Question- Does a collaborative healthcare approach decrease the number of adolescents diagnosed with Human Papillomavirus? 

P- Human Papillomavirus.

I -Education.

C – Declining the Human Papillomavirus vaccination.

O- A decreased amount of Human Papillomavirus diagnosis. 

Question- Does a collaborative healthcare approach decrease the number of adolescents diagnosed with Human Papillomavirus?

P- Human Papillomavirus.

I -Education.

C – Declining the Human Papillomavirus vaccination.

O- A decreased amount of Human Papillomavirus diagnosis.

Directions: Using the four articles you identified in your Unit 4 assignment, develop a dissemination plan using the following as a guide. This paper should be 3-5 pages (not including title and reference pages) in APA format.

 

This paper should include:

1. A title page in APA format including a running head, name, date and institution.

2. An introductory paragraph including a thesis statement and closing paragraph that summarizes your paper.

3. A one paragraph appraisal of the evidence critiquing the findings from each article for its relevance/application to your PICO(T).

4.  A one paragraph synthesis of the evidence where you will compare the results of all the studies, discussing similarities and differences applying them to your PICO(T).

5. A minimum of one organizational process change (clinical policy, procedure, or guideline) your practice change.

6. A minimum of two educational approaches/initiatives that would be required if you implemented this change into nursing practice.

7. Description of the ways in which the proposed practice change would improve care delivery.

8. Discuss the impact on patient outcomes, as a result of your practice change, using the EBP process (clinician expertise, the evidence, and patient values and preferences).

9. A reference page in APA formatting.

Question

Does a collaborative healthcare approach decrease the number of adolescents

diagnosed with

Human

Papillomavirus

?

P

Human Papillomavirus.

I

Education.

C

Declining the

H

uman Papillomavirus

vaccination.

O

A decreased amount of H

uman Papillomavirus diagnosis

.

Direction

s:

Using the four articles you identified in your Unit 4 assignment, develop a

dissemination plan using the following as a guide. This paper should be 3

5 pages (not

including title and reference pages) in APA format.

This paper should include:

1.

A title page in APA format including a running head, name, date and institution.

2.

An introductory paragraph including a thesis statement and

Dissemination of Evidence Paper Grading Rubric 05.18


Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeTitle page and reference page – completed in APA format.

a. Includes running head b. Includes name c. Includes date d. Includes institution e. All references in

10.0 pts

Less than 2 APA errors

5.0 pts

2-4 APA errors

0.0 pts

Greater than 4 APA errors

10.0 pts

This criterion is linked to a Learning OutcomeIntroduction and closing

a. Introduction paragraph describing clinical issue, clinical question and PICO b. Thesis statement at end of introductory paragraph c. Closing- Paragraph summarizing key points of paper

10.0 pts

Met all criteria

5.0 pts

Missing one criteria

0.0 pts

Missing two or greater criteria.

10.0 pts

This criterion is linked to a Learning OutcomeAppraisal of evidence – Critiques research findings from each article for its relevance/application to the PICO (T) – Article 1

a. Research methodology b. Main findings of research c. Is research methodology sound? d. Do findings support your practice change (Intervention in PICO)

10.0 pts

Met all criteria

5.0 pts

Missing one criteria.

0.0 pts

Missing two or greater criteria.

10.0 pts

This criterion is linked to a Learning OutcomeAppraisal of evidence – Critiques research findings from each article for its relevance/application to the PICO (T) – Article 2

a. Research methodology b. Main findings of research c. Is research methodology sound? d. Do findings support your practice change (Intervention in PICO)

10.0 pts

Met all criteria

5.0 pts

Missing one criteria.

0.0 pts

Missing two or greater criteria.

10.0 pts

This criterion is linked to a Learning OutcomeAppraisal of evidence – Critiques research findings from each article for

RESEARCH ARTICLE Open Access

Barriers and facilitators to HPV
vaccination in primary care practices:
a mixed methods study using the
Consolidated Framework for
Implementation Research
Jane M. Garbutt1*, Sherry Dodd2, Emily Walling2,3, Amanda A. Lee4, Katharine Kulka2 and Rebecca Lobb4

Abstract

Background: In the United States, the effective, safe huma papilloma virus (HPV) vaccine is underused and
opportunities to prevent cancer continue to be missed. National guidelines recommend completing the 2–3 dose
HPV vaccine series by age 13, well before exposure to the sexually transmitted virus. Accurate characterization of
the facilitators and barriers to full implementation of HPV vaccine recommendations in the primary care setting
could inform effective implementation strategies.

Methods: We used the Consolidated Framework for Implementation Research (CFIR) to systematically investigate
and characterize factors that influence HPV vaccine use in 10 primary care practices (16 providers) using a concurrent
mixed methods design. The CFIR was used to guide collection and analysis of qualitative data collected through in-person
semi-structured interviews with the primary care providers. We analyzed HPV vaccine use with data abstracted from
medical charts. Constructs that most strongly influenced vaccine use were identified by integrating the qualitative and
quantitative data.

Results: Of the 72 CFIR constructs assessed, seven strongly distinguished and seven weakly distinguished between
providers with higher versus lower HPV vaccine coverage. The majority of strongly distinguishing constructs were
facilitators and were related to characteristics of the providers (knowledge and beliefs; self-efficacy; readiness for
change), their perception of the intervention (relative advantage of vaccinating younger vs. older adolescents), and
their process to deliver the vaccine (executing). Additional weakly distinguishing constructs that were facilitators were
from outer setting (peer pressure; financial incentives), inner setting (networks and communications and readiness
for implementation) and process (planning; engaging, and reflecting and evaluating). Two strongly distinguishing
constructs were barriers to use, one from the intervention (adaptability of the age of initiation) and the other from
outer setting (patient needs and resources).

Conclusions: Using CFIR to systematically examine the use of this vaccine in independent primary care practices
enabled us to identify facilitators and barriers at the provider, interpersonal and practice level that need to be
addressed in future efforts to increase vaccine use in such settings. Our findings suggest that implementation
strategies that target the provider and help them to address multi-level barriers to HPV vaccine use merit further
investigation.

Keywords: HPV vaccine, Implementation strategies, CFIR

* Corr

Evaluation of the Implementation of a

Multicomponent Intervention to Improve Health Care

Provider Communication About Human

Papillomavirus Vaccination

D1X XJenna E. Reno, D2X XPhD; D3X XSean T. O’Leary, D4X XMD, MPH; D5X XJennifer Pyrzanowski, D6X XMSPH;
D7X XSteven Lockhart, D8X XMPH; D9X XJacob Thomas, D10X XMPH; D11X XAmanda F. Dempsey,D12X XMD, PhD, MPH

From the Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), School of Medicine, University
of Colorado Denver, Aurora
The authors have no conflicts of interest to disclose.>
Address correspondence to Jenna E. Reno, PhD, ACCORDS, Adult and Child Consortium for Health Outcomes Research
and Delivery Science, University of Colorado Denver, Mail Stop F443, 13199 E Montview Blvd, Suite 300, Aurora, CO 80045
(e-mail: [email protected]).
Received for publication May 7, 2018; accepted August 7, 2018.

TAGGEDPABSTRACT

OBJECTIVE: To evaluate the relative use, usefulness, and facil-
itators and barriers to use as perceived by providers of 5 differ-

ent components in a human papillomavirus vaccine

communication intervention—which was found to be effective
at improving human papillomavirus vaccination rates.

METHODS: Four serial surveys of 108 providers (doctor of
medicine, nurse practitioner, or doctor of osteopathic medi-

cine) from intervention clinics involved in the study assessed

the use and usefulness of the 5 communication intervention

components during a 12-month period.

RESULTS: Survey response rates were 79% to 86%. The fact
sheet (64%−77%) and motivational interviewing techniques
(MI; 86%) were the most used components—use was sus-
tained during the 12-month period. These components also

were perceived as somewhat or very useful by most providers,

and this perceived usefulness increased over time (very or

somewhat useful at end of study, 97% fact sheet, 98% MI,

respectively). Although fewer providers reported using the

Web site

(15%−42%), or disease images (6%−17%), when these were
used, most providers (67%−87%) felt they were somewhat or
very useful. The decision aid was not used frequently (17%

−41% of providers), and 43% of providers felt it was not very
or not at all useful. Facilitators and barriers were identified for

each component. The fact sheet and MI were perceived as the

easiest to integrate into the clinic workflow.

CONCLUSIONS: The fact sheet and MI were the most used and
most useful intervention components. Both were easy to inte-

grate into clinic workflow, and their use was sustained over

time. Dissemination of similar interventions in the future

should focus on

Importance of a team approach to recommending the human
papillomavirus vaccination

Holly B. Fontenot, PhD, RN, WHNP-BC (Associate Professor)1,
Melanie L. Kornides, ScD, RN, FNP-BC (Research Fellow)2,
Annie-Laurie McRee, DrPH (Assistant Professor)3, & Melissa B. Gilkey, PhD (Assistant Professor)4

ABSTRACT
Background and purpose: Few studies have examined human papillomavirus (HPV) vaccine communication in the
context of the health care team.
Methods: In 2016, the investigators conducted a national, online survey of U.S. parents who reported having dis-
cussed HPV vaccination with their adolescent’s health care team. Multivariable logistic regression assessed asso-
ciations between HPV vaccine initiation ($1 dose) and having: 1) discussed HPV vaccination with multiple team
members and 2) received congruent recommendations about HPV vaccination.
Conclusions: Of the 795 parents in the sample, about half (52%) reported discussing HPV vaccination with multiple
team members, including nurse practitioners, nurses, and physicians. Most reported receiving congruent recom-
mendations for (76%) or against (12%) HPV vaccination; few (12%) received mixed recommendations. Parents who
discussed HPV vaccination with multiple team members had greater odds of series initiation (odds ratio [OR] = 2.34,
95% CI: 1.61–3.40), whereas those who received mixed versus congruent recommendations for HPV vaccination had
lower odds of vaccination (OR = 0.56, 95% CI: 0.33–0.95).
Implications for practice: Findings suggest that a coordinated team approach to recommendations may encourage
HPV vaccination. Nurse practitioners are well positioned to facilitate coordination efforts within their clinical
practices.
Keywords: Adolescent health; human papillomavirus infections/prevention and control; human papillomavirus
vaccine.

Journal of the American Association of Nurse Practitioners 30 (2018) 368–372, © 2018 American Association of Nurse Practitioners

DOI# 10.1097/JXX.0000000000000064

Introduction
Human papillomavirus (HPV) is the most common sexually
transmitted infection in the United States (U.S.) and causes
multiple cancers in men and women. Human papilloma-
virus vaccine has been available for first-line prevention of
HPV-related diseases for over a decade, yet HPV vaccina-
tion coverage is not on target to meet national goals (U.S.
Department of Health and Human Services, 2014). Cover-
age is especially low for men, younger adolescents, and

those living in certain geographic areas (Reagan-Steiner
et al., 2016). Research, primarily among physicians, has
established health care providers’ communication as
a key determinant of vaccination uptake; youth who do,
versus do not, receive a recommendation for HPV vaccina-
tion have 5 to 23 times the odds of being vaccinated (Bartlett
& Peterson, 2011; Holman et al., 2014; Lau, Lin, & Flores, 2012;
Rahman, Laz, McGrath, & Benson,

Zeliha Ko0, PhD, RN

Emel Kurto?lu Ozdez, MD

Serap Topatan, PhD, RN

Tu?ba /NnarlN, MSc, RN

Asuman yener, MSc, RN

Esra DanacN, MSc, RN

Cansu Atmaca Palazo?lu, MSc, RN

The Impact of Education About Cervical
Cancer and Human Papillomavirus on
Women’s Healthy Lifestyle Behaviors
and Beliefs
Using the PRECEDE Educational Model

K E Y W O R D S

Awareness

Behaviors

Belief

Cervical cancer

Education

Human papillomavirus

Knowledge

Papanicolaou test

Perception

Prevention

Background: Early detection of cervical cancer improves the chances of successful

treatment. Objective: The aim of this study was to determine the effect of education

about cervical cancer and human papillomavirus on the healthy lifestyle, behavior,

and beliefs of Turkish women who were without cancer, using the PRECEDE

education model. Methods: This qualitative and quantitative study was conducted

as a prospective, randomized, 2-group (intervention and control) trial at a

community training center in north Turkey. A total of 156 Turkish women who were

without cancer participated in this study. The semistructured interview form, the

SF-36 Health Status Questionnaire, the Health Belief Model Scale for Cervical

Cancer and Pap Smear Test, and the Healthy Lifestyle Behavior Scale II were used.

Results: The subdimension scores of the Health Belief Model Scale for Cervical

Cancer and Pap Smear Test were found to be higher among women in the study

group (cervical cancer seriousness, P = .001; health motivation, P = .001) as

compared with the control group after the education program. The SF-36 Health

Status Questionnaire domain scores for physical role limitations, mental role

limitations, and general health perceptions increased in the study group after the

106 n Cancer NursingA, Vol. 42, No. 2, 2019 Ko0 et al

Copyright B 2017 Wolters Kluwer Health, Inc. All rights reserved.

Author Affiliations: Health Science Faculty, Department of Nursing (Dr Ko0);
Medicine Faculty, Department of Obstetric Gynecology (Mrs Ozdez); Health
Science Faculty, Department of Midwifery (Dr Topatan); and Health Services
Vocational School (Mrs /NnarlN and Dr yener), Ondokuz MayNs University,
Samsun; Ahmet Erdo?an Health Services Vocational School, B[lent Ecevit
University, Zonguldak (Mrs DanacN); and Health Services Vocational School,
G[m[zhane University (Mrs Palazo?lu), Turkey.

This project, no. 214S560, was supported by TZBITAK.

The authors have no conflicts of interest to disclose.
Correspondence: Zeliha Ko0, PhD, Samsun Health Science Faculty, Depart-

ment of Nursing, Ondokuz MayNs University, University Campus, 55139 Samsun,
Turkey (