Balancing Between Being Proactive and Neutral: School Nurses' Experiences of Offering Human Papilloma Virus Vaccination to Girls

Influence of Knowledge and Cultural Beliefs on Attitudes Toward HPV Vaccination Among Israeli Nurses and Nursing Students: Implications for Vaccine Advocacy

BACKGROUND

Human papillomavirus (HPV) poses a significant health burden, yet the vaccine which successfully prevents HPV and its associated cancers remains underutilized. Nurses play a crucial role in patient education and advocacy for HPV vaccination. This study explores how knowledge, along with cultural, religious, and social beliefs, shapes the attitudes of Israeli nurses and nursing students toward the HPV vaccine and their advocacy efforts.

METHODS

A cross-sectional study was conducted from August 2023 to January 2024 using an anonymous online questionnaire distributed via Facebook groups targeting Israeli nurses and nursing students. The questionnaire assessed demographic data, HPV-related knowledge, and attitudes toward HPV vaccination.

RESULTS

The study included 458 participants (229 nurses and 229 nursing students). Significant knowledge gaps were found, with 52% of participants incorrectly believing that the vaccine can cure existing infections and 47% mistakenly believing that it is administered in a single dose. Logistic regression revealed that nurses working in community settings were more likely to have positive attitudes toward HPV vaccination (OR = 2.98, 95% CI: 1.84-4.85). Higher levels of HPV-related knowledge (OR = 3.35, 95% CI: 2.10-5.35) and secular or traditional religious affiliations (OR = 2.45, 95% CI: 1.52-3.97) were strongly associated with positive attitudes toward and advocacy for the vaccine.

CONCLUSIONS

Targeted educational programs addressing knowledge gaps, especially those tailored to Israel's cultural and religious diversity, are crucial for empowering nurses and nursing students as advocates for HPV vaccination. Enhancing their understanding of HPV can increase vaccine uptake, reduce the incidence of HPV-related diseases, and strengthen public health initiatives in Israel.

Moving the Needle: A Qualitative Exploration of the School Nurses' Experience with Virginia's Human Papillomavirus Mandate

In all US localities, students provide proof of compliance with vaccination requirements to attend school. Despite benefits, vaccine legislation remains contentious. The human papillomavirus (HPV) vaccine is recommended for adolescents and prevents cancer, but its inclusion in school immunization requirements is challenged. Virginia was the first state to mandate HPV vaccination. HPV is the only required vaccine in VA that allows caregivers to elect out. School nurses are trusted members of communities and enforce vaccine compliance. This study aims to understand Virginia school nurses' practice in implementing the HPV vaccine mandate through the exploration of their subjective experiences. Semi-structured interviews were conducted. Thematic analysis using the socioecological model guided data analysis. Factors that influence nursing practice were identified at all socioecological model levels The data from this study is intended to provide an understanding of school nursing practice so that interventions to improve HPV vaccination rates can be developed.

School Nurses' Experiences and Roles in Promoting and Administering the HPV Vaccine: A Systematic Review Using the Socioecological Framework

Understanding the school nurse's experience in human papillomavirus (HPV) vaccine promotion can reduce vaccine disparities. HPV vaccination is critical to cancer prevention. Despite the importance of the school nurse in vaccine promotion, there is a lack of understanding. This article aims to examine the knowledge, attitude, experience, and role of school nurses related to HPV vaccination and promotion in school settings. A systematic search for school nurses and their experiences related to HPV vaccination was conducted. A thematic synthesis was undertaken using the socioecological model. This review highlights the complexity of HPV vaccine promotion in schools over time. Multilevel factors impact nursing practice. Nurses have good vaccine knowledge and positive attitudes. Poor workflow processes, competing demands, and vaccine communication challenge school nurses. The themes that were synthesized informed the LEADS model. With the support of school nurses, reaching the goal of eliminating cervical cancer as a public health problem is possible.

Barriers in the School-Based Pan-Gender HPV Vaccination Program in Sweden: Healthcare Providers' Perspective

BACKGROUND

Human papillomavirus (HPV) vaccines effectively prevent, and can even eliminate, HPV-related cancers. Currently, vaccination rates are suboptimal in the national Swedish school-based vaccination program. School nurses play a key role in all aspects of the vaccination process. Therefore, this study aims to explore school nurses' perceived HPV vaccination challenges.

METHODS

Seven focus group interviews were conducted with school nurses (n = 35) working in nine socio-demographically diverse municipalities in mid-Sweden. Data were analyzed using qualitative content analysis.

RESULTS

Participants described difficulties in encountering and handling the diversity of reasons for vaccine hesitancy. Parents known to be skeptical of vaccines in general were seen as most difficult to reach. Uncertainty was expressed concerning the extent of professional responsibility for vaccine promotion. The informants expressed a lack of guidelines for vaccine promotion and described challenges in supporting the child's own wishes. Creating a safe space for the individual child was seen as crucial. Other problems described were the challenges of overcoming children's fear of needles, supporting unvaccinated children, and being confronted with the remaining gender inequities of the pan-gender vaccination program.

CONCLUSIONS

Our results suggest that school nurses, especially those new to their profession, may benefit from training and guidance22 material on how to address vaccine hesitancy.

The needle pricking and two modes of 'doing good' in the Swedish school-based human papillomavirus vaccination programme

In this article, we draw on science and technology studies literature on care practices to analyse school nurses' work with human papillomavirus (HPV) vaccination in schools, in the context of a new vaccination policy including all children in the fifth grade in Sweden. Drawing on 21 interviews with school nurses working in municipalities across a larger Swedish region, we focus on the mundane work of handling the vaccination and supporting the children while they are being vaccinated. We utilise the notion of 'modes of doing good' to analyse routines and ideals oriented towards specific, and sometimes contradictory, forms of 'good care' in HPV vaccination practice. Two modes of doing good are identified: the vaccination as a caring for 'the flow' of children getting vaccinated and the vaccination as a caring about the specific child. We analyse three 'child subjects' alongside these modes: the informed and already prepared child, the anxious child, and the specific child. By identifying tensions and interferences between different child subjects and modes of doing good, we discuss possible consequences of our findings for how HPV vaccination is envisioned and conceptualised in social science research and in policy settings.

Parents' reasoning about HPV vaccination in Sweden

INTRODUCTION

The aim of this study was to describe parents' reasoning in making decisions about vaccinating their daughters against human papilloma virus (HPV), a part of the Swedish vaccination programme.

METHOD

Twenty parents whose daughter had been offered HPV vaccination participated. Semi-structured individual interviews were conducted and analysed using thematic analysis.

RESULTS

The findings reveal that the decision-making process is complex. The parents trusted the vaccination programme and saw it as beneficial to society. They also described using different resources to decide about HPV vaccination, but they did not include their daughters in making the decision.

DISCUSSION

Parents need better vaccine and health literacy to be able to decide, based on evidence and in consultation with their daughters, on HPV vaccination. School nurses can play an important role in evidence-based decision-making about HPV vaccination and introducing children to this health-promoting intervention.