Problem Statement Despite the availability of a vaccine as well as its proven efficacy in cancer prevention, many parents and adolescents are hesitant to get the human papillomavirus vaccination leading to low HPV vaccination rates around the country.

DNP Executive Summary Emily Fusiek Purdue University School of Nursing Problem Statement Despite the availability of a vaccine as well as its proven efficacy in cancer prevention, many parents and adolescents are hesitant to get the human papillomavirus vaccination leading to low HPV vaccination rates around the country. Significance Human papillomavirus (HPV) are pathogens that can cause cancers of the cervix, vulva, vagina, anus, penis, mouth and throat as well as genital warts. The American Cancer Society (2019) estimates that 13,800 new cases of cervical cancer will be diagnosed and around 4,290 women will die from cervical cancer in the United States in 2020. In the most recent study published by the National Cancer Institute in 2015, 91% of cervical cancers were caused by HPV (Sariya et al, 2015). This would mean that approximately 12,558 newly diagnosed cases and 3,904 deaths in the United States 2020 will be due to the human papillomavirus. Current HPV vaccination rates based on the most recent National Immunization Survey completed in 2017 show that 48.6% of adolescents in the United States aged 13-17 years of age have completed the HPV vaccine series (Walker et al, 2018). Much of the research available suggests that lack of vaccination recommendation by a healthcare provider or lack of overall education on the vaccine are the main reasons for low vaccination rates (Holman et al, 2014, Holman et al, 2014, Healy & Pickering, 2011 & Dela Cruz et al., 2017). Healthcare providers can provide critical information that produces a high impact on decisions to vaccinate and it is critical that our healthcare practitioners feel prepared to provide an effective recommendation and educate their patients about the vaccine. Many recent studies have shown that providing educational sessions on how to effectively recommend the HPV vaccine as well as successfully communicating with parents and adolescents can show significant improvements in HPV vaccine rates (Austin & Morgan, 2019; Rand et al., 2018; Rand et al., 2018). The purpose of this study was to evaluate the effectiveness of an HPV educational session on provider recommendation practices. Methodology Using Shewart and Demings Plan, Do, Study, Act framework for quality improvement projects (Taylor et al., 2014), the researcher planned and presented a 20 minute educational PowerPoint presentation created by the Center for Disease Control in 2017 as part of the “You Are the Key to Cancer Prevention” campaign (CDC, 2017). The intervention was presented to 10 pediatricians and 6 pediatric nurse practitioners in the pediatric department at IU Health Arnett on January 17, 2020, and 7 family medicine physicians and 4 family nurse practitioners in the family medicine department at IU Health Arnett on February 7, 2020. Provider recommendation practices were evaluated pre intervention January 2020 with an 8-item provider survey, created by the researcher, that was emailed as well as handed out in person to eligible healthcare providers to assess provider’s initial HPV recommendation practices. HPV recommendation practices were also assessed post educational intervention using the same survey used pre-intervention which was distributed via email in March 2020 and again in May 2020. Parental surveys, which were also created by the researcher, were distributed via clinic staff to parents of eligible HPV eligible patients and were collected in the clinics to assess receipt of the HPV vaccination as well as provider recommendation practices from January 20, 2020, to April 1, 2020. Both provider and parental survey data were entered into RedCap, a secure online database. Lastly, overall HPV vaccination rates for all of both clinics were requested via IU Health Arnett and pulled monthly data from January 2019 to March 2020 and assessed the percentage of patients aged 9-17 years of age that were seen in the clinic those months and had received at least one HPV vaccine. The Statistical Package for the Social Sciences (SPSS) version 22 was used for analysis. An independent-sample t-test was run to determine the primary outcome of whether or not providers’ recommendation practices changed from the pre to post-survey. Chi-squared tests were then run to see if there was any association between demographic characteristics of the patients and receipt of the vaccine as well as any associations between the type of provider and vaccine acceptance and recommendation. Additionally, chi-squared tests were run to determine if there was any statistically significant difference between the 2019 HPV vaccine rates and the 2020 HPV vaccine rates for both the pediatric and family medicine clinics. Results This project was implemented over 5 months from January 2020 to May 2020. A total of 17 healthcare providers took the pre-survey including 4 pediatric nurse practitioners, 6 pediatric MDs, 3 family medicine nurse practitioners, and 4 family medicine MDs wi