Increasing Parental Knowledge Related to the Human Papillomavirus (HPV) Vaccine

Joseph J. Cipriano, DNP, RN, FNP-BC; Robert Scoloveno, PhD, RN, CCRN; Angela Kelly, DNP, RN, APN, WHNP-BC, RNC-OB


J Pediatr Health Care. 2018;32(1):29-35. 

In This Article

Abstract and Introduction


Introduction The purposes of this study were to evaluate parental attitudes toward general vaccination protocols and increase parental knowledge of the human papilloma virus (HPV) vaccine.

Methods A nonprobability convenience sample (N = 75) using a pre-/postintervention study design was conducted in a pediatric office in southern New Jersey. The Parental Attitudes Module measured the general disposition toward having children receive any type of vaccine. The HPV Knowledge Survey was a second tool used to specifically measures knowledge of the HPV vaccine. A self-directed computer-based learning was part of the educational intervention.

Results A paired t test showed that HPV Knowledge Survey postintervention scores were significantly higher than HPV Knowledge Survey preintervention scores (t = −10.585, p < .001). The Parental Attitudes Module and the HPV Knowledge Survey pretest showed a positive moderate relationship (rs = .552, p < .001).

Discussion In the 10 years since the HPV vaccine has been on the market, there is a continued need to increase parental knowledge about the HPV vaccine to close the gap on vaccine nonadherence. A self-directed, computer-based learning tablet appears to be an effective tool to educate parents or legal guardians about the purpose, efficacy, and safety of the HPV vaccine.


Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (Ratanasiripong, 2012). Approximately 79 million Americans are infected with HPV, and 14 million new cases of HPV-related cancers occur each year (Centers for Disease Control and Prevention [CDC], 2016). In the United States alone, over 12,900 new cases were diagnosed and more than 4,100 deaths from cervical cancer occurred in 2015 (The Henry J. Kaiser Family Foundation, 2015). There are approximately 12,000 cases of oropharyngeal cancers diagnosed each year in the United States, making it the second most common HPV-related cancer (Fontenot, Collins-Fantasia, Charyk, & Sutherland, 2014). Medical expenses related to HPV-associated cancers are estimated to rise to $8 billion per year in the United States (Chesson et al., 2012). Additionally, the U.S. Department of Health and Human Services (2015) has set a Healthy People 2020 goal of having 80% of adolescents fully vaccinated against HPV.

Parental consent to the HPV vaccine is at a significantly lower rate compared with other routinely recommended vaccines such as tetanus, diphtheria, and acellular pertussis (i.e., Tdap) and meningococcal conjugate, which have completion rates of 87.6% and 79.3%, respectively (CDC, 2015b). In the United States, completion rates for the HPV vaccine are only 39.7% for adolescents (Kepka, Ding, Bodson, Warner, & Mooney, 2015). This rate is substantially lower than that in other developed countries such as the United Kingdom and Portugal, whose HPV vaccine completion rates are about 80% (Bruni et al., 2016).

The development of the HPV vaccine has led to an increase in attention to HPV in the media, often resulting in misinformation being disseminated to the public regarding the vaccine (Teitelman et al., 2011). Primary care providers carry the responsibility and challenge of educating parents on the benefits of the HPV vaccine during office visits, which often are time limited and focus on the patient's chief complaint (Obulaney, Gilliland, & Cassells, 2016). A lack of parental education initiatives focusing on the HPV vaccine continues to be a problem with HPV vaccine compliance (Warner et al., 2015).

Parents and guardians must consent for their children to receive the HPV vaccine (Grimes, Benjamins, & Williams, 2013). According to Grimes et al., parental knowledge and attitudes toward vaccines affect whether parents consent for their child to receive the HPV vaccine. Multiple studies have provided empirical evidence into parents' perceptions of the HPV vaccine, concluding that parents are more likely to refuse the HPV vaccine than any other adolescent vaccination (Gold et al., 2013, Obulaney et al., 2016).

To meet the Healthy People 2020 goal of 80% series completion rates for the HPV vaccine, there is a need for informed education to address the important benefits of the HPV vaccine and dispel any misinformation about the vaccine (Grandahl et al., 2014, Grimes et al., 2013, Warner et al., 2015). The purpose of this project was to increase parental knowledge of the HPV vaccine. A second purpose of this project was to evaluate parental attitudes toward vaccination protocols in general.