ArticleHuman vaccines & immunotherapeutics2021
Implementation of the human papillomavirus school-entry requirement in Puerto Rico: barriers and facilitators using the consolidated framework for implementation research.
Article in Human vaccines & immunotherapeutics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Public policy on Human Papillomavirus immunization: an analysis based on the Walt and Gilson policy triangle.Revista da Escola de Enfermagem da U S P · 2026Article
- Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity.Lancet regional health. Americas · 2025Review
- Article
- Implementing a School-Entry Mandate for the Human Papillomavirus Vaccine: Benefits and Challenges.Cureus · 2024Review
- Implementing interventions to start HPV vaccination at age 9: Using the evidence we have.Human vaccines & immunotherapeutics · 2023Article
- Epidemiology of Cervical Cancer in the Caribbean.Cureus · 2023Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
In 2018, Puerto Rico (PR) enacted a Human papillomavirus (HPV) vaccine school-entry requirement for students ages 11 to 12. Using the Consolidated Framework for Implementation Research (CFIR), we aimed to identify potential barriers and facilitators of this implementation. We conducted 38 qualitative interviews with stakeholders in PR from different organizations (Department of Health, Schools, Healthcare Providers, and Community organizations). We evaluated construct rating variability between the organizations to determine barriers and facilitators. The strongest facilitator determined was stakeholder's awareness of the parent's and student's needs to meet the HPV school-entry requirement. Other facilitators included initiatives for school-entry policies and the relative advantage of this requirement over different strategies. The strongest barriers included was the cost for private providers to administer the HPV vaccine, the negative influence of social media about the vaccine, which affected parents' acceptance, and the lack of school nurses as available staff resources for the school entry requirement. Findings from this study can be used to improve implementation (adaptations/modifications) and inform other states and countries in earlier stages of consideration of the adoption of similar immunization policies. Most barriers can be modifiable with the implementation of educational programs/training across schools, considering that they are the first line of response to parents of this school entry requirement.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.