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      School nurses’ attitudes towards and experiences of the Swedish school-based HPV vaccination programme – A repeated cross sectional study

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          Abstract

          The aim was to investigate school nurses’ attitudes towards, and experiences of vaccination against human papillomavirus (HPV), and compare the results with a similar study three years earlier. School nurses (n = 736) from all counties in Sweden completed a questionnaire in spring 2016, four years after the implementation of the national HPV vaccination programme, and three years after the previous survey. Overall, the school nurses had more favourable attitudes towards the HPV vaccination programme compared to the study in 2013 ( p = 0.015). More than half of the nurses (n = 415, 56%) strongly agreed that boys should also be offered the vaccine ( p<0.001). There were no differences in school nurses’ perceived knowledge about HPV in order to inform and to answer questions about the vaccine from the girls or from the parents. More than half of the nurses (n = 409, 56%) reported that they needed more education about HPV. Almost all nurses (n = 659, 90%) had been contacted by parents with questions about the vaccine, and most questions were related to vaccine safety. School nurses have a more favourable attitude towards the vaccination programme against HPV compared to three years earlier, although almost all nurses had been contacted by parents with diverse questions and concerns. The nurses believed that they needed more education about HPV. Thus, it is essential to provide ongoing education and training for school nurses who are key healthcare professionals for providing information about HPV and HPV vaccination to parents and to pupils.

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          Most cited references20

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          Strategies intended to address vaccine hesitancy: Review of published reviews.

          When faced with vaccine hesitancy, public health authorities are looking for effective strategies to address this issue. In this paper, the findings of 15 published literature reviews or meta-analysis that have examined the effectiveness of different interventions to reduce vaccine hesitancy and/or to enhance vaccine acceptance are presented and discussed. From the literature, there is no strong evidence to recommend any specific intervention to address vaccine hesitancy/refusal. The reviewed studies included interventions with diverse content and approaches that were implemented in different settings and targeted various populations. Few interventions were directly targeted to vaccine hesitant individuals. Given the paucity of information on effective strategies to address vaccine hesitancy, when interventions are implemented, planning a rigorous evaluation of their impact on vaccine hesitancy/vaccine acceptance will be essential.
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            HPV vaccination crisis in Japan.

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              Diagnosing the determinants of vaccine hesitancy in specific subgroups: The Guide to Tailoring Immunization Programmes (TIP).

              Despite relatively high vaccination coverage rates in the European Region, vaccine hesitancy is undermining individual and community protection from vaccine preventable diseases. At the request of its European Technical Advisory Group of Experts on Immunization (ETAGE), the Vaccine-preventable Diseases and Immunization Programme of the WHO Regional Office for Europe (WHO/EURO) developed tools to help countries address hesitancy more effectively. The Guide to Tailoring Immunization Programmes (TIP), an evidence and theory based behavioral insight framework, issued in 2013, provides tools to (1) identify vaccine hesitant population subgroups, (2) diagnose their demand- and supply-side immunization barriers and enablers and (3) design evidence-informed responses to hesitancy appropriate to the subgroup setting, context and vaccine. The Strategic Advisory Group of Experts on Immunization (SAGE) through its Working Group on Vaccine Hesitancy has closely followed the development, implementation, use and evolution of TIP concluding that TIP, with local adaptation, could be a valuable tool for use in all WHO regions, to help address countries' vaccine hesitancy problems. The TIP principles are applicable to communicable, noncommunicable and emergency planning where behavioral decisions influence outcomes.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                18 April 2017
                2017
                : 12
                : 4
                : e0175883
                Affiliations
                [1 ]Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
                [2 ]Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
                Rudjer Boskovic Institute, CROATIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: MG ML TT CS.

                • Data curation: MG CS.

                • Formal analysis: MG CS.

                • Funding acquisition: MG ML TT CS.

                • Investigation: MG CS.

                • Methodology: MG ML TT CS.

                • Project administration: MG.

                • Supervision: ML.

                • Validation: MG CS.

                • Visualization: MG ML TT CS.

                • Writing – original draft: MG.

                • Writing – review & editing: MG ML TT CS.

                Author information
                http://orcid.org/0000-0002-4553-6656
                Article
                PONE-D-16-51495
                10.1371/journal.pone.0175883
                5395208
                28419156
                e1d8d6cd-2a50-4a96-9f05-1473121d8c59
                © 2017 Grandahl et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 30 December 2016
                : 31 March 2017
                Page count
                Figures: 0, Tables: 4, Pages: 12
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100002794, Cancerfonden;
                Award ID: 130744
                Award Recipient :
                Funded by: Uppsala-Örebro Regional Research Council
                Award ID: 387561/476021
                Award Recipient :
                This work was supported by the Swedish Cancer Society grant number 130744 ( https://www.cancerfonden.se/forskning), and Uppsala-Örebro Regional Research Council grant number RFR-387561/476021 ( http://www.fou.nu/is/rfr/ansokan). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Health Care
                Health Care Providers
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                Immunology
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