Rosen Brittany L, Goodson Patricia, Thompson Bruce, Wilson Kelly L
University of Cincinnati, School of Human Services, PO Box 210068, Cincinnati, OH 45221.
J Sch Health. 2015 Feb;85(2):73-81. doi: 10.1111/josh.12229.
Because human papillomavirus (HPV) vaccine rates remain low, we evaluated US school nurses' knowledge, attitudes, perceptions of their role as opinion leaders, and professional practice regarding HPV vaccine, and assessed whether knowledge, attitudes, and perceptions of being an opinion leader influenced their professional practice regarding the HPV vaccine.
We used a cross-sectional design by recruiting members from the National Association of School Nurses. All participants (N = 505) were e-mailed a survey designed for this study. Structural equation modeling (SEM) tested direct and indirect effects.
Overall, school nurses had knowledge about HPV and the vaccine, and positive attitudes toward the vaccine. They had less-than-enthusiastic perceptions of their role as opinion leaders regarding the vaccine and implemented few activities related to providing vaccine information. The model revealed a good fit (χ(2)=20.238 [df=8, p< .01]), with knowledge directly related to attitudes, attitudes directly related to perceptions and practice, and perceptions directly affecting practice. In our model, perceptions functioned as a partial mediator.
To enhance school nurses' practice regarding the HPV vaccine, focus should be on increasing positive attitudes toward the vaccine and strengthening perceptions of their role as opinion leaders.
由于人乳头瘤病毒（HPV）疫苗接种率仍然较低，我们评估了美国学校护士关于HPV疫苗的知识、态度、对自身作为意见领袖角色的认知以及专业实践，并评估了知识、态度和对意见领袖角色的认知是否影响了他们关于HPV疫苗的专业实践。
我们采用横断面设计，从全国学校护士协会招募成员。向所有参与者（N = 505）发送了为本研究设计的调查问卷。结构方程模型（SEM）测试了直接和间接影响。
总体而言，学校护士了解HPV及该疫苗，且对疫苗持积极态度。他们对自己作为该疫苗意见领袖的角色认知不太积极，开展的与提供疫苗信息相关的活动很少。该模型显示拟合良好（χ(2)=20.238 [自由度 = 8，p <.01]），知识与态度直接相关，态度与认知及实践直接相关，认知直接影响实践。在我们的模型中，认知起到了部分中介作用。
为加强学校护士关于HPV疫苗的实践，应着重提高对该疫苗的积极态度，并强化他们对自身意见领袖角色的认知。
