AdvisorSheppard, Kate G.
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PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractPurpose: To identify barriers to implementing practice recommendations regarding HPV (human papillomavirus) vaccination for male adolescent patients among Family Nurse Practitioners (FNPs). Rationale/Background: HPV infection is a source of numerous cancers. More than one-quarter of the HPV-associated cancers in the United States occur in males. The quadrivalent vaccine is approved in young males and is effective in the prevention of genital warts and reducing HPV related cancers yet vaccination rates are low and expected to remain low. Barriers to vaccination exist even after the 2011 recommendation for routine use. Method: Quantitative, surveys. A 22-item instrument was administered to FNPs working in primary care settings. Participants were surveyed regarding financial, logistic, provider, and parental barriers to vaccination among adolescent males. Results: Descriptive analysis at both the item and scale level demonstrated that FNPs report financial barriers as the most significant barrier. The barriers of least concern were provider attitudes. Barriers regarding FNPs' perception of parental attitudes were seen as moderately concerning. Independent samples t-tests showed that FNPs who did not administer the HPV vaccine to male adolescent patients reported having significantly more financing barriers as compared to FNPs who did. Conclusion: Results suggested that financial issues may constrain FNPs' implementation of practice recommendations for the HPV vaccine and that FNPs who did not administer the HPV vaccination to adolescent male patients may be unable to do so due to financial reasons. Perceptions of parental attitudes are also seen as playing a role in preventing male adolescent patients from receiving the HPV vaccine. Efforts to reduce barriers to implementing recommended HPV vaccine practices should focus on lessening the expense of the vaccine for both providers and parents and increasing parental knowledge and understanding of the HPV vaccine for their sons. Definitions: HPV4 is used to reference the quadrivalent and Gardasil® vaccinations; permissive refers to the 2009 Advisory Committee on Immunization Practices (ACIP) support of allowing adolescent males aged 9-26 to decide, in collaboration with their health care providers, to vaccinate; recommended is the ACIP's modification from permissive to routine recommendation.
Degree ProgramGraduate College