title: Implementation and Evaluation of a School-Based Human Papillomavirus Vaccination Program in Rural Kentucky.
abstract: BACKGROUND
  Human papillomavirus (HPV) vaccination rates remain marginal across the U.S., including Kentucky, a state recognized for increased HPV-related cancer burden. School-based HPV immunization programs may be a viable approach to improving vaccination initiation and completion rates among youth. Therefore, the purpose of this study was to design, implement, and evaluate a school-based HPV vaccination program conducted in rural south-central Kentucky.
  
  
  METHODS
  Guided by evidence-based approaches to increasing immunization rates, the practical expertise of school nursing staff, and a detailed study protocol, academic and health department-based investigators implemented an HPV vaccination project in two high schools during the 2012-2013 academic year; data were analyzed in 2013-2014. Rates of returned parental consent forms, parental consent/declination, and HPV vaccination rates were documented.
  
  
  RESULTS
  At the beginning of the school year, all 935 students at the two schools were given HPV vaccination parental consent forms. Five hundred eleven students returned consent forms (55% return rate), and 447 of these students were HPV vaccine naïve (87%). Of these students, 315 (70%) initiated the vaccine series, with 276 (62%) completing the entire three-dose series, so that 88% of students initiating the vaccine series successfully completed the series. In estimating rates for the entire school body, 45% of students had received all three doses by the end of the project.
  
  
  CONCLUSIONS
  Despite study design limitations, results of this project provide further evidence about school-based immunization programs as an effective strategy for improving HPV vaccination rates among Kentucky and U.S. adolescents.
authors.affiliation: Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, Kentucky. Electronic address: robin@kcr.uky.edu.
authors.forename: Robin C
authors.initials: RC
authors.lastname: Vanderpool
authors.affiliation: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Breheny
authors.affiliation: Lake Cumberland District Health Department, Somerset, Kentucky.
authors.forename: Peggy A
authors.initials: PA
authors.lastname: Tiller
authors.affiliation: Lake Cumberland District Health Department, Somerset, Kentucky.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Huckelby
authors.affiliation: Lake Cumberland District Health Department, Somerset, Kentucky.
authors.forename: Amy D
authors.initials: AD
authors.lastname: Edwards
authors.affiliation: Lake Cumberland District Health Department, Somerset, Kentucky.
authors.forename: Kristi D
authors.initials: KD
authors.lastname: Upchurch
authors.affiliation: Lake Cumberland District Health Department, Somerset, Kentucky.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Phillips
authors.affiliation: Lake Cumberland District Health Department, Somerset, Kentucky.
authors.forename: Christine F
authors.initials: CF
authors.lastname: Weyman
mesh_terms: D000293:Adolescent; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007629:Kentucky; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D033282:Parental Consent / Q000706:statistics & numerical data; D012424:Rural Population; D012572:School Health Services; D013334:Students; D014611:Vaccination / Q000379:methods*
chemical_list: D053918:Papillomavirus Vaccines