Factors influencing HPV vaccination recommendations among nurses in the ambulatory setting
Chopp, Shannon Richard
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The human papillomavirus (HPV) vaccination rates for adolescent males and females is well below the Healthy People 2020 goals of 80% vaccination rate. In the ambulatory care setting, licensed nurses of all educational levels have the ability to counsel and recommend the HPV vaccine. Prior to determining the impact of nurses within the ambulatory care setting on HPV vaccine uptake, the knowledge, attitude, self-efficacy, and intent to recommend the HPV vaccine to preteen males and females should be measured. An anonymous, secure, online survey was conducted via PsychData® using the Shared Decision Making Inventory-Revised (SDMI-R). The recruitment and reminder letters with embedded link to the survey was placed on the discussion boards of nursing organizations. Snowball sampling was encouraged in the recruitment and reminder letters. A total of 208 participants responded to the survey. Four multiple linear regressions with eight predictor variables were used to address the two research questions. For the first research question, which examined the effect of HPV knowledge level and clinician education level on clinician attitude, it was found that HPV knowledge level was a significant predictor for attitudes toward recommending the HPV vaccine to preteen males and females. This finding lends support to previous studies. The differences in the results of the regression equations noted between males and females suggest that overall HPV knowledge for males may be lower than for females, which may influence clinician attitude. No significant relationships were found between clinician education level and attitude for males or females in this study, or in previous research. Research Question 2 examined the effect of clinician attitude and self-efficacy on intent to recommend the HPV vaccine. For females, it was found that both attitude and self-efficacy were significant predictors of intent. For males, self-efficacy was found to be a significant predictor of intent, but attitude was not. As knowledge levels affect attitudes, the differences in the results of the regression equations may be attributed to lower HPV knowledge levels for males.