1. By: Jennifer Cox

2.  HPV is the most common sexually transmitted disease affecting more than 20 million people in the U.S.  HPV is responsible for 70% of all cervical cancers, 90% genital warts, 90% anal/rectal cancers, 50% vulvar, 35% penile, and 70% oropharyngeal cancers  HPV types 16 and 18 are found in over 90% of all cervical cancers and HPV associated cancers

3.  2 nd leading cause of death in women worldwide  In 2012, there were 12,340 new cases reported with 4030 deaths  Hispanics and Blacks are the most at risk Cervical Cancer is PREVENTABLE

4.  Vaccination- currently available to all males and females age 10-26 years of age  Routine Pap Testing- all females  HPV Testing- females over 30 or high risk,  All high risk males  Healthy People 2020 goal is 80% of targeted group vaccinated  Currently HPV uptake is only 35%  HPV uptake for males is only 8%

5.  To reduce the occurrences of HPV infection, cervical cancer, and HPV associated cancers through education, awareness, and action on primary and secondary preventive measures  To increase the HPV vaccination rates for males and females within the targeted range  To increases a women's knowledge on the importance of routine Pap testing and HPV testing for early detection and treatment of cervical cancer  Empower women in making smarter health choice behaviors  Initiate at least one person to schedule the HPV vaccine and/or Pap Test

6.  Location:  Community Health Center in Chester County, PA  Targeted Audience  Males and females age 18-26 years of age  Only females attended the program

7.  Conducted a survey based upon the Health Belief Model in assessing participants level of awareness and knowledge on HPV, cervical cancer, and HPV Vaccination  Presented power point slides and handouts related to HPV and HPV associated cancers  Identified HPV and Cervical Cancer risks

8.  Educated on the importance of routine Pap testing and HPV testing for early detection and treatment of HPV  Educated on how HPV correlates with cervical cancer and HPV associated cancers  Overview on the American Cancer Society’s updated 2013 cervical cancer screening guidelines  Regardless of vaccination, routine Pap testing and HPV testing continues to be the best protection for early detection against cervical cancer

9.  Educated on the benefits of HPV vaccination in cervical cancer prevention  Discussed the two HPV vaccines: Gardasil and Cervarix  Identified targeted age groups: males and females ages 10-26  Discussed the HPV vaccines dosing, costs, and safety  Identified barriers to the HPV vaccine  Watched a short video from the National Cervical Cancer Coalition on vaccination

10.  Louise Warner from the Chester County Vaccination Program spoke to the group regarding the HPV vaccine  She discussed three shot dosing, costs, and adverse events  Led a very interactive discussion about the safety and benefits of the HPV vaccine  Able to clarify any myths and misconceptions about the HPV vaccine

11.  Even though there were no males in the group, it was important to educate on HPV infection, HPV associated cancers, and HPV vaccination in males to improve awareness  Discussed common HPV cancers in men  Identified high risk population  Importance of HPV testing in men  Distributed handout on HPV and Men  Watched a video on HPV and Men

12.  Health Care Providers are key determinants in HPV vaccination uptake and cervical cancer prevention  Internet access was provided via laptop  Played a game- Guess the STD (pictures were shown of various STD infections  Participants were shown how to navigate the Chester County Health Department website, CDC website, and West Chester Health Center for information about STD testing, HPV vaccination costs, free testing sites, HPV information, and National Cervical Cancer Coalition website

13.  Safety issues, long term efficacy of the vaccine  Mandatory vaccination: States are lobbying for HPV vaccination to be given with 6 th grade pediatric mandatory vaccines  Parental acceptance  High cost: 3 shot series costs $390 (many health insurances cover the cost)  Lack of access to health care and/or insurance; can not afford vaccine, lack of knowledge on free testing sites and Vaccination for Children Program

14.  HPV questionnaire survey was performed in week 1to assess awareness, knowledge, and attitudes on HPV, cervical cancer, and prevention  Same survey was performed in week 6 to assess for any changes in opinions, beliefs, and knowledge regarding HPV, vaccination, and cervical cancer  5 questions on the programs effectiveness using the Likert Scale  Follow-up phone call was made one week later to see if any participants made an appointment to get the HPV vaccine or pap test

15. Age: 19-24RaceSmoke 16 females 0 Males White 13, Other 2 Hispanic 1 Yes 3 No 13 () post survey Heard about HPV? Heard about HPV vaccine? Received the HPV Vaccine? Do you think the HPV is safe? Will you receive the vaccine in the next year? Ever been tested for STD? Ever been told you have an STD? Yes 100% Yes 100% No 100% Yes 9 Don’t know- 7 Yes -12 No-2 Undecided- 2 Very likely 9 Maybe 2 Don’t know 5 Very Likely- 12 Maybe- 2 Undecided - 2 Yes 14 No 2 Yes 4 No 10 Never 2

16. Did you know HPV was a STD? Have you ever had a Pap test? Has anyone spoke to you about the HPV vaccine? Do you think the HPV should be mandatory? Yes 13 No 3 Yes- 16 Yes 14 No 2 Health care provider 9 Mom 6 None 1 Yes 9 No 7 Same results Are you sexually active? How many partners? Wear condoms regularly? Did you know men can receive the HPV vaccine? Did you know most colleges offer it for free? Yes 15 No 1 0: 1 Under 5: 7 5-10: 5 10-15: 3 Yes 3 No 9 Yes 7 No 9 Yes- 16 Yes 2 No 14 Yes- 16

17. Did you know HPV caused: How concerned are you about cervical cancer? How much do you think the HPV vaccine costs? Cervical cancer yes 16 Genital warts Y-14, N-2 Anal Cancer Y-7, N-9 Throat Cancer Y 8, N-8 Yes- 100% post survey Very Concerned 4 Somewhat- 9 Not Concerned 3 Very concerned- 100% post survey Under $100- 7 $100-$200-3 $200-$300- 2 $300-$400-4 Cost is $390 for all 3 Would you be willing to receive the HPV vaccine? Did you know 90% of cervical cancer is caused by HPV? Do you plan on receiving the vaccine within : Yes 9 Maybe 3 Don’t Know 4 Yes 11 No 5 Yes 100% post survey The next month 2 Within the year 7 Don’t know 7

18. Made an appointment with OB/GYN Made an appointment with primary care doctor Plan on getting the HPV vaccine within the next year Continue to be unsure about the HPV vaccine No response 2154421544 A follow –up phone call was made one week after the end of the program to assess if any participants scheduled an appointment to get a Pap test or HPV vaccine Overall, HPV knowledge and awareness increased Initiated three people in action plans for the HPV vaccine or pap test

19.  Follow-up: 2 people made appt with Ob/Gyn  1 made appt with regular MD  5 plan on receiving vaccine within next year  4 were still unsure  4 no response  12 stated they spoke to their friends and/or parents about the HPV vaccine  Overall: increased awareness and knowledge on HPV, HPV vaccination, and cervical cancer  Improved knowledge on primary and secondary preventive measures to reduce risk of cervical cancer

20.  Persistence, collaboration, research, funding, and time is needed for any community project  Overall, this age group demonstrated awareness and knowledge toward the HPV vaccine and cervical cancer  HPV programs need to be specifically targeted towards parents and males to increase HPV uptake and increase HPV awareness in males  Until long-term efficacy of the HPV can be demonstrated within the next 40 years from vaccinated women, routine cervical cancer screenings continues to be our best prevention in early detection and treatment of cervical cancer

22.  Bosch, F., Qiao, Y., & Castellsague, X. (2006). The epidemiology of human papillomavirus infection and its association with cervical cancer. International Journal of Gynecology and Obstetrics, 94(1), 8-21. Retrieved from http://screening.iarc.fr/doc/HPV%20supplement%20- %20chapter%2002.pdf  CDC (2011). Cervical Cancer Rates by Race and Ethnicity. Retrieved from http://www.cdc.gov/features/dscervicalcancer/  CDC (2013). Human Papillomarvirus (HPV). Retrieved from http://www.cdc.gov/hpv/  Chester County Department of Health (2013). STD Testing. Retrieved from http://chesco.org/index.aspx?nid=860  Mehta, P., & Sharma, M. (2011). Predictors of HPV Vaccine in College Men. Journal of Community Medicine & Health Education, 1(2), 1-5. Retrieved from http://www.omicsonline.org/JCMHE/JCMHE-1-111.pdf  National Cervical Cancer Coalition (2013). HPV/Cervical Cancer Overview. Retrieved from http://www.nccc-online.org/index.php/overview  Rodriquez, M. (2010). Is Increasing HPV Infection Awareness Promoting Increased Vaccine Compliance. The Internet Journal of Advanced Nursing Practice, 11(1). http://dx.doi.org/10.5580/295a