Improving HPV Vaccination Rates Through Healthcare Worker Education

Human Papilloma Virus (HPV) is an insidious and nearly ubiquitous sexually transmitted infection (STI). The Centers for Disease Control and Prevention (CDC) estimates that nearly all sexually active adults will experience at least one HPV infection at some point in their lives. Chronic infection with HPV can lead to devastating cancers and genital warts in both men and women. Fortunately, a vaccine against HPV has been developed and is available for both females and males. This project aims to improve knowledge and recommendation of this vaccine among healthcare workers within the University of Utah organization. Utilization of the HPV vaccine has been poor nationwide and particularly within the state of Utah since its approval in 2006. Rates have essentially stagnated over the past several years. These rates currently fall well below the goal of 80% for the Healthy People 2020 initiative. The first objective of this project is to identify the most common barriers to HPV vaccination among stakeholders and identify the most effective methods of addressing those barriers. The second is to assess healthcare workers' baseline knowledge of HPV and the vaccine, assess frequency of vaccine recommendation, comfort discussing the vaccine with patients, and administer an educational presentation regarding HPV. The third is to assess improvement in healthcare workers' knowledge of HPV, assess for increased vaccine recommendation, and improved comfort discussing the vaccine with post-presentation evaluations. The final objective is to disseminate the project findings via poster presentation at a professional nursing conference. The literature on HPV vaccination provides insights into why vaccination rates are so poor. First, healthcare workers themselves lack knowledge about HPV infection, the diseases it causes, and specifics of the HPV vaccine series. Second, they simply do not recommend the vaccine frequently enough. The number one indicator of HPV vaccination success is a provider's recommendation. The literature also indicates that parents and their children lack awareness of HPV and lack trust in the HPV vaccine. Providers avoid recommending the vaccine because they do not want to address parental concerns or they view the vaccine as optional. An educational presentation on HPV was developed with thorough literature review of the most common obstacles to HPV vaccination. A brief pre-presentation questionnaire was administered to assess healthcare workers' baseline knowledge of HPV, the vaccine, comfort with discussing the vaccine with patients, and frequency of recommendation. Following the educational presentation, participants were sent a post-presentation questionnaire to assess improvement in baseline knowledge. A follow-up questionnaire was administered after two weeks to assess improvement in comfort discussing the vaccine and increase in vaccine recommendation. This data was evaluated for statistically significance via a paired student t-test. Results demonstrated moderate knowledge gaps among healthcare workers, particularly regarding HPV infection, related diseases, and HPV vaccine administration. However, baseline knowledge, comfort with discussing the vaccine, and frequency of vaccine recommendation were shown to improve significantly post-educational presentation. In summary, this project sought to improve HPV vaccination rates through provider and healthcare worker training and education. Training our providers and healthcare workers to be knowledgeable about how to address patient concerns should improve HPV vaccination rates.