Knowledge and beliefs regarding human papillomavirus among college nursing students at a minority-serving institution

The effect of theoretical and student-centered interactive education on intern nursing students' knowledge and consideration regarding human papillomavirus and its vaccine in Turkey: A repeated measures design

Background

Intern nursing students not only belong to the high-risk group for human papillomavirus (HPV) infection and its associated complications but also represent the future healthcare workforce. Therefore, they constitute a significant group that should comprehensively understand HPV and its vaccine.

Objective

This study aimed to assess the impact of educational interventions on intern nursing students' knowledge and considerations related to HPV and its vaccine.

Methods

A repeated measures design with pretest/posttest measures was employed. The study involved 88 students at a university in Turkey and was conducted between November 2021 and February 2022. Data were collected using a Personal Information Form and the HPV Information Scale. All participants received theoretical and student-centered interactive education, and data were analyzed using numerical data, percentage distributions, Bonferroni correction, and one-way repeated measures ANOVA.

Results

The total score of the scale and the scores of all four sub-dimensions obtained in the first and third months after the education were significantly higher than those obtained before the education (p <0.001). Additionally, the proportion of students considering getting an HPV vaccine increased following the education (p <0.001).Conclusions: The education on HPV and its vaccine potentially improved students' knowledge levels and increased consideration for vaccination. Implementing interventions that equip nursing students with sufficient knowledge about HPV and its vaccine can contribute to reducing HPV-related cancer rates. Therefore, it is recommended to implement educational programs focused on the prevention of HPV-related cancers.

An Interactive Educational Tool to Improve Human Papillomavirus Vaccine Knowledge and Recommendation Among Nurses

In United States, only 57% of  women and 53% of men in the recommended age groups have received all recommended doses of the human papillomavirus (HPV) vaccine. Healthcare provider education has been associated with strong vaccine recommendation and vaccination uptake. Our objective was to create a 7-min interactive online educational tool to improve knowledge and willingness to recommend the HPV vaccine among nurses. This is a prospective pre-test/post-test study to evaluate the effectiveness of the educational tool consisting of 10 flashcards in a question-answer format. Oncology nurses at our cancer center were invited to participate by email, which led them to the educational tool (i.e., intervention) along with pre- and post-test questions on HPV-associated cancers, vaccine-eligible age groups, dosing schedules, adverse events, and willingness to recommend. Of the 110 participants (mean age of 41.2 ± 11.4, 98% female, 64% >10 years of practice), there was improvement in knowledge after intervention in HPV-associated cancers (81% to 97%; p = 0.02), percentage of cervical caused by HPV (33% to 64%; p < 0.05), and dosing schedule (47% to 93%; p < 0.05). All participants correctly stated that continued screening is needed after vaccination both pre- and post-intervention. Eighty-five percent strongly agreed that the intervention improved their HPV knowledge, and 77% stated they were more likely to recommend the HPV vaccine after the intervention. While nurses are willing to recommend the vaccine, there remains persistent knowledge gaps. A brief 7-min self-administered online interactive flashcard educational intervention is effective in improving the HPV vaccine knowledge among nurses.

Exploring Sources of Information and Religious Beliefs in Regard to HPV and Vaccination Among Hispanic/Latino College Students in the USA

We identified (a) sources of and communication about HPV information and (b) factors (e.g., religious affiliations) related to information sources and communication regarding HPV among Hispanic/Latino college students attending US institutions. Applying a cross-sectional design, we recruited 209 participants from US colleges. Most participants used healthcare professionals for their sources and communication about HPV-related information. Respondents who were practicing Catholics tended to use the Internet and healthcare professionals as their sources for HPV-related information. Healthcare professionals, TV, schoolteachers, same-sex friends, and family members affected participants' HPV vaccination, knowledge, and attitudes. Religious faith may influence information-seeking behaviors and requires more research.

Factors Associated with Human Papillomavirus Vaccination and the Intention among Undergraduate Nursing Students: A Cross-Sectional, Correlational Study

PURPOSE

To examine factors associated with overall human papillomavirus (HPV) vaccination status, completion of HPV vaccination, and intention to receive vaccination among nursing students.

DESIGN

A Cross-sectional, correlational study.

METHODS

Data from 86 students were analyzed using logistic and multiple regression.

FINDINGS

Among knowledge, attitudes and beliefs, and recommendation, more positive attitudes and beliefs were the only factors associated with initiation and/or completion of HPV vaccination and the intention to receive HPV vaccination.

CONCLUSIONS

More positive attitudes and beliefs need to be enhanced for HPV vaccination.

CLINICAL EVIDENCE

Changes in attitudes and beliefs can be important targets of interventions to increase HPV vaccination.

Human papillomavirus (HPV) and HPV vaccine knowledge, the intention to vaccinate, and HPV vaccination uptake among male college students

ObjectiveThis systematic mixed studies review aims to summarize the results of available research on knowledge of the human papillomavirus (HPV) and HPV vaccine, the intention to vaccinate, and HPV vaccination uptake among male college students. Methods: PubMed, ProQuest, EBSCO, PsycINFO, JSTOR, MEDLINE, and Google Scholar searches were performed to identify studies. A total of 39 studies were included in this review. Results: Most studies were cross-sectional (n = 27) and used convenience samples (n = 18). Although many students were aware of HPV and the HPV vaccine, gaps in their knowledge about the mode of transmission, symptoms, risk factors, and HPV vaccine mechanism were evident. The cost of HPV vaccination and concerns about safety and side effects were the most frequently reported barriers to obtaining the vaccination. Conclusion: More effort to increase knowledge about HPV and the uptake of the HPV vaccination among college men in the United States is necessary.

Relationship between awareness of cervical cancer and HPV infection and attitudes towards HPV vaccine among women aged 15-49 years: a cross-sectional study

BACKGROUND

Cervical cancer is a type of cancer caused by human papillomavirus (HPV).

OBJECTIVE

To determine the relationship between awareness of cervical cancer and HPV infection and attitudes towards HPV vaccine among women aged 15-49 years.

DESIGN AND SETTING

Cross-sectional study conducted at Karabük Training and Research Hospital, Turkey.

METHODS

500 women who visited the gynecology outpatient clinic of a public hospital between July 15 and December 31, 2019, were selected through random sampling. Data were collected using a sociodemographic questionnaire comprising nine questions (created by the researchers), the HPV and Cervical Cancer Awareness Questionnaire and the Carolina HPV Immunization Attitudes and Beliefs Scale.

RESULTS

The relationship between the awareness questionnaire and the beliefs scale was explained through simple effect modeling of a structural equation. The women's knowledge score regarding cervical cancer and HPV infection was 4.69 ± 4.02 out of 15. Women were afraid of being diagnosed with cervical cancer and HPV infection, but they did not have sufficient information. They had poor information about the HPV vaccine, did not know how to obtain the vaccine and did not have enough information about its benefits and harmful effects. Women who were afraid of getting cervical cancer, and who thought that they were at risk, had more information about the HPV vaccine.

CONCLUSION

Women need information about cervical cancer, HPV infection and the HPV vaccine. Midwives, nurses and physicians who provide healthcare services in gynecological follow-ups should provide information to women about the HPV vaccine and cervical cancer.

A brief educational intervention can improve nursing students' knowledge of the human papillomavirus vaccine and readiness to counsel

Provider recommendation is a primary reason for patient uptake of the human papillomavirus (HPV) vaccine. Most provider-focused educational interventions are focused on physicians, even though nurses are also important sources of vaccine-related information for their patients. This study examined whether a HPV educational intervention could improve nursing students' HPV knowledge, beliefs, and comfort with counseling. The same lecture on HPV and HPV vaccination was given to both medical and nursing students. To determine the effects of the lecture, students were asked to complete identical pre- and post-lecture tests with questions on demographics, knowledge, attitudes, and comfort with counseling on the HPV vaccine. Pre- and post-lecture test scores were compared between nursing and medical students to assess whether there were differences in pre-lecture test scores and/or changes in post-lecture test scores. On the pre-lecture tests, fewer nursing students responded correctly to knowledge questions, indicated positive attitudes or comfort with counseling about the HPV vaccine compared to medical students. However, similar frequencies of nursing and medical students responded correctly to knowledge questions and indicated a positive attitude, as well as a high comfort level with counseling on the post-lecture tests. Study results show that integrating lectures in a nursing program curriculum could be a feasible way to increase students' HPV knowledge. Having health-care providers with similar levels of knowledge, attitudes, and comfort with counseling on HPV vaccination is ideal, as all share the responsibility of recommending the vaccine to patients.

Human papillomavirus (HPV) vaccination in the transition between adolescence and adulthood

PURPOSE

Young adulthood is characterized by changes in health care decision-making, insurance coverage, and sexual risk. Although the human papillomavirus (HPV) vaccine is now approved for adults up to age 45, and catch-up vaccination is currently recommended up through age 26, vaccination rates remain low in young adults. This study explored perspectives on HPV vaccination among young adults receiving care at the student health center of a large public university.

METHODS

We conducted semi-structured interviews (n = 27) and four focus groups with female and male undergraduate and graduate students (n = 18) and semi-structured interviews with health care providers (n = 6). Interviews and focus groups explored perceived risk of HPV infection, benefits of the HPV vaccine, and motivations for and barriers to HPV vaccination.

RESULTS

Many young adults cited their parents' views and recommendations from medical providers as influential on their decision-making process. Students perceived that cervical cancer prevention was a main benefit of the HPV vaccine and sexual activity was a risk factor for HPV infection. Students often lacked knowledge about the vaccine's benefits for males and expressed some concerns about the safety and side effects of a vaccine perceived as new. Logistical barriers to vaccination included uncertainty over vaccination status and insurance coverage for the vaccine, and concerns about balancing the vaccine schedule with school obligations. Providers' vaccine recommendations were impacted by health system factors, including clinical infrastructure, processes for recommending and documenting vaccination, and office visit priorities. Suggested vaccination promotion strategies included improving the timing and messaging of outreach efforts on campus and bolstering clinical infrastructure.

CONCLUSIONS

Although college may be an opportune time to reach young adults for HPV vaccination, obstacles including navigating parental influence and independent decision-making, lack of awareness of vaccination status, and numerous logistical and system-level barriers may impede vaccination during this time.

HPVs Vaccination among Racial/Ethnic Minority College Students: Current Status and Future Direction

OBJECTIVES

College is an important period for catch-up vaccination for Human Papillomaviruses (HPVs), but HPVs vaccination rates are low among college students. Given that racial/ethnic minorities are disproportionately affected by HPVs-related cancers, the aim of the present study is to conduct a scoping review about HPVs and HPVs vaccination conducted among racial/ethnic minority college students. Specifically, we examined: 1) the prevalence of HPVs vaccination among racial/ethnic minority college students in the US and 2) the correlates of HPVs vaccination or vaccination intention/interest.

METHODS

We searched three database (PubMed, PsycINFO, and CINAHL) for relevant articles. Of 58 articles initially identified, 23 articles met all inclusion/exclusion criteria.

RESULTS

Racial/ethnic minority college women (especially Black and Asian/Pacific Islander) were less likely to be vaccinated compared to their non-Hispanic white counterparts. Racial/ethnic minority college men reported lower knowledge of HPVs and HPVs vaccination compared with their women counterparts. However, overall, a majority of racial/ethnic minority college students appeared to have high knowledge about HPVs and intention to vaccinate. Age, doctor recommendation, and psychosocial and cultural factors (e.g., HPVs/HPVs vaccine knowledge, perceived benefits of vaccination, social norms and values, mistrust of health care providers, and cultural norms) were associated with vaccination and individuals' intention to be vaccinated.

DISCUSSION

Significant racial/ethnic disparities in HPVs vaccination exist among both college men and women. Interventions to increase vaccine awareness, access, and uptake among racial/ethnic minority college students are lacking and warranted. Interventions targeting only knowledge and/or intention might not be sufficient. Theory-based studies that examine unique factors involved in vaccine uptake during college across multiple levels of influence including psychosocial, provider, health care, and culture are needed.

Knowledge, Perceptions, and Uptake of the Human Papillomavirus Vaccine in a Sample of US High School Adolescents

OBJECTIVE

To assess high school students' knowledge and perceptions of human papillomavirus (HPV) and HPV vaccines and evaluate high school students' self-reported uptake of the HPV vaccine.

METHODS

This was an observational, descriptive study using a 44-question survey. Participants were ninth grade students in a Colorado public school district. The survey was administered as part of a health education course.

RESULTS

Ninety-two surveys were included in the analysis. Demographic characteristics included 64/92 (69.6%) male and 55/92 (59.8%) Hispanic/Latino students. There was no difference between males and females regarding self-reported vaccination status. Non-Hispanic students were 71.6% less likely to have received the HPV vaccine than Hispanic students (OR 0.284; 95% CI, 0.088–0.920; p = 0.036). The average score on the knowledge section was 42.7% with a standard deviation of 22.6%. When assessing students' perceptions, 71/92 (77.2%) disagreed or strongly disagreed that they felt at risk for getting an HPV infection. There was no significant difference between males and females regarding awareness of the HPV vaccine (p = 0.14). More than half of students (58.7%) did not know if they had received the HPV vaccine.

CONCLUSION

HPV vaccine awareness was low and many students did not know if they had received the HPV vaccine. Ninth grade students did not have accurate knowledge of HPV and HPV vaccines and this study presents opportunities for increased education.

Human Papillomavirus Infection and Vaccination: Knowledge, Attitude and Perception among Undergraduate Men and Women Healthcare University Students in Switzerland

Background: Human Papillomavirus is a common sexually transmitted infection, representing the main cause of genital warts and cervical cancer. The objective of this study was to evaluate basic knowledge and beliefs regarding HPV infection and HPV vaccine among undergraduate healthcare men and women students, as well as their attitudes towards HPV vaccine. Methods: Undergraduate women and men (nursing and midwifery curses) attending three Schools of Health Sciences located in Switzerland. A total of 427 women and 223 men have completed the web questionnaire, which included questions on their socio-demographic background and about basic knowledge and attitudes toward the HPV infection and vaccination. Results: Women undergraduate students have a better knowledge of HPV infection than their men counterparts, although there was a significant gap in knowledge of the disease’s mode of transmission and prevention. Among women, 72.6% of respondents reported having received at least one dose of HPV vaccines versus 31.4% for men respondents. Conclusion: The results of this study revealed a poor understanding among undergraduate healthcare men and women students about the HPV infection, its mode of transmission and its prevention. Our findings highlight the need to improve education on HPV for undergraduate healthcare students in order to increase the awareness of the disease.

Knowledge and perception of female nursing students about human papillomavirus (HPV), cervical cancer, and attitudes toward HPV vaccination

Objective: The researchers aimed to evaluate the knowledge and perceptions of first-year female nursing students about human papillomavirus (HPV), cervical cancer (CC), and HPV vaccination. Participants: The sample included 690 female nursing students from sampled universities between April and June 2015. Methods: Students were surveyed by using a pretested HPV and CC awareness questionnaire. Results: More than half of the students (65.1%) answered questions incorrectly with a mean HPV knowledge score of 6.085 ± 3.38. The majority of students (82.6%) did not hear HPV vaccine. Only, 2.8% of the students had been vaccinated. A statistically significant relationship was found between HPV knowledge score and hearing about HPV vaccine (U = 28280.500, p = .015), and believing HPV vaccine protectiveness (χ² = 14.153, p = .001). Conclusions: This study highlights the lack of knowledge and low level of awareness about HPV, CC, and HPV vaccination among first-year nursing college students.

Knowledge and Awareness of Human Papillomavirus Among College Students in South Carolina

Despite the existence of a safe and effective vaccine, human papillomavirus (HPV) remains prevalent in the United States, with late adolescence and early adulthood being periods of increased risk. Thus, targeting college-aged individuals for HPV prevention and vaccination promotion is critical—particularly in regions such as the Deep South where vaccination rates remain low. This study sought to examine awareness and knowledge of HPV as well as experiences and attitudes regarding HPV vaccination among college students in the Deep South. Specifically, we completed a cross-sectional survey of 256 undergraduate students from a large public university in South Carolina. Although a majority of participants were aware of HPV, significant knowledge gaps existed, particularly regarding prevention, symptoms, and consequences of HPV infection. Participants were also largely unaware of men’s susceptibility for negative HPV outcomes. Multivariate regression modeling was used to identify predictors of HPV knowledge, with results indicating that participants who were female and white, as well as those who were vaccinated, had higher levels of HPV knowledge. Findings highlight the need for comprehensive HPV education on college campuses and offer insights to priority populations that may be appropriate focuses of efforts to increase HPV knowledge and vaccination rates.

Knowledge, Behaviors, and Attitudes About Human Papilloma Virus Among Nursing Students in Izmir, Turkey

Human papillomavirus (HPV) is transmitted through sexual contact and can cause cervical cancer. The aim of this study was to determine knowledge, behaviors, and attitudes about human papillomavirus (HPV) in nursing students in a baccalaureate program. This study was conducted with a sample of 624 students. Data were collected via questionnaires administered during the first class time. Students' knowledge about HPV was high; 90.5% knew HPV can cause cervical cancer; 94.6% recognized it as a sexually transmitted disease. Although; 87.7% stated a vaccine is available to protect women from HPV, nearly all participants (98.1%) had not received HPV vaccination. Findings show students' level of knowledge about HPV's risk factors and modes of transmission were high. However, this knowledge did not translate into engagement in health related behaviors such as being vaccinated against HPV.

Missed opportunities for catch-up human papillomavirus vaccination among university undergraduates: Identifying health decision-making behaviors and uptake barriers

BACKGROUND

Suboptimal adolescent human papillomavirus (HPV) vaccine rates in the US highlight the need for catch-up vaccination. When teenagers enter college, there may be a shift in healthcare decision-making from parents and guardians to the students themselves. Little is known about factors influencing college students' healthcare decision-making processes.

STUDY DESIGN

We evaluated HPV vaccine decision-making among 18-to-26-year-old college students through a self-administered, anonymous, cross-sectional survey. This survey was distributed to a sample of men and women in classroom settings at two universities. Categorical data comparisons were conducted using Chi-square and Fisher's exact tests. Multivariate Poisson regression was used to model initiation of HPV vaccine and compute prevalence ratios while controlling for key influential covariates at the 0.05 alpha level.

RESULTS

A total of 527 students participated (response proportion=93.1%). Overall, 55.8% of participants received the HPV vaccine. Encouraging conversations with doctors and/or parents/guardians were identified as one of the most influential factors to increase vaccine uptake. Among students who received encouragement from both a doctor and parent, 95.8% received the vaccine. Campaigns about cancer prevention were viewed as more influential than those that focus on preventing genital warts. Approximately one-third of students indicated they didn't know where to get the HPV vaccine. Women were more likely to report that their parents would not let them get the HPV vaccine compared to men (26.7% vs. 2.3%). The majority of students (77.3%) indicated their parents were sometimes, equally, or mostly involved in making decisions about receiving vaccines (other than flu).

CONCLUSION

Students' decision-making is greatly influenced by their parents; therefore, interventions for this population should work to increase students' control over decision-making while also addressing parental concerns.