• The Anti-Vaccination Movement: Past and Present

      Morgosh, Kelsey; The University of Arizona College of Medicine - Phoenix; Kravetz, Robert, MD (The University of Arizona., 2015-02-15)
    • Barriers To HPV Vaccination Among Male Adolescents

      Sheppard, Kate G.; Gora, Kelli; Sheppard, Kate G.; Berg, Judith; Rigney, Ted (The University of Arizona., 2014)
      Purpose: 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.
    • The C.A.S.E. Approach (Corroboration, About Me, Science, Explain/Advise): Improving Communication with Vaccine-Hesitant Parents

      Peek, Gloanna; Stevens, Jessica Celeste; Peek, Gloanna; McArthur, Donna B.; Badger, Terry A. (The University of Arizona., 2016)
      OBJECTIVES: The anti-vaccination movement is prevalent in today's media with claims which continue to create feelings of fear and trepidation in the minds of many parents. The C.A.S.E. Approach (Corroboration, About Me, Science, Explain/Advise) is a method ofcommunication to be used in formulating meaningful, rapid responses to parents hesitant to vaccinating their children. This DNP project assessed the effects of a C.A.S.E. Approach learning module on family nurse practitioner (FNP) students' perceived levels of knowledge and self-efficacy regarding vaccination discussion with vaccine hesitant parents (VHPs). METHODS: This DNP project used a pretest-posttest design to measure the effects of the C.A.S.E. Approach training intervention on both knowledge and self-efficacy levels of FNP students. Fourteen students participated in this study. Each took the 20-question pretest C.A.S.E. Approach Questionnaire, then participated in the C.A.S.E. Approach learning module,and finished by repeating the questionnaire as a posttest following the intervention. The questionnaire was designed using four-item Likert questions scored 1 (strongly disagree) to 4(strongly agree), wherein higher scores reflected better understanding and self-efficacy in the C.A.S.E. Approach. Students were recruited via an online classroom format within a nursing course offered at the University of Arizona: Nursing 612, Introduction to Pediatrics. All testing and module information was accessed online and questionnaire responses were stored at Qualtrics.com, also online. RESULTS: Students' posttest scores following the intervention of the C.A.S.E. Approach learning module were significantly higher than pretest scores. Perceived knowledge (p< 0.001)of the C.A.S.E. Approach increased more significantly than did perceived self-efficacy (p =0.001) of the C.A.S.E. Approach following the module. Mean test scores increased on average 14.29 points in perceived knowledge of the C.A.S.E. Approach following the module, and 7.93 points for perceived self-efficacy following the module. CONCLUSION: Key findings included an observed increase in participating students' perceived knowledge regarding the C.A.S.E. Approach as well as an observed increase inparticipating students' perceived self-efficacy in using the C.A.S.E. Approach. There was strong statistical evidence (p≤0.05) to suggest the learning module increased student knowledge andself-efficacy regarding vaccine discussion.
    • The Effect of an Immunization Training Program on the Willingness of Pharmacy Students to Receive, Administer, Recommend, and Counsel About Vaccinations: A retrospective, pre-post study

      Spencer, Jenene; Fazel, Maryam; Ivanov, Marina; Rodriguez, Jessica; College of Pharmacy, The University of Arizona (The University of Arizona., 2017)
      Objectives: To determine whether pharmacy students were more willing to receive, administer, recommend and counsel patients about vaccinations after completing an immunization training program Methods: Anonymous and voluntary questionnaires administered on paper during a regularly scheduled class collected ratings of confidence on the willingness of first year pharmacy students to receive, administer, recommend and counsel about vaccinations prior to and after the completion of an immunization training program. Data on gender, age range, status of completion and source of the immunization training program completed was also collected. This study was approved by the University of Arizona Institutional Review Board (IRB). Results: Questionnaires were completed by 110 students at the Tucson and Phoenix campus. Students were equally willing (p=0.235) to receive all vaccinations, even if they were not required to by the UA COP, before and after the immunization training program.There was a statistically significant difference in the willingness to administer (p<0.001), to recommend (p=0.024) and to counsel (p<0.001) about vaccinations after completion of an immunization training program. Conclusions: Completing an immunization training program did not have influence on the willingness of pharmacy students to receive vaccinations. However, the results suggest pharmacy students are more willing to administer, recommend and counsel about vaccinations after the completion of an immunization training program.
    • Influenza Acquisition occurring Post-Vaccination Among University of Arizona College of Pharmacy Students

      Tran, Kim; Slack, Marion; Flynn, Shannon; Malott, Megan; College of Pharmacy, The University of Arizona (The University of Arizona., 2019)
      Specific Aims: Assess the incidence of influenza despite being vaccinated among pharmacy students in the 2017/2018 influenza season at the University of Arizona. Our working hypothesis is that pharmacy students who received the influenza vaccine in the 2017 year will have a lower rate of acquisition than among people who did not receive the influenza vaccine. Methods: Questionnaires were administered to first, second, and third year pharmacy students during scheduled class times to gather information on influenza acquisition, influenza symptoms, vaccine attainment, and demographic characteristics through self-reported answers. Main Results: The characteristics of pharmacy students were similar between those who acquired the flu or not. However, whether or not the pharmacy students had kids was significantly different between those who had influenza versus not ( p= 0.0146) Pharmacy students who received the vaccine had lower rates of acquiring the flu compared to the national average (p=0.0005). When comparing pharmacy students who received the vaccine and those who did not there was no difference in acquiring influenza (p= 0.854) Conclusions: The findings for this study show that pharmacy students who received the influenza vaccine had lower rates of acquiring the flu when compared to the national average of people who were not vaccinated and acquired the flu. It can be assumed that even with an efficacy as low as 40%, the vaccine still plays a great role in influenza prevention. However, pharmacy students who received the influenza vaccine in the 2017 year did not have significantly different acquisition rates of the flu when compared to the students who did not receive the influenza vaccine that year.
    • Pertussis Cocooning for Alaska: Development of an Educational Brochure

      Peek, Gloanna; Ernest, Lisa Lorene; Peek, Gloanna; Peek, Gloanna; Phipps, Lorri M.; Bencs, Nicole (The University of Arizona., 2016)
      Background and Significance: Pertussis infection rates have significantly increased in the United States even though pertussis is a vaccine preventable illness. Alaska has been significantly impacted by this disease and is ranked 3rd highest in the nation for infection rates per capita. Infants less than three months of age suffer the highest proportion of infections. The effects of pertussis are most severe in this age group, sometimes requiring hospitalization and causing death. One theorized contributing factor to the increased pertussis infection rates is the transition to an acellular pertussis vaccine. The acellular component of the Tdap vaccine may wane up to 42% a year, thus decreasing coverage from 10 years to approximately three to five years. The increased infection rate and decreased vaccine efficacy necessitates improved education regarding preventative measures. The cocooning vaccination strategy immunizes all eligible individuals in contact with the infant, thus creating a cocoon of protection.Purpose and Specific Aims: This Doctor of Nursing Practice (DNP) project addresses the need for improved educational material regarding infantile pertussis prevention for Alaskan families having a baby. Throughout this DNP project an educational brochure is developed, emphasizing the importance of pertussis prevention through cocooning vaccination.Methods: The educational brochure was created using the framework of the Health Belief Model (HBM). The HBM was utilized to structure the information included within the brochure to influence individual health behaviors towards immunization of pertussis through cocooning. Evaluation: Three content experts evaluated the brochure utilizing the Patent Education Materials Assessment Tool (PEMAT) auto-scoring tool. Content experts reviewed the brochure and determined the understandability and actionability of the brochure in the form of a percentage. The content expert evaluations all indicated scores of 100%. Conclusion: The brochure created within this DNP Project addresses the educational needs of Alaskan families regarding pertussis infection and the severity of these infections in the infant population. Future implications include brochure production and distribution. The brochure will have the most impact when distributed to maternity units, obstetrical, and gynecological offices in Alaska.