Dissertations & Theses (Open Access)

Date of Award

Spring 5-2019

Degree Name

Doctor of Philosophy in Nursing (PhD)


Diane M. Santa Maria, DrPH

Second Advisor

Diane Wardell, PhD

Third Advisor

Maria E. Fernandez, PhD


Background: Human papillomavirus (HPV) vaccination has immense potential to prevent HPV-related infections but vaccination rates remain suboptimal. Nurses could potentially increase vaccination rates by providing recommendations and addressing vaccine concerns. As student nurses’ transition into practice, it is important to identify factors that could influence their attitudes and uptake of the HPV vaccine; however, these factors remain unknown.

Purpose: We proposed to: (1) identify factors associated with HPV vaccination status and (2) to identify student nurses’ perception of parental vaccine hesitancy, preferred counseling strategies, and factors associated with intention to counsel parents on HPV.

Methods: The current study was a secondary analysis of a randomized controlled trial (NCT02600884, PI: Santa Maria). UTHealth student nurses (n=153) provided data through a 172-item baseline Student Nurse Survey. Descriptive statistics, chi-square tests, and independent t-tests (p < .05) were utilized to characterize the sample and to compare responses between non-initiators, initiators, and completer groups. A logistic regression model was developed to identify factors associated with vaccination status.

Results: Only slightly more than half of student nurses (58%) had received at least one dose of the HPV vaccine. Those who were older and married or living with a partner were less likely to complete the HPV vaccine series. The most common reasons for receiving the vaccine were: doctor’s recommendation, confidence in the HPV vaccine, and mother’s recommendation. Conclusion: To increase vaccine uptake among student nurses, research should explore the impact of age and marital status on HPV vaccination status and also identify how risk perception may impact provider vaccine uptake and recommendation practices. Interventions are needed to improve HPV vaccine uptake among adults, provider endorsement of the HPV vaccination, and provider-patient communication, which in turn may influence evidence-based practices and health interventions, ultimately increasing vaccine recommendations, uptake, and completion.


HPV vaccination, HPV uptake, Student Nurses, HPV Endorsement, Pediatrics

Included in

Nursing Commons



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