Abstract
Background/Significance: Human papillomavirus (HPV) is the most common sexually transmitted disease according to the Centers for Disease Control and Prevention (2014). In 2014 there were about 79 million HPV-infected Americans and that number was expected to subsequently increase by 14 million each year (CDC, 2014; Dixon et. al., 2017). It is estimated that about 75% of the population will be exposed to HPV at some point in their lifetime (Carozzi et al., 2018). Many people do not even know they have contracted HPV until they develop some of the negative effects of HPV, such as cancer (CDC, 2014). HPV-related cervical cancer causes around 4,000 deaths a year in the United States (Downs et al., 2010). HPV is not only responsible for cervical cancer, but also vaginal, penile, oropharyngeal and rectal cancers (CDC, 2017). The Advisory Committee on Immunization Practices (ACIP) recommends that all children ages 11 and 12 be vaccinated against HPV as well (CDC, 2011).|Problem: The US Food and Drug Administration (2014) reports that the HPV vaccine has been shown to be up to 96.7%, depending on cancer type, effective in preventing cancers caused by HPV. Even though the vaccine has been shown to be effective, in 2016, less than 64% of all teens, 13-17 years of age, were vaccinated against HPV in Nebraska (CDC, 2017). Out of that, only 41.3% of males in that group are fully vaccinated against HPV, lower than their female counterparts (CDC, 2017).|Purpose: The purpose of the quality improvement project was to increase the parental intention to vaccinate their children against HPV in the state of Nebraska.|Methods: The project was a descriptive-exploratory quality improvement project. The framework was the Plan-Do-Study-Act cycle. The target population for this study was parents of preteens in Nebraska. The sample was drawn from students in 6th-grade. This is the ideal time for this population to start the HPV vaccination series since Nebraska Law mandates 7th-grade physicals. A fact sheet obtained from the CDC was distributed to all public schools within the state of Nebraska. However, this only generated three responses. We set out to find the cause of such a low response rate and found four school nurses willing to participate, which generated a better response rate. The parents reviewed the fact sheet, and hopefully, the preteen as well in their own environment, on their own time. Ethical considerations were taken to make sure that no respondents information was obtained or shared. Informed consent as a cover letter which provided the purpose of the project and an email address was provided for participant questions. Respondents gave their consent when they responded to the survey. Subjects were not forced or coerced into completing the survey. Participants were not discriminated against based on their response or lack of response to the survey. The IP addresses of the respondents was blocked and not traceable. The aggregate data gained from this study was only used to determine if there is a need for increased education about HPV and the HPV vaccine to increase uptake of the vaccine. Approvals were sought from the Creighton Institutional Review Board (IRB) in addition to school or state approvals that were needed.