Identifying effective vaccine champions: Findings from a national survey of primary care professionals.

BACKGROUND: Vaccine champions are common in primary care, but little is known about which champions are effective. METHODS: In 2022, we surveyed 2,144 US primary care professionals (PCPs) who reported working with vaccine champions. Respondents rated the champion with whom they worked most closely on their effectiveness at improving vaccination rates. RESULTS: About half (49 %) of PCPs perceived their closest champion as highly effective. PCPs perceived advanced practice providers and nursing staff as highly effective somewhat more often than physicians (52 % and 58 % vs 43 %, p <.001). Other correlates of perceived effectiveness included being a formally appointed versus informal champion, working extremely versus less closely with PCPs, and using a high (4-5) versus low (0-1) number of implementation strategies to improve vaccination rates (all p <.001). CONCLUSIONS: Results suggest vaccine champions may benefit from having formal roles and opportunities to work closely with colleagues to improve vaccination rates using multiple strategies.

Challenges and Collaborations: A Case Study for Successful Sexual Assault Nurse Examiner Education in Rural Communities During the COVID-19 Pandemic.

ABSTRACT: Challenges can often only be overcome with collaboration. In this case report of a Health Resources and Services Administration-funded program for Advancing Nurse Education - Sexual Assault Nurse Examiner, we describe the unique challenges and collaborations that have taken place in rural communities as we continued to train nurses during the COVID-19 pandemic. Geography and lack of availability of sexual assault nurse examiner (SANE) trainees brought many challenges as we prepared them to successfully pass the SANE certification examination and recruit new cohorts to expand SANE education.During the implementation of this program, we found that our process model, community collaboration, and commitment to these rural counties were the keys to our success before and during the COVID-19 pandemic.SANE trainee process and outcome measures were collected through quantitative and qualitative data collection. These data from the first cohort, along with the strategies implemented as all partners navigated the challenges of COVID-19, helped to strengthen our collaboration and expand the program. Details of these strategies and outcomes to date will be discussed.

A short report: parents HPV vaccine knowledge in rural South Florida.

An exploratory pilot descriptive research study was conducted in the rural counties of Hendry and Glades Florida exploring parental knowledge and hesitancy of HPV vaccination. Participants included parents/caregivers with children ages 9 to 13; using quantitative methods, we evaluated knowledge, feelings, and beliefs toward HPV vaccination including vaccination prevalence and correlates among participating parents/caregivers. Our measures included the Parental HPV Survey with a Cronbach's alpha of .96. Hesitancy-focused results revealed 26% of parents showed caution because of stigma around vaccination while attributing low levels of knowledge about HPV vaccination; 80% had a persistent belief HPV vaccination could leave their child sterile, perpetuating hesitancy. Participants with a high-school education or less (64%) and conservative religious affiliation, e.g., Baptist and Catholic (74%), did not decline HPV vaccination. Results are striking considering research indicating conservative religious views and lack of a college education leads to lower HPV vaccination rates. Numerous interventions to increase HPV vaccination have been studied including strong recommendations for increased provider communication but our data indicates increasing public education with community input and a focus on cultural norms in each specific rural community among parents and providers is needed to increase HPV vaccine knowledge and decrease HPV vaccine hesitancy.

A summative evaluation of productivity and accomplishments of Robert Wood Johnson Foundation Nurse Faculty Scholars Program participants.

From 2008 to 2017, the Robert Wood Johnson Foundation Nurse Faculty Scholars Program inspired, developed, and supported cohorts of next generation national leaders in academic nursing through career development awards. With support from mentors, scholars in the program created individual development plans focused on scholarship, teaching, service, and leadership. The curriculum of the scholar development program combined goals and objectives related to leadership development, enhancement of nursing education skills, and focused programs of research and scholarship. In addition, program outcomes emphasized engagement in institutional, university, and professional governance systems. This article describes and recounts findings from the program participants regarding accomplishments, productivity, and facilitators contributing to their achievement of program outcomes.

Sexual Risk Behaviors of African American Adolescent Females: The Role of Cognitive and Religious Factors.

INTRODUCTION: African American (AA) high school-age girls are more likely to have had sex before age 13 years and have higher rates of all sexually transmitted infections. Cognition and religion/spirituality are associated with adolescent sexuality, therefore, the purpose of this study was to identify cognitive and religious substrates of AA girls' risky sexual behaviors. METHOD: A descriptive study was conducted with 65 AA girls aged 15 to 20 years using computerized questionnaires and cognitive function tasks. RESULTS: Average age was 17.8 ± 1.9 years and average sexual initiation age was 15.5 ± 2.6 years. Overall, 57.6% reported a history of vaginal sex. Girls who reported low/moderate religious importance were significantly younger at vaginal sex initiation than girls for whom religion was very/extremely important. Girls who attended church infrequently reported significantly more sexual partners. IMPLICATIONS: Health care providers can use these findings to deliver culturally congruent health care by assessing and addressing these psychosocial factors in this population.

Mothers, Fathers, Sons, and Human Papillomavirus Immunization Practices.

Despite the fact that human papillomavirus (HPV) infection and HPV-related cancers are on the rise in men, male HPV vaccine series completion is less than 10% in many areas. This study examined parental knowledge of the HPV vaccine and intent to vaccinate their sons. A cross-sectional study of 341 parents of boys was conducted in school settings in rural southeastern Georgia. Mothers were 2.07 times more likely than fathers to vaccinate their sons. Future research directions should include strategies to increase HPV vaccination in both genders and focus on parents' perceived severity and vulnerability of their sons to HPV infection.

Examination of the Role of Religious and Psychosocial Factors in HIV Medication Adherence Rates.

Optimal adherence to antiretroviral therapy (ART) is associated with favorable HIV outcomes, including higher CD4 cell counts, HIV virus suppression and a lower risk of HIV transmission. However, only 25% of people living with HIV/AIDS (PLWH) in the USA are virally suppressed. Sub-optimal adherence (<90-95%) contributes to antiretroviral resistance and worse medical outcomes, including more rapid progression to AIDS and death. Psychosocial factors and religion/spirituality (R/S) have a significant impact on ART adherence, but the findings are mixed. The purpose of this study was to examine religious and psychosocial correlates and predictors of ≥90% ART adherence in PLWH. A cross-sectional study was conducted with a sample of 292 outpatient PLWH in the Southeastern USA. Participants completed computerized surveys. The mean ART adherence percentage was 80.9% and only about half reported ≥90% adherence. There were statistically significant differences in ART adherence rates based on age, depressive symptom status and frequency of religious attendance and prayer. Praying at least once a day was significantly associated with ≥90% ART adherence (OR = 2.26, 95% CI [1.06-4.79], p < 0.05). Social support satisfaction was also significantly associated with ART adherence (OR = 1.52, 95% CI [1.11-2.08], p < 0.05) and energy/fatigue/vitality (OR = 1.03, 95% CI [1.00-1.05], p < 0.05).

Factors Motivating HPV Vaccine Uptake Among Vaccinated and Nonvaccinated Hispanic Young Adult Women.

INTRODUCTION: To identify factors influencing human papillomavirus (HPV) vaccination up taking decision making among vaccinated and nonvaccinated Hispanic college women. PARTICIPANTS: Hispanic young women between the ages of 18 and 24 years (N = 49). In total, 26 had not received the HPV vaccine, and 23 had started/completed the vaccine series. METHOD: Participants registered for the study via a psychology research pool at a large public university in the southeast United States after institutional review board approval. After completing a demographic information and HPV knowledge Web-based survey, participants were individually interviewed. RESULTS: Differences in HPV vaccine knowledge emerged between vaccinated and nonvaccinated women. Fear of side effects, perceptions of risk, and sources of encouragement influenced willingness to be vaccinated against HPV. Health care providers played a central role in addressing concerns and promoting vaccination. CONCLUSIONS: Health care providers must address and integrate unique decision-making processes influencing Hispanic young adult women's perceptions of HPV vaccination.

Cancer Prevention: HPV Vaccination.

OBJECTIVES: To provide an overview of human papillomavirus (HPV) vaccination as cancer prevention with current strategies that nurses can use to help patients and parents overcome barriers to HPV vaccination. DATA SOURCES: Peer-reviewed literature, presentation abstracts, and current immunization recommendations from the Advisory Council on Immunization Practice. CONCLUSION: Nurses can help prevent cancer by encouraging HPV vaccination during routine immunization and make HPV vaccination normal and routine. IMPLICATIONS FOR NURSING PRACTICE: A vaccine to reduce/eliminate HPV-related cancers enables nurses' at all educational levels to advocate for cancer prevention through initiation and completion of the HPV vaccine series.

The Student Human Papillomavirus Survey: Nurse-Led Instrument Development and Psychometric Testing to Increase Human Papillomavirus Vaccine Series Completion in Young Adults.

BACKGROUND AND PURPOSE: The Student Human Papillomavirus Survey (SHPVS) was developed to examine students' perceived benefits or barriers to human papillomavirus (HPV) vaccination. METHODS: Survey development included (a) 2-phase integrative literature reviews; (b) draft of survey items based on the literature; (c) critique of survey items by young adults, nursing and psychology faculty, and health care providers; and (d) pilot testing. The psychometric properties of the SHPVS were evaluated using classical item analysis and exploratory factor analysis (EFA) among a sample of 527 university students' ages 18-24 years. RESULTS: The estimated Cronbach's alpha for the SHPVS is .74. CONCLUSIONS: The SHPVS is a measure of young adults HPV perceived vulnerability, perceived severity, perceived barriers, and perceived benefits of HPV vaccination.

Young Hispanic Men and Human Papillomavirus Vaccination Choices.

This exploratory descriptive study examined perceived vulnerabilities to human papillomavirus (HPV) and the correlation to factors influencing vaccine beliefs and vaccine decision making in young Hispanic males attending a large public urban university. Only 24% of participants believed that the HPV vaccine could prevent future problems, and 53% said they would not be vaccinated. The best predictors of HPV vaccination in young Hispanic men were agreement with doctor recommendations and belief in the vaccine's efficacy. Machismo cultural norms influence young Hispanic men's HPV-related decision making, their perceptions of the vaccine, and how they attitudinally act on what little HPV information they have access to. This study provides culturally relevant information for the development of targeted health education strategies aimed at increasing HPV vaccination in young Hispanic men.

Assessing the Critical Parameters of eSMART-MH: A Promising Avatar-Based Digital Therapeutic Intervention to Reduce Depressive Symptoms.

PURPOSE: To assess, from the young adults' (YAs') perspectives, the critical parameters (necessity, acceptability, feasibility, fidelity, and safety) of an avatar-based intervention, eSMART-MH, to reduce depressive symptoms. DESIGN AND METHODS: YAs (n = 60) were randomly assigned to eSMART-MH or control and observed for 12 weeks. Qualitative and quantitative data were collected. FINDINGS: Necessity, acceptability, fidelity, and safety of eSMART-MH were supported. Feasibility results were mixed. When benchmarked against usual care, eSMART-MH demonstrated greater feasibility. PRACTICE IMPLICATIONS: eSMART-MH is a promising digital therapeutic for depressive symptoms. Feasibility can be strengthened through "on the go" access via mobile devices and Internet delivery.

The Influence of Religiosity and Spirituality on Rural Parents' Health Decision Making and Human Papillomavirus Vaccine Choices.

General health implications of religiosity and spirituality on health have been associated with health promotion, so the purpose of this study was to examine the influence of religiosity and spirituality on rural parents' decision making to vaccinate their children against human papillomavirus (HPV). The associations of religiosity and spirituality with parental HPV vaccine decisions were examined in a sample of parents residing in small rural communities (N = 37). Parents of children aged 9 to 13 years participated in focus groups held in rural community contexts. Religiosity (i.e., participation in religious social structures) was a recurring and important theme when discussing HPV vaccination. Spirituality (i.e., subjective commitment to spiritual or religious beliefs) was found to influence the ways in which parents perceived their control over and coping with health issues potentially related to HPV vaccination. Together, religiosity and spirituality were found to play integral roles in these parents' lives and influenced their attitudes toward HPV vaccination uptake for their children.

Religious and Psychosocial Covariates of Health-Related Quality of Life in People Living with HIV/AIDS.

HIV/AIDS is a chronic, highly stigmatized illness that requires significant lifestyle adjustments, including consistent adherence to Antiretroviral Therapy (ART) in order for People Living With HIV/AIDS (PLWH) to survive and maintain good immune health. PLWH often report poor or moderate Health-Related Quality of Life (HRQoL) that is worse than the general population. This may be related to the psychological and physiological demands of HIV disease and the sociodemographic stressors associated with it. The role of religious coping, religiosity, and social support in the mental and physical dimensions of HRQoL is less known, although recent studies highlight that PLWH rely on spirituality/religion to cope with HIV-associated stressors. This study examined the effects of religious coping, religiosity, depressive symptoms, medication adherence, and social support satisfaction in various dimensions of Health- Related Quality of Life (HRQoL) in a sample of 292 PLWH. Majority of participants were African-American (90.1%) and 56.2% were male. Mean age was 45 years and, on average, participants lived with HIV for nearly 11 years. Descriptive statistics, correlations, Analysis of Variance (ANOVA), and hierarchical multiple linear regression were used to analyze the data. Income, sex (ß= .14), age (ß= -.14), depressive symptoms (ß= -.27), and social support satisfaction (ß= .17) significantly predicted physical HRQoL. Results indicate that income (ß= .13), sex (ß= .14), medication adherence (ß= .13), negative religious coping (ß= -.18), religious attendance (ß= .13), religiousness (ß= .16), and social support satisfaction (ß= .27) significantly predicted mental HRQoL. Depressive symptoms (ß= -.38), positive religious coping (ß= .24), and social support satisfaction (ß= .16) significantly predicted general HRQoL. Participants, who were female, prayed less than daily, attended religious services less than weekly or who were non/less religious had significantly poorer HRQoL. The findings confirm the importance of religion, mental health, medication adherence and social support in the HRQoL of PLWH, which should all be routinely assessed by clinicians.

Stigma Scale for Receiving Psychological Help (SSRPH): An Examination Among Adolescent Girls.

Stigma is one of the greatest obstacles to care and impedes recovery. The Stigma Scale for Receiving Professional Psychological Help (SSRPH), a measure of public stigma, has been used in young adults and has limited psychometric data in adolescents. This article reports the reliability and validity of the SSRPH in adolescent girls (N = 156, age = 13-17). Discriminant validity was supported, but concurrent validity was not. The confirmatory factor analysis revealed excellent model fit and serves as beginning evidence for construct validity. Cronbach's alpha for the SSRPH was .65. The SSRPH was stable over 8 weeks. Findings suggest that the SSRPH can serve as a foundation for further instrument development. Future studies may explore enhancing the reliability and validity of the SSRPH and use advanced analytic techniques to examine the overall global construct of stigma, the latent constructs of public and private stigma, and associations of individual items to these constructs.

Cross-cultural differences and sexual risk behavior of emerging adults.

PURPOSE: The authors examined population-specific risk factors that increase emerging adults' risk of acquiring sexually transmitted infections (STIs), including the human papillomavirus (HPV). DESIGN AND METHOD: A cross-sectional sample of 335 diverse, emerging adults ages 18 to 24 years was recruited from a health center at a large university in the Southeastern United States. The mean age was 20.6 ± 1.9 years, majority were females (74.0%), and 61.0% were Hispanic. RESULTS: Findings revealed inconsistent condom use, reasons for not using condoms, and a need for more culturally specific intervention strategies. DISCUSSION AND CONCLUSIONS: Healthcare providers should identify culturally specific reasons for inconsistent condom use, examine cultural and geographic differences in sexual risk behaviors among groups and communities, and modify communication, educational programs, and interventions accordingly. IMPLICATIONS FOR PRACTICE: By adopting a multicultural approach to the control of STIs, nurses can address specific cultural attitudes and behaviors that may influence exposure to STIs, including HPV.

Overcoming the triad of rural health disparities: How local culture, lack of economic opportunity, and geographic location instigate health disparities.

OBJECTIVE: To discuss how the effects of culture, economy, and geographical location intersect to form a gestalt triad determining health-related disparities in rural areas. METHODS: We critically profile each component of the deterministic triad in shaping current health-related disparities in rural areas; evaluate the uniquely composed intersections of these disparities in relation to Human Papillomavirus (HPV)-related cancer prevention in three isolated rural Georgia counties; and develop implications for future leadership in rural healthcare research, policy, and practice. RESULTS: The deterministic triad of culture, economy, and geographical location is unique to a rural community, and even if two rural communities experience the same health disparity, each community is likely to have a discretely different composition of cultural, economic, and geographic determinants. CONCLUSION: The deterministic triad presents a challenge for health policymakers, researchers, and practitioners trying to develop health-related interventions that are equitable, efficacious, and practical in low-resource rural communities. The situation is worsened by the limited opportunities for employment, which leads to greater disparities and creates propagating cultural norms that further reduce access to healthcare and opportunities for sustainable health promotion.

Initial evaluation of the Robert Wood Johnson Foundation Nurse Faculty Scholars program.

BACKGROUND: The Robert Wood Johnson Foundation Nurse Faculty Scholars (RWJF NFS) program was developed to enhance the career trajectory of young nursing faculty and to train the next generation of nurse scholars. Although there are publications that describe the RWJF NFS, no evaluative reports have been published. The purpose of this study was to evaluate the first three cohorts (n = 42 scholars) of the RWJF NFS program. METHODS: A descriptive research design was used. Data were derived from quarterly and annual reports, and a questionnaire (seven open-ended questions) was administered via Survey Monkey Inc. (Palo Alto, CA, USA). RESULTS: During their tenure, scholars had on average six to seven articles published, were teaching/mentoring at the graduate level (93%), and holding leadership positions at their academic institutions (100%). Eleven scholars (26%) achieved fellowship in the American Academy of Nursing, one of the highest nursing honors. The average ratings on a Likert scale of 1 (not at all supportive) to 10 (extremely supportive) of whether or not RWJF had helped scholars achieve their goals in teaching, service, research, and leadership were 7.7, 8.0, 9.4, and 9.5, respectively. The majority of scholars reported a positive, supportive relationship with their primary nursing and research mentors; although, several scholars noted challenges in connecting for meetings or telephone calls with their national nursing mentors. CONCLUSIONS: These initial results of the RWJF NFS program highlight the success of the program in meeting its overall goal-preparing the next generation of nursing academic scholars for leadership in the profession.

An integrative review of guidelines for anal cancer screening in HIV-infected persons.

HIV-infected individuals are 28 times more likely than the general population to be diagnosed with anal cancer. An integrative review of recommendations and guidelines for anal cancer screening was performed to provide a succinct guide to inform healthcare clinicians. The review excluded studies that were of non-HIV populations, redundant articles or publications, non-English manuscripts, or nonclinical trials. The review found no formal national or international guidelines exist for routine screening of anal cancer for HIV-infected individuals. To date, no randomized control trial provides strong evidence supporting efficaciousness and effectiveness of an anal cancer screening program. The screening recommendations from seven international-, national-, and state-based reports were reviewed and synthesized in this review. These guidelines suggest anal cancer screening, albeit unproven, may be beneficial at decreasing the incidence of anal cancer. This review highlights the paucity of screening-related research and is an area of need to provide clear direction and to define standard of care for anal cancer screening in HIV-infected persons.