1. GARDASIL Vaccination HEALTH PROMOTION PROJECT BRANDI MALSY DECEMBER 3, 2014

2. What is Health Promotion?  Improving health through education, community action, and through development of public health policy  An effort to prevent disease and illness  Three levels of prevention: 1. Primary prevention- prevention of disease 2. Secondary prevention- early screenings and detection of disease 3. Tertiary prevention- restoration of health after illness or disease has occurred.

3. Goals of Health Promotion  Nurse practitioners play a vital role in health promotion  Education of patients  Encouraging patients to adopt positive health promotion behaviors  Health screenings  Healthy diet  Immunizations

4. Health Promotion Project

5. Implementation  Site: Calhoun County Health Department Anniston, Alabama  Chosen due to lack of knowledge regarding Human Papillomavirus (HPV)  Patients are unaware of lifelong dangers and risks of HPV  Provided an area of need for health promotion

6. Design  The project was directed toward males and females, ages 9-26, seen in the Calhoun County Health Department during the month of November.  Implemented over three clinical days  GOAL: Educate families and patients regarding the GARDASIL vaccine so that they may make an educated decision regarding the benefits of receiving the vaccine.  An informational brochure was created and given to each individual with the following information on Human Papillomavirus (HPV) and the GARDASIL vaccine.

7. Human Papillomavirus (HPV)  Most common sexually transmitted infection in the United States  Affects nearly 20 million Americans  Estimated 6.2 million newly infected individuals each year  Exclusively infects the basal layer of epithelial cells, producing epithelial tumors of the skin and mucous membranes  More than 150 genotypes of HPV  Only 40 genotypes affect the lower genital tract  Categorized as low-risk (nononcogenic HPVs)- Types 6 and 11  High-risk (oncogenic HPVs)- Types 16 and 18

8. Complications of HPV  Low-risk (Types 6 &11): * Majority of low-risk are asymptomatic and self-limiting * 90% of genital warts cases in males and females * Associated with conjunctival, anal, oral, and laryngeal warts  High Risk (Types 16 & 18): * 75% of cervical cancer cases * 70% of vaginal cancer cases * 50 % of vulvar cancer cases

9. GARDASIL  Approved in June 2006 by U. S. Food and Drug Administration (FDA)  First pharmaceutical product specifically developed to protect against HPV  Quadrivalent vaccine-protects against Types 6, 11, 16, &18  Recommended to be given prior to onset of sexual activity

10. Dosing of GARDASIL  Recommended for males and females, ages 9-26  Given in three intramuscular injections in the deltoid muscle  Dose 1: Given on the day decided on by health care provider and individual  Dose 2: Given 2 months after Dose 1  Dose 3: Given 6 months after Dose 1  May be given at the same time as other immunizations

11. Side Effects of GARDASIL  Most common S/E : Pain, Swelling, Itching, Redness, and Bruising at injection site  Other S/E: Headache, Fever, Nausea, Dizziness, Vomiting, and Fainting

12. Who should not get GARDASIL?  Pregnant women  Individuals who have experienced severe reactions to: * Yeast * Amorphous Aluminum Hydroxyphosphate Sulfate * Polysorbate 80

13. Delivery  The teaching method was designed after Nola Pender’s Health Promotion Model.  Three components to this model: 1. Individual characteristics and experiences : Individuals’ views on importance of vaccinations as well as previous experience with vaccines 2. Behavior-specific cognitions and affect : Individuals perceptions of +/- effects of vaccine, long term benefit of receiving vaccine, & effect vaccine will have on overall health 3. Behavioral outcomes : Desired outcome if individual chooses to receive vaccine

14. Evaluation Survey  1. Was the education provided to you easy to read and understand?  2. Was the educational brochure helpful to you in explaining HPV?  3. Did the education provided help you to understand what HPV is and what effects HPV can have on your health?  4. With the education provided, do you think it is important to receive the GARDASIL vaccine?

15. Result  16 individuals educated  12 individuals received vaccine; 9 females and 3 males

16. References Centers for Disease Control and Prevention 2014 Human Papillomavirus (HPV)Centers for Disease Control and Prevention. (2014). Human Papillomavirus (HPV). Retrieved from http://www.cdc.gov/hpv/vaccine.html. http://www.cdc.gov/hpv/vaccine.html Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2011). Primary Care: the Art and Science of Advanced Practice. (5th ed.). Philadelphia, PA: F. A. Davis Company. Uphold, C. R., & Graham, M. V. (2012). Clinical guidelines in family practice (5th ed.). Gainesville, FL: Barmarrae Books, Inc.