommended Citations

Citations

  • Kent, D. A. (2018). Increasing Human Papillomavirus Immunization in Pediatric Cancer Survivors for Population Health: A Quality Improvement Approach [Doctoral dissertation, Xavier University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1524824560677099

    APA Style (7th edition)

  • Kent, Debra. Increasing Human Papillomavirus Immunization in Pediatric Cancer Survivors for Population Health: A Quality Improvement Approach . 2018. Xavier University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=xavier1524824560677099.

    MLA Style (8th edition)

  • Kent, Debra. "Increasing Human Papillomavirus Immunization in Pediatric Cancer Survivors for Population Health: A Quality Improvement Approach ." Doctoral dissertation, Xavier University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1524824560677099

    Chicago Manual of Style (17th edition)

xavier1524824560677099
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© 2018, all rights reserved.
This open access ETD is published by Xavier University and OhioLINK.