title: School nurses' knowledge, attitudes, perceptions of role as opinion leader, and professional practice regarding human papillomavirus vaccine for youth.
abstract: BACKGROUND
  Because human papillomavirus (HPV) vaccine rates remain low, we evaluated US school nurses' knowledge, attitudes, perceptions of their role as opinion leaders, and professional practice regarding HPV vaccine, and assessed whether knowledge, attitudes, and perceptions of being an opinion leader influenced their professional practice regarding the HPV vaccine.
  
  
  METHODS
  We used a cross-sectional design by recruiting members from the National Association of School Nurses. All participants (N = 505) were e-mailed a survey designed for this study. Structural equation modeling (SEM) tested direct and indirect effects.
  
  
  RESULTS
  Overall, school nurses had knowledge about HPV and the vaccine, and positive attitudes toward the vaccine. They had less-than-enthusiastic perceptions of their role as opinion leaders regarding the vaccine and implemented few activities related to providing vaccine information. The model revealed a good fit (χ(2)=20.238 [df=8, p< .01]), with knowledge directly related to attitudes, attitudes directly related to perceptions and practice, and perceptions directly affecting practice. In our model, perceptions functioned as a partial mediator.
  
  
  CONCLUSIONS
  To enhance school nurses' practice regarding the HPV vaccine, focus should be on increasing positive attitudes toward the vaccine and strengthening perceptions of their role as opinion leaders.
authors.affiliation: University of Cincinnati, School of Human Services, PO Box 210068, Cincinnati, OH 45221.
authors.forename: Brittany L
authors.initials: BL
authors.lastname: Rosen
authors.forename: Patricia
authors.initials: P
authors.lastname: Goodson
authors.forename: Bruce
authors.initials: B
authors.lastname: Thompson
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology; D009726:Nurses / Q000523:psychology*; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000523:psychology*; D053918:Papillomavirus Vaccines; D011364:Professional Practice; D012573:School Nursing; D012938:Social Perception; D012956:Societies, Nursing
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccine; diffusion of innovations; professional nursing practice; school nurses