title: Investigating stakeholder attitudes and opinions on school-based human papillomavirus vaccination programs.
abstract: BACKGROUND
  In several countries worldwide, school-based human papillomavirus (HPV) vaccination programs have been successful; however, little research has explored US stakeholders' acceptance toward school-based HPV vaccination programs.
  
  
  METHODS
  A total of 13 focus groups and 12 key informant interviews (N = 117; 85% females; 66% racial/ethnic minority) were conducted with 5 groups of stakeholders: parents of adolescent girls, parents of adolescent boys, adolescent girls, middle school nurses, and middle school administrators throughout the 5 public health regions of New Mexico.
  
  
  RESULTS
  All groups of stakeholders lacked knowledge on HPV and HPV vaccines. Stakeholders were interested in--but apprehensive about--the benefits of HPV vaccination. Despite previous literature showing the benefits of using middle schools as an HPV vaccination site, stakeholders did not deem middle schools as a viable site for vaccination. Nurses reported that using the school as an HPV vaccination site had not occurred to them; parents and adolescents stated they were uncertain about using this type of program. School administrators indicated that they lacked implementation authority.
  
  
  CONCLUSIONS
  Our study uncovered barriers to using middle schools as a site of HPV vaccination. Resources should be directed toward increased support and education for middle school nurses who function as opinion leaders relevant to the uptake of HPV vaccination.
authors.affiliation: Department of Communication Studies, Augustana College, Old Main Office 212, 639 38th Street, Rock Island, IL 61201. jessicanodulman@augustana.edu.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Nodulman
authors.forename: Randall
authors.initials: R
authors.lastname: Starling
authors.forename: Alberta S
authors.initials: AS
authors.lastname: Kong
authors.forename: David B
authors.initials: DB
authors.lastname: Buller
authors.forename: Cosette M
authors.initials: CM
authors.lastname: Wheeler
authors.forename: W Gill
authors.initials: WG
authors.lastname: Woodall
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration* / Q000592:standards; D007407:Interviews as Topic; D008297:Male; D009516:New Mexico; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000592:standards; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D012572:School Health Services / Q000458:organization & administration* / Q000592:standards; D012573:School Nursing / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV; HPV vaccination; child and adolescent health; nurses; school-based clinics
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