scholarly journals Implementation of the human papillomavirus school-entry requirement in Puerto Rico: barriers and facilitators using the consolidated framework for implementation research

2021 ◽  
pp. 1-10
Author(s):  
Vivian Colón-López ◽  
Roxana Soto-Abreu ◽  
Diana T. Medina-Laabes ◽  
Olga L. Díaz-Miranda ◽  
Ana P. Ortiz ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Human Papillomavirus ◽  
Implementation Research ◽  
Barriers And Facilitators ◽  
School Entry

scholarly journals Implementation of the Human Papillomavirus School-entry Requirement in Puerto Rico: Barriers and Facilitators Using the Consolidated Framework for Implementation Research

2021 ◽  
Author(s):  
Vivian Colón-López ◽  
Roxana Soto-Abreu ◽  
Diana T. Medina-Laabes ◽  
Olga L. Díaz-Miranda ◽  
Ana P. Ortiz ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Human Papillomavirus ◽  
Implementation Research ◽  
Hpv Vaccine ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Negative Influence ◽  
Barriers And Facilitators ◽  
School Entry ◽  
Relative Advantage

Abstract Background: In 2018, Puerto Rico (PR) enacted a Human papillomavirus (HPV) vaccine school-entry requirement for students ages 11 to 12. Using the Consolidated Framework for Implementation Research (CFIR), we aimed to identify potential barriers and facilitators of this implementation.Methods: We conducted a total of 36 qualitative interviews with key informants who were stakeholders from different organizations (Department of Health, Schools, Healthcare Providers, and Community organizations in favor of the requirement) from July 2018 to January 2020. Three researchers performed the interview guide, data coding, and analysis according to the CFIR framework. We evaluated construct rating variability between the organizations to determine barriers and facilitators. Results: The strongest facilitators determined under the CFIR construct include the stakeholder's awareness of the parent's and student's needs to meet the HPV school-entry requirement. Other facilitators include initiatives for school-entry policies and the relative advantage of this requirement over different strategies. The strongest barriers included the cost for private providers to administer the HPV vaccine, the negative influence of social media about the vaccine, which affected parents' acceptance, and the lack of school nurses as available staff resources for the school entry requirement. Conclusions: Findings from this study can be used to improve implementation (adaptations/modifications) and inform other US states and countries in earlier stages of consideration of the adoption of similar immunization policies. Most barriers can be modifiable with the implementation of educational programs/training across schools, considering that they are the first line of response to parents of this school entry requirement.

Abstract D047: Human papillomavirus school-entry vaccination mandate in Puerto Rico: Barriers and facilitators from the perspective of key informants

2020 ◽  
Author(s):  
Roxana Soto-Abreu ◽  
Manuel E. Rivera-Encarnación ◽  
Vilnery Rivera-Figueroa ◽  
Glizette O. Arroyo-Morales ◽  
Diana T. Medina-Laabes ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Human Papillomavirus ◽  
Barriers And Facilitators ◽  
School Entry ◽  
Key Informants

scholarly journals Content Analysis of Digital Media Coverage of the Human Papillomavirus Vaccine School-Entry Requirement Policy in Puerto Rico

2020 ◽  
Author(s):  
Vivian Colón-López ◽  
Vilnery Rivera-Figueroa ◽  
Glizette O Arroyo-Morales ◽  
Diana T Medina-Laabes ◽  
Roxana Soto-Abreu ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Digital Media ◽  
Hpv Vaccine ◽  
Media Coverage ◽  
News Coverage ◽  
The United States ◽  
School Entry ◽  
Theory Approach

Abstract BackgroundIn August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11-12 years old. Evidence suggests that the content of media coverage may impact people's perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR.MethodsA content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix to summarize each article’s content about the policy and 2) qualitative analysis using a grounded theory approach. ResultsThe search resulted in 34 articles in 17 online local and international news outlets that reported on the implementation of the policy. Analyses showed that 61% of the news articles did not mention the number of required doses, and 79% discussed the new policy concerning cancer prevention. In 2017, news coverage focused mostly on describing the policy, while 2018 coverage focused on controversies surrounding the implementation. Negative emergent codes included: 1) infringement to patient and parental autonomy; 2) Hesitancy from the political sector 3) Hesitancy from groups and coalitions. Positive content included: 1) knowledge and acceptance of HPV vaccine for cancer prevention; 2) importance of education and protective sexual behaviors; and 3) new vaccination law proposal. Neutral emergent codes included: 1) Description of the policy; 2) Information about HPV related cancers; and 3) General information about HPV vaccine.ConclusionsMost of the media coverage in PR was neutral and included limited information related to the vaccine, HPV, and HPV-related cancers. Neutral and negative themes could influence public concerns regarding the new policy, as well as HPV vaccination rates in PR.

scholarly journals Content analysis of digital media coverage of the human papillomavirus vaccine school-entry requirement policy in Puerto Rico

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vivian Colón-López ◽  
Vilnery Rivera-Figueroa ◽  
Glizette O. Arroyo-Morales ◽  
Diana T. Medina-Laabes ◽  
Roxana Soto-Abreu ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Digital Media ◽  
Hpv Vaccine ◽  
Media Coverage ◽  
News Coverage ◽  
The United States ◽  
School Entry ◽  
Theory Approach

Abstract Background In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11–12 years old. Evidence suggests that the content of media coverage may impact people’s perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR. Methods A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix to summarize each article’s content about the policy and 2) qualitative analysis using a grounded theory approach. Results The search resulted in 34 articles obtained from 17 online local and international news outlets that reported the policy's implementation. Analyses showed that 61% of the news articles did not mention the number of required doses, and 79% discussed the new policy concerning cancer prevention. In 2017, news coverage focused mostly on describing the policy, while 2018 coverage focused on controversies surrounding the implementation. Neutral emergent codes included: 1) Description of the policy; 2) Information about HPV related cancers; and 3) General information about HPV vaccine. Negative emergent codes included: 1) infringement to patient and parental autonomy; 2) Hesitancy from the political sector, and 3) Hesitancy from groups and coalitions. Positive content included: 1) knowledge and acceptance of HPV vaccine for cancer prevention; 2) importance of education and protective sexual behaviors; and 3) new vaccination law proposal. Conclusions Most of the media coverage in PR was neutral and included limited information related to the vaccine, HPV, and HPV-related cancers. Neutral and negative themes could influence public concerns regarding the new policy, as well as HPV vaccination rates in PR.

Abstract D045: Content analysis of online media coverage of the human papillomavirus vaccine as a school-entry policy in Puerto Rico

2020 ◽  
Author(s):  
Vilnery Rivera-Figueroa ◽  
Glizette O Arroyo-Morales ◽  
Roxana Soto-Abreu ◽  
Manuel E Rivera-Encarnación ◽  
Olga L Díaz-Miranda ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Content Analysis ◽  
Human Papillomavirus ◽  
Media Coverage ◽  
School Entry ◽  
Online Media ◽  
Human Papillomavirus Vaccine ◽  
Papillomavirus Vaccine

The Intersection of Problems, Policy, and Politics: The Adoption of an HPV Vaccine School-Entry Requirement in Puerto Rico

2021 ◽  
Vol 31 (5) ◽  
pp. 859-870
Author(s):  
Coralia Vázquez-Otero ◽  
Ellen M. Daley ◽  
Cheryl A. Vamos ◽  
Nancy Romero-Daza ◽  
Jason Beckstead ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Nonprofit Organizations ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
School Entry ◽  
Advisory Panel ◽  
Policy Entrepreneurs ◽  
Vaccination Rates ◽  
Policy Initiatives ◽  
Policy Window

Persistent human papillomavirus (HPV) infections can cause cancer (e.g., cervical/vaginal/penile/anal/oropharyngeal). The HPV vaccine prevents cancer, yet U.S. vaccination rates remain low. We explored sociopolitical factors in the adoption of Puerto Rico’s HPV vaccine school-entry requirement. Multiple streams framework explains how the intersection of problems, policy, and politics streams influence policy adoption. Policy entrepreneurs work on joining these streams. Interviews ( n = 20) were conducted with stakeholders (e.g., physicians/researchers/nonprofit organizations’ leaders). Data were analyzed using applied thematic analysis. High incidence of HPV and HPV-related cancers in Puerto Rico were indicators of problems. Focusing events included Rhaiza’s case and the HPV-Advisory Panel Report. During summer 2017, a policy window opened; the Department of Health (DOH) adopted the requirement in summer 2018. Stakeholders discussed policy initiatives. Political turnover positively influenced the process. Policy entrepreneurs created an extended period of intersection resulting in the adoption of the requirement. Findings can inform policy initiatives to improve HPV vaccination rates and reduce HPV-related cancers.

Abstract PO-040: Understanding views against the HPV vaccine school-entry requirement in Puerto Rico

2022 ◽  
Author(s):  
Gloriany Rivas ◽  
Roxana Soto-Abreu ◽  
Glizette O. Arroyo-Morales ◽  
Diana T. Medina-Laabes ◽  
Olga L. Díaz-Miranda ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Hpv Vaccine ◽  
School Entry

scholarly journals Lack of school requirements and clinician recommendations for human papillomavirus vaccination

2018 ◽  
Author(s):  
Linda M. Niccolai ◽  
Anna L. North ◽  
Alison Footman ◽  
Caitlin E. Hansen
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
School Entry ◽  
Structured Interviews ◽  
Human Papillomavirus Vaccination ◽  
Strong Recommendation ◽  
Entry Requirements ◽  
Design And Methods ◽  
Purposive Sample

Background: A strong recommendation from a clinician is one of the best predictors of human papillomavirus (HPV) vaccination among adolescents, yet many clinicians do not provide effective recommendations. The objective of this study was to understand how the lack of school entry requirements for HPV vaccination influences clinicians’ recommendations. Design and Methods: Semi-structured interviews with a purposive sample of 32 clinicians were conducted in 2015 in Connecticut USA. Data were analysed using an iterative thematic approach in 2016-2017. Results: Many clinicians described presenting HPV vaccination as optional or non-urgent because it is not required for school entry. This was noted to be different from how other required vaccines were discussed. Even strong recommendations were often qualified by statements about the lack of requirements. Furthermore, lack of requirements was often raised initially by clinicians and not by parents. Many clinicians agreed that requirements would simplify the recommendation, but that parents may not agree with requirements. Personal opinions about school entry requirements were mixed. Conclusions: The current lack of school entry requirements for HPV vaccination is an important influence on clinicians’ recommendations that are often framed as optional or non-urgent. Efforts are needed to strengthen the quality of clinicians’ recommendations in a way that remains strong and focused on disease prevention yet uncoupled from the lack of requirements that may encourage delays. Additionally, greater support for requirements among clinicians may be needed to successfully enact requirements in the future.

scholarly journals Barriers and facilitators of implementation of a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda using the Consolidated Framework for Implementation Research

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rawlance Ndejjo ◽  
Rhoda K. Wanyenze ◽  
Fred Nuwaha ◽  
Hilde Bastiaens ◽  
Geofrey Musinguzi
Keyword(s):  
Cardiovascular Disease ◽  
Low Income ◽  
Implementation Research ◽  
Health Workers ◽  
Scale Up ◽  
Barriers And Facilitators ◽  
Prevention Programme ◽  
Intervention Implementation ◽  
Design Quality ◽  
Middle Income

Abstract Background In low- and middle-income countries, there is an increasing attention towards community approaches to deal with the growing burden of cardiovascular disease (CVD). However, few studies have explored the implementation processes of such interventions to inform their scale up and sustainability. Using the consolidated framework for implementation research (CFIR), we examined the barriers and facilitators influencing the implementation of a community CVD programme led by community health workers (CHWs) in Mukono and Buikwe districts in Uganda. Methods This qualitative study is a process evaluation of an ongoing type II hybrid stepped wedge cluster trial guided by the CFIR. Data for this analysis were collected through regular meetings and focus group discussions (FGDs) conducted during the first cycle (6 months) of intervention implementation. A total of 20 CHWs participated in the implementation programme in 20 villages during the first cycle. Meeting reports and FGD transcripts were analysed following inductive thematic analysis with the aid of Nvivo 12.6 to generate emerging themes and sub-themes and thereafter deductive analysis was used to map themes and sub-themes onto the CFIR domains and constructs. Results The barriers to intervention implementation were the complexity of the intervention (complexity), compatibility with community culture (culture), the lack of an enabling environment for behaviour change (patient needs and resources) and mistrust of CHWs by community members (relative priority). In addition, the low community awareness of CVD (tension for change), competing demands (other personal attributes) and unfavourable policies (external policy and incentives) impeded intervention implementation. On the other hand, facilitators of intervention implementation were availability of inputs and protective equipment (design quality and packaging), training of CHWs (Available resources), working with community structures including leaders and groups (process—opinion leaders), frequent support supervision and engagements (process—formally appointed internal implementation leaders) and access to quality health services (process—champions). Conclusion Using the CFIR, we identified drivers of implementation success or failure for a community CVD prevention programme in a low-income context. These findings are key to inform the design of impactful, scalable and sustainable CHW programmes for non-communicable diseases prevention and control.

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