NursingStudyHub

Week 5: Research Literature, Design, Sampling, and Implementation

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by

Liu
in

 

PICOT/PICo Question:

For adolescents (ages 13-17), does the implementation of an HPV educational program result in a 25% increase in vaccination rates within one year compared to current practices?

Nursing Concern:

The identified nursing concern is the low rate of HPV vaccination among adolescents, which increases their risk of developing HPV-related cancers. Addressing this concern is crucial for promoting long-term health and reducing the incidence of preventable diseases.

1. Research Literature Support:

To provide a comprehensive background for the identified concern and PICOT question, a review of relevant research studies is conducted. Below are summaries of ten key research articles that support the need for an HPV educational program to increase vaccination rates among adolescents.

Article 1: Albright et al. (2017)

  • Purpose: To understand why English- and Spanish-speaking parents of adolescent girls do not initiate or complete the HPV vaccine series.
  • Research Approach: Qualitative study.
  • Data Collection Methods: Focus groups and semi-structured interviews.
  • Results: The study found that healthcare providers need to improve recommendations, coordination, and follow-up efforts to ensure better vaccine uptake.
  • Strength: Provides insights into cultural and linguistic barriers to vaccination.
  • Limitation: Small sample size limited to a single metropolitan area.

Article 2: Cruz et al. (2016)

  • Purpose: To explore barriers and motivators related to HPV vaccination among multicultural parents in Hawaii.
  • Research Approach: Qualitative interviews.
  • Data Collection Methods: In-person and telephone interviews.
  • Results: Identified the importance of culturally tailored educational materials and physician influence on vaccination decisions.
  • Strength: Highlights the role of cultural factors in vaccination acceptance.
  • Limitation: Small sample size, focused on female participants only.

Article 3: Garbutt et al. (2018)

  • Purpose: To identify barriers to implementing national HPV vaccination recommendations in primary care.
  • Research Approach: Mixed-methods study.
  • Data Collection Methods: Analysis of medical records and interviews with physicians.
  • Results: Emphasized the need for strategies to increase vaccine acceptance, especially among pre-exposed individuals.
  • Strength: Combines quantitative and qualitative data for a comprehensive analysis.
  • Limitation: Limited to one geographical area.

Article 4: Javid et al. (2016)

  • Purpose: To identify barriers and facilitators to HPV vaccine uptake in Texas pediatric care settings.
  • Research Approach: Qualitative survey method.
  • Data Collection Methods: Surveys conducted via the Qualtrics platform.
  • Results: Communication issues and misconceptions about HPV were significant barriers.
  • Strength: Large-scale survey provides broad insights.
  • Limitation: Response rate and potential selection bias were not clearly determined.

Article 5: Kasting et al. (2016)

  • Purpose: To explore healthcare providers’ awareness and informational needs regarding the nine-valent HPV vaccine.
  • Research Approach: Qualitative, semi-structured interviews.
  • Data Collection Methods: Recorded interviews with healthcare providers.
  • Results: Found that providers had unmet educational needs that could affect vaccine recommendations.
  • Strength: Focuses on provider perspectives, a critical factor in vaccination uptake.
  • Limitation: Convenience sampling may limit generalizability.

Article 6: Kornides et al. (2018)

  • Purpose: To assess the correlation between parental satisfaction with provider communication and HPV vaccination behaviors.
  • Research Approach: Qualitative online cross-sectional study.
  • Data Collection Methods: Online surveys with a national sample.
  • Results: Effective communication by providers was linked to higher vaccination rates.
  • Strength: Large sample size with national representation.
  • Limitation: Cross-sectional design limits the ability to determine causality.

Article 7: Kulczycki et al. (2016)

  • Purpose: To examine how physician-initiated discussions and perceived barriers affect HPV vaccination rates.
  • Research Approach: Quantitative regression analysis.
  • Data Collection Methods: Online and mailed surveys.
  • Results: Communication with parents and patients is vital for increasing vaccination rates.
  • Strength: Provides statistical evidence of the importance of provider communication.
  • Limitation: Sample size may limit the ability to generalize findings.

Article 8: Perkins et al. (2014)

  • Purpose: To examine why parents and providers postpone HPV vaccination for adolescent girls.
  • Research Approach: Qualitative interviews.
  • Data Collection Methods: Semi-structured interviews.
  • Results: Identified concerns about vaccine safety and the age of the child as significant barriers.
  • Strength: Provides insights into specific reasons for vaccine hesitancy.
  • Limitation: Small, non-random sample focused on a specific geographic area.

Article 9: Rosen et al. (2017)

  • Purpose: To assess how different sources of information influence adolescents’ knowledge and perceptions of the HPV vaccine.
  • Research Approach: Longitudinal descriptive analysis.
  • Data Collection Methods: Surveys administered in clinical settings.
  • Results: Social media and healthcare providers were the most influential sources of information.
  • Strength: Highlights the importance of targeted information dissemination.
  • Limitation: Cross-sectional design limits understanding of long-term effects.

Article 10: Young et al. (2018)

  • Purpose: To explore the informational needs of young women undergoing colposcopy after receiving the HPV vaccine.
  • Research Approach: Semi-controlled qualitative interviews.
  • Data Collection Methods: In-person and telephone interviews.
  • Results: Found that women had a partial understanding of the vaccine and its limits.
  • Strength: Focuses on a specific patient population undergoing diagnostic testing.
  • Limitation: Information may have been updated during the colposcopy, affecting responses.

2. Research Approach and Design:

The research approach for this EBP project will be quantitative, focusing on numerical data to assess the effectiveness of the HPV educational program in increasing vaccination rates. A pretest-posttest design will be employed, where vaccination rates before and after the implementation of the educational program will be compared. This design is appropriate because it allows for the measurement of change over time and can establish a cause-effect relationship between the intervention and the outcome.

3. Sampling Method:

The sampling method for this project will be stratified random sampling. Adolescents aged 13-17 from multiple schools in the target area will be stratified based on age, gender, and previous vaccination status. This method ensures that all relevant subgroups are adequately represented in the sample, leading to more generalizable results.

4. Implementation and Change Model:

The implementation of this EBP project will be guided by the Iowa Model of Evidence-Based Practice to Promote Quality Care. This model emphasizes the importance of identifying a problem, forming a team, gathering and appraising evidence, piloting the practice change, and evaluating the outcomes.

Steps of Implementation:

  1. Form a Multidisciplinary Team: A team comprising nurses, school health officials, and public health educators will be formed.
  2. Gather and Appraise Evidence: The team will review the existing literature on HPV vaccination and educational interventions.
  3. Develop the Educational Program: Based on the evidence, an HPV educational program tailored to adolescents and their parents will be developed.
  4. Pilot the Program: The program will be piloted in a few selected schools, and feedback will be collected.
  5. Evaluate Outcomes: Vaccination rates before and after the program will be compared to assess the effectiveness of the intervention.
  6. Disseminate Findings: The results will be shared with stakeholders, including healthcare providers and policymakers, to encourage broader adoption.

Conclusion:

This assignment has outlined the research literature, design, sampling, and implementation plan for an EBP project aimed at increasing HPV vaccination rates among adolescents. The selected research studies provide robust support for the project, and the use of a quantitative approach with stratified random sampling and the Iowa Model will ensure the project’s success.

References:

  • Albright, K., et al. (2017). Noninitiation and Noncompletion of HPV Vaccine Among English- and Spanish-Speaking Parents of Adolescent Girls: A Qualitative Study. Academic Pediatrics, 17(7), 778-784.
  • Cruz, M. R., et al. (2016). Human Papillomavirus (HPV) Vaccination Motivators, Barriers, and Brochure Preferences Among Parents in Multicultural Hawai‘i: A Qualitative Study. Journal of Cancer Education, 32(3), 613-621.
  • Garbutt, J. M., et al. (2018). Barriers and Facilitators to HPV Vaccination in Primary Care Practices: A Mixed-Methods Study Using the Consolidated Framework for Implementation Research. BMC Family Practice, 19(1).
  • Javid, M., et al. (2016). Human Papillomavirus Vaccine Uptake in Texas Pediatric Care Settings: A Statewide Survey of Healthcare Professionals. Journal of Community Health, 42(1), 58-65.
  • Kasting, M. L., et al. (2016). A Qualitative Study of Healthcare Provider Awareness and Informational Needs Regarding the Nine-Valent HPV Vaccine. Vaccine, 34(11), 1331-1334.
  • Kornides, M. L., et al. (2018). Associations between Parents’ Satisfaction with Provider Communication and HPV Vaccination Behaviors. Vaccine, 36(19), 2637-2642.