title: Engaging parents and schools improves uptake of the human papillomavirus (HPV) vaccine: examining the role of the public health nurse.
abstract: BACKGROUND
  Nova Scotia has the highest rate of cervical cancer in Canada, and most of these cases are attributed to the Human Papillomavirus (HPV). In 2007, Gardasil(®) was approved and implemented in a successful school-based HPV immunization program. Little is known, however, which strategies (if any) used within a school-based program help to improve vaccine uptake.
  
  
  METHODS
  A retrospective, exploratory correlation study was conducted to examine the relationship between school-based strategies and uptake of HPV vaccine. Data was analyzed through Logistic regression, using PASW Statistics 17 (formerly SPSS 17).
  
  
  RESULTS
  HPV vaccine initiation was significantly associated with Public Health Nurses providing reminder calls for: consent return (p=0.017) and missed school clinic (p=0.004); HPV education to teachers (p<0.001), and a thank-you note to teachers (p<0.001). Completion of the HPV series was associated with vaccine consents being returned to the students' teacher (p=0.003), and a Public Health Nurse being assigned to a school (p=0.025).
  
  
  CONCLUSIONS
  These findings can be used to help guide school-based immunization programs for optimal uptake of the HPV vaccine among the student population.
authors.affiliation: School of Nursing, Dalhousie University, Canada. Electronic address: nl776649@dal.ca.
authors.forename: Noella W
authors.initials: NW
authors.lastname: Whelan
authors.affiliation: School of Nursing, Dalhousie University, Canada; Canadian Center for Vaccinology, IWK Health Centre, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Steenbeek
authors.affiliation: School of Nursing, Dalhousie University, Canada.
authors.forename: Ruth
authors.initials: R
authors.lastname: Martin-Misener
authors.affiliation: Canadian Center for Vaccinology, IWK Health Centre, Canada; Department of Medicine, Dalhousie University, Canada.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Scott
authors.affiliation: Canadian Center for Vaccinology, IWK Health Centre, Canada; Department of Mathematics and Statistics, Dalhousie University, Canada.
authors.forename: Bruce
authors.initials: B
authors.lastname: Smith
authors.affiliation: Public Health, Capital Health, Halifax, Nova Scotia, Canada.
authors.forename: Holly
authors.initials: H
authors.lastname: D'Angelo-Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006293:Health Promotion / Q000379:methods; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D016015:Logistic Models; D008875:Middle Aged; D009674:Nova Scotia; D064689:Nurses, Public Health; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D010290:Parents; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D012572:School Health Services / Q000706:statistics & numerical data*; D012574:Schools / Q000706:statistics & numerical data; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines