Nurses’ Practices, Attitudes, and Beliefs regarding Human papillomavirus (HPV) Vaccine: a Cross-sectional State-wide Survey of Montana Nurses

Background: Human papillomavirus (HPV) infection, with 13 million new infections emerging every year, is the most common sexually transmitted infection in the US. About 10% of these infections persists, progressing to cause cancers. In previous research conducted in Montana, physicians and public health stakeholders identified greater parental/patient informational needs and limited time for vaccine discussions as barriers to HPV vaccination. Non-physician health care personnel, like nurses and medical assistants, could help bridge this gap and serve as vaccine champions. So far, majority of the studies focused on vaccine confidence among providers have primarily focused on physicians. Through this project we collated state-level data on the knowledge, attitudes, and beliefs of nurses with a long-term goal of optimizing their impact in HPV vaccine promotion in Montana. Methods: We developed a 70-item survey instrument based on a review of existing literature and surveys, including questions created through the CDC-funded Rapid Cycle Survey Collaborative for Provider Input on Immunization Issues. The survey instrument was pre-tested with a small but diverse group (n=7) of nurses and medical assistants. We administered electronic surveys to a state-wide network of nurses and medical assistants working at facilities that participated in the VFC program between December 2020 to March 2021. We sent two email reminders before closing the survey. Data were analyzed for a final sample of 270 participants. Results: Overall, 56% of respondents were registered nurses, 24% were medical assistants, and 17% were licensed practical nurses. Among respondents, 53.7% reported having a process at their clinics to identify and contact patients that are due for their immunization visit. More nurses reported experiencing greater parental vaccine refusal or delay among males than females and this finding remained consistent across age groups. Most respondents (92.5%) agreed that it is important to vaccinate adolescents against HPV ...