Table of ContentsIntroductionBackground and ImportanceProblem StatementEvaluation ApproachOrganization DescriptionMacrosystemMesosystemMicrosystemPotential BarriersEvaluation OpportunitiesIntroductionHuman papillomavirus (HPV) is a sexually transmitted disease that not only causes cervical cancer, but also other cancers and genital warts. The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents aged eleven to twelve years routinely receive vaccines to prevent disease, including HPV-associated cancers. The current recommendation is two doses, with the second dose given six to twelve months after the initial dose. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay Ethnicity plays a role in the epidemiology of cervical cancer, with twice as many African American women dying as white women. Hispanic women also have a high mortality rate compared to white women. The problem is low HPV vaccination among adolescents in the targeted population (9th grade minority students at Washington High School). Currently, approximately 40% of 9th grade students receive at least the first dose of the HPV vaccine. The goal is to increase this number by approximately 20-25% and increase HPV uptake among adolescents in this population by implementing evidence-based tactics. Background and Significance A gap exists when it's about properly vaccinating children against HPV. According to research, barriers include parental fears, lack of doctor communication with parents, religious beliefs, and perceived stigma that accompanies the vaccine, all contributing to low vaccine uptake. The key to increasing vaccination rates is removing these barriers and implementing sustainable interventions. In the United States, the current rates are 39.7% for girls and 21.6% for boys ages 13 to 17 for completing the three-dose vaccine series. In 2014–2015, coverage among adolescents aged 13 to 17 years increased for each dose of HPV vaccine among men (from 41.7% to 49.8%) and increased slightly among women (from 60.0% to 62.8%). By Reagan Steiner (2016), in 2015, nationally, HPV vaccination coverage among all adolescents with ≥1 dose was 56.1% (95% CI = 54.9%-57.4 %), with ≥2 doses was 45.4% (95% CI = 44.2-3we4z%-46.7%), and with ≥3 doses, 34.9% (95% CI = 33. 7% – 36.1%). The HPV vaccine is not routinely administered during visits while other recommended vaccines are administered, and demonstrates continued missed opportunities for the prevention of HPV-associated outcomes, including cancers. According to the Centers for Disease Control and Prevention (CDC) (2016), the Texas HPV Vaccination and Immunization Survey in 2015 showed that approximately 66% of girls received the first dose of the vaccine at Houston. The survey found that around 58.1% of girls received the second dose and around 42.8% received the 3rd dose. The survey found that Houston boys were less vaccinated than girls in 2015, with only about 58.6% of boys receiving the first shot, followed by 46.4% and 22.7% vaccinated with the second and third doses. Problem StatementParents of adolescents are receptive and seek advice from their medical providers. Improving communication between parents and providers could increase HPV vaccine uptake. Additionally, respondaddressing parents' fears and implementing school-based interventions could also be effective. It is important to address and understand current barriers to increasing HPV uptake before strategies can be successfully implemented. Medical providers should gain a deeper understanding of their parents' personal beliefs and feelings. The link between HPV and cancer needs to be reiterated and discussed in depth. The technology is booming and using it to educate adolescents about the importance of the vaccine could be beneficial. It is important to design and test context-specific strategies to improve adolescent vaccination rates and dose completion rates. Potential recommendations include requiring an integrated approach ranging from mass availability of vaccines nationally to targeting adolescents at school and during health care visits to improve the effectiveness of vaccination programs. . Further research is recommended to explore why missed vaccination opportunities exist and to develop evidence-based strategies to reduce the number of missed opportunities and improve adolescent vaccination coverage. The decline in HPV vaccination among adolescents in recent years, particularly among adolescent girls, can be combatted by improving communication between health care providers and parents, who often ignore medical advice or refuse to allow their children to get vaccinated based on misconceptions that could easily be dispelled by clear information and evidence. Information and education are the common threads of this problem, providing the means to strengthen public and medical assets and develop multifaceted approaches to the situation that communicate effectively with key stakeholders, such as health care providers. health and parents. From an economic perspective, it is important to consider closing the gap between underserved or minority populations when it comes to vaccinations. The cost of vaccination in hopes of eliminating the risk of contracting HPV is economically more beneficial than the cost of treating HPV itself. According to Richardson (2007), priorities should include investment in health as a means of increasing the chances of a child becoming a healthy adult and maximizing their intellectual potential rather than becoming a burden on social systems. HPV vaccines can be very effective and potentially life-saving. if administered to adolescents according to clinical studies. These studies also show that “HPV vaccination can be cost-effective with an incremental cost-effectiveness ratio (ICER) of $100,000 or less per quality-adjusted life year (QALY) gained if administered to older adults. women aged 12 years in the context of cervical cancer screening intervals. generally longer than 1 year. “Catching up” and getting vaccinated until age 21 will increase the cost per QALY to over $100,000, which can strain an economy (Armstrong, 2010), especially when the population is already poorly served. Assessment Approach The researcher identified different types of assessment data and data collection methods based on barriers in the literature (parental fears, lack of communication from the provider during the clinic visit, lack knowledge about the vaccine by the parent, effectiveness problems, lack of knowledge of the school nurse). According to Rosen et al.(2015), school nurses can increase their influence on parents regarding the HPV vaccine by focusing on increasing positive attitudes toward the vaccine and strengthening perceptions of their role as opinion leaders. Provider-focused interventions, such as educating parents and providing individualized feedback, have also produced sustained improvements in HPV vaccination rates (Perkins et al., 2015). Beavis & Levinson (2016) reported that physicians in the South were less likely to offer the vaccine than physicians in other regions. Understanding the target audience and communities is important because each group has different cultural needs when it comes to learning and retaining information. Parent-facing systems, such as phone calls, letters, outreach visits, focus groups, and text messages, are interventions that have been shown to be effective and have increased HPV vaccine uptake. Organization Description The Houston Independent School District is the largest public school system in the world. State of Texas with two hundred and eighty-seven schools total. There are approximately 215,000 students, approximately 62.1% Hispanic, 24.5% African American, 3.7% Asian, 8.4% White, and approximately 75.5% disadvantaged. economically. Booker T. Washington High School has approximately 700 students enrolled. It is located in the Independence Heights community in Houston, Texas. About 56% of students are African American, 40% are Hispanic, and 3% are white. About 69% of students are from low-income families, so it is a Title 1 school. The per capita household income for 77018 is $41. Most students who attend the school do not have health insurance or have some form of Medicaid. Health and Medical Services assigned me this project at Washington High. Use of the high school for the pilot study will support the design and implementation of the project. It provides access to the adolescent's parents, school vaccination records, the names of primary care physicians and the holding of focus groups. In addition, it allows the school nurse to observe vaccination suggestions during 9th grade registration, provides a beneficial way to distribute and receive questionnaires and, above all, helps establish a relationship with students and the parents. Stakeholders include the Houston Independent School District Health and Medical Services (HMS) manager, community physicians, school nurses and school principals. These individuals were chosen because they have a genuine interest and concern regarding HPV and its effects on adolescents. The interprofessional team, comprised of the district HMS department manager and a nurse directly reporting to them, will facilitate and ensure access to immunization data reported to the state. They are also responsible for choosing schools willing to allow the project to be carried out. The principal of Washington High is also a member of the team because he allows the collection and distribution of questionnaires, leads the discussion groups and provides a place for dialogue between parents and nurses.MacrosystemFor the purposes of this project, the macrosystem is described as the Houston Independent School District (HISD). The district sets policy guidelines and monitors changes through data collection. HISD is made up of students from diverse social, economic, and racial backgrounds. The culture within HISD is to maintain a sense of safety on every campus and to propel each child academically to their full potential. The macrosystem of.