ASPO Abstracts
Increasing access to HPV vaccination for active duty soldiers: Evaluating the feasibility and sustainability of a nursing education intervention
Category: Behavioral Science & Health Communication
Conference Year: 2022
Abstract Body:
Purpose. Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the military and accounts for more healthcare visits than other STIs. Although vaccination against HPV is safe and effective, it is not required for U.S. military service, and HPV vaccination coverage is extremely low among active duty soldiers. To improve coverage, we sought to evaluate the feasibility and sustainability of using a nursing education intervention to integrate HPV vaccination into medical processing procedures for soldiers at a large military base.Methods. In March 2021, we conducted a 1-hour training about HPV vaccination for nursing staff (n=11) at the Medical One Stop, a medical clinic that supports the intake of soldiers at Fort Bragg, North Carolina. Training included using presumptive recommendations to present HPV vaccine as the default choice in routine care and guidance on addressing soldiers' concerns. After the training, nursing staff integrated HPV vaccination into clinic procedures for soldiers, ages 18-26. We conducted online surveys of nursing staff to assess their perspectives on intervention feasibility. Nursing staff also tracked HPV vaccine uptake among soldiers for 4 weeks after the training to assess adoption and then for 2 weeks at a 4-month follow-up to assess sustainability. Results. Nursing staff strongly agreed that the presumptive recommendation approach fit in with medical processing procedures (mean=4.6 of 5.0). Of 516 soldiers offered HPV vaccine in the 4 weeks following the training, 198 (38%) accepted and received the vaccine. Younger soldiers, ages 18-20, more often accepted HPV vaccination than older soldiers, ages 21-26 (46% versus 32%, p<0.01). Vaccine uptake was similar at 4-month follow-up, with 98 of 230 eligible soldiers (43%) receiving HPV vaccine. Conclusions. Our findings suggest our light-touch intervention to train nursing staff to recommend and administer HPV vaccines to soldiers is feasible and sustainable, and warrants wider-scale testing as a strategy to protect soldiers from HPV-attributable cancers. Even in the absence of policies requiring HPV vaccination for military service, improving HPV vaccine access via a nursing education intervention may be one path to increasing coverage among soldiers.
Keywords: soldier, HPV vaccine, communication training, feasibility, sustainability