Bird or Bee,

You’re at Risk for

HPV
An HPV Vaccination Plan

A Project Proposal by
Sarah Christenbury, Blaire Justen, Erin Moore, Peyton Pretsch, and
Tanner Sutter


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Executive Summary .............................................4
Needs Assessment   ..............................................7
What is HPV .........................................................................7
Who is our Target Population .............................................8
Looking Forward .................................................9
Mission Statement ................................................................9
Goals ......................................................................................9
Objectives ............................................................................10
Program Resources ............................................11
Resources .............................................................................11
Materials .............................................................................12
Personnel .............................................................................13
Implementation .................................................14
Theory ..................................................................................14
Intervention Strategy..........................................................15
Gantt Chart ..........................................................................15
Intervention .........................................................................16
Kick-off:  ..........................................................................................................................16
Educational Sessions:  .................................................................................................... 16
Vaccination Day:  ............................................................................................................17

Logic Model .........................................................................18

Marketing ...........................................................19
Marketing plan....................................................................19
Budget ..................................................................................21
Budget cont. ........................................................................23
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Evaluation ..........................................................24
Appendix ............................................................25
Example Consent Form ......................................................25
Pre-Test/Post-Test:.............................................................26
Gantt Chart Extended .........................................................27
References .........................................................28

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Executive Summary
Program Rationale 

As stated by the CDC, human papillomavirus, more concisely known as HPV, is

a sexually transmitted illness that is linked to several cancers such as cervical,
penile, anal and vaginal to name a few (CDC, 2017f, para. 1). This illness has
become so common that on average every man and woman will get it in their
lifetime. This virus is especially dangerous because it can be asymptomatic until
it develops into a form of cancer. This can make it very difficult to catch outside
of specific medical tests. The simple solution to the spread of this disease is the
HPV immunization. The HPV immunization process consists of multiple
vaccinations spread out over several months. It is recommended that these
vaccines be administered during childhood, specifically between 11 and 12 years
of age. In some cases it can be administered as late as 27 years old, but earlier
immunization is recommended (CDC, 2016a). 

National and Local Issues 

In the United States approximately a quarter of the population is currently

infected with HPV, coming to around 80 million people. On average, four out of
every ten children will go unvaccinated (CDC, 2017a). Of the people who
decided to receive the vaccinations, less than half are currently up to date on all
of their doses (CDC, 2017d). In South Carolina, only 49% or less of adolescent
boys and girls have received the HPV vaccine (CDC, 2017b). The vaccine is
readily available at several locations around the state’s capital city of Columbia,
but many public institutions, including the University of South Carolina, do not
require the vaccination for admission (University of South Carolina, n.d.). 

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Target Population 

In order to narrow down our focus to a specific population, we evaluated what

regions, races and genders were most at risk for this disease. The state of South
Carolina ranks near the top in the United States in terms of HPV infection, and
rural areas see a significantly smaller rate of vaccination than more urban areas
(Mullin, 2017). Within South Carolina, it was found by the Hollings Cancer
Center that African Americans were much more likely to be diagnosed with
cervical cancer, a result of contracting HPV. The key age range to vaccinate is
between the ages of 11 and 17, but getting vaccinated later in life, up to 27 years
old, is preferable to not getting vaccinated at all. South Carolina teens have an
especially low rate of vaccination, with only 31% of the population being up to
date on the HPV vaccine (Mullin, 2017). Looking at these statistics, we
determined that African American teenagers were especially at risk for this
disease. We decided to conduct our pilot program at a rural middle school in
Allendale County, where African Americans constitute the majority of the
student population. Since the parents of these children have the most say over
whether or not their children get vaccinated, we will be catering our
educational sessions towards them. 

Community Marketing

We will begin with a community town hall about the program so that all
members of the community can ask questions and feel involved in the program
process. We will encourage community ownership by inviting local media to
cover the town hall and vaccination day. This will make the community aware
of the program preceding as well as increase their feelings of self efficacy within
the program. We will also invite representative of our sponsors to these events
to help promote their involvement.

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Program Overview 

Our program will host several information sessions for the parents of the
students attending the Allendale-Fairfax Middle School. We will use incentives
such as food and free child care during these sessions to attract as many
parents as possible. Each session will include a pre-test and post-test to show
growth, and will be hosted by a professional health educator. During these
sessions parents will learn about the risks of letting their child go unvaccinated,
and will be encouraged to have their child attend further events hosted by the
program. These events, which we are calling our Vaccination Days, will be a
series of two events where children can receive both rounds of the vaccine free
of charge. In order to attract the largest portion of the population as possible,
we will have many different attractions present to entertain the kids and help
build a positive association with getting vaccinated. Evaluations will take place
at all stages of the program, and based on our results, we hope to spread the
program to reach as many people as possible in the future in order to reduce
the amount HPV infected persons. 


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Needs Assessment  
What is HPV
Human papillomavirus (HPV) is a group of more than 150 viruses that spread
through sexual contact. It is named after the warts (papillomas) that some of
the viruses in the group cause (Centers for Disease Control and Prevention
[CDC], 2017g). The main cause of concern with the virus is not with the virus
itself, but with the many forms of cancer it can cause. The CDC states, "HPV
infection can cause cervical, vaginal, and vulvar cancers in women and penile
cancer in men. HPV can also cause anal cancer, throat cancer, and genital warts
in both men and women" (CDC, 2017f, para. 1).  Someone with HPV related
cancer will typically not experience symptoms until the cancer is quite
advanced, when it has already become serious and difficult to treat (CDC,
2016b). For those who do develop symptoms, life can be described as “a
glamorous life of pap smears, colposcopies, biopsies, cryotherapy,
the legendary Loop Electrosurgical Excision Procedure (LEEP) and
seeing your gynecologist so often that you have her personal cell
phone number,” (Delaney, 2015, para. 4). For however long the disease
remains in their system, the victims’ lives remain at the illness’ mercy.   

HPV is now so common that almost every person will get it in his or her
lifetime (CDC, 2017a). This epidemic has a simple solution: the HPV
vaccination. The HPV vaccination consists of two rounds of vaccines spaced out
over several months. It is recommended for boys and girls to be vaccinated at
ages 11-12 in an effort to vaccinate them against the virus before they come in
contact with it but, it can also be administered as late 27 (CDC, 2017h).  The
vaccine has been studied very carefully, and no serious side effects have been
observed. 


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Who is our Target Population
Gender: HPV infections can lead to cancer in both men and women.  The
recent data shows that boys and girls are both equally recommended to be
vaccinated (CDC, 2016a).  Taking this into account, we have decided to
vaccinate both girls and boys.    

Region: When compared nationally, South Carolina ranks among the highest in
the United States for HPV-associated cancers (CDC, 2017c.)  In South Carolina,
only 49% or less of adolescent boys and girls have received the HPV vaccine
(CDC, 2017e). 

Race: African American men and women have higher rates of HPV-

associated cancer than white men and women (CDC, 2017b).  

Age:  The HPV vaccine is recommended for both males and females ages 11
through 12. Since children this age are unable to make medical decisions for
themselves, the focus will be on their parents.  

Pilot School: Allendale County has the highest density of our target population
in South Carolina (United States, 2016). Allendale-Fairfax Middle School is the
only school in the county that includes our target age range.  

The level of prevention we will focus on is primary. We will investigate the rates
and effects of HPV vaccination.   

Our health problem is the lack of vaccinated children against HPV. The high
rate of the virus and its cancer-associated symptoms make it a serious public
health concern.   


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Looking Forward
Mission Statement
The mission of our program is to educate all parents about HPV and its vaccine
in order for them to choose the best option to prevent their children from
contracting the virus during their lifetimes, resulting in a decrease in
unvaccinated children against HPV.  

Goals
• To prevent the spread of HPV in South Carolina  

• To reduce the amount of people who contract HPV in their lifetime  

• Create a social environment that allows open discussion of HPV and its
prevention technique  

• Give parents the tools to be knowledgeable about HPV and educate their
children  
• Create an opportunity for parents to have discussions with and educate their
children on the topic of HPV and ways to be safe in regards to sexual
relations  

• Give all parents equal access to accurate information regarding HPV and its
vaccine 

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Objectives
• By August 1, 2018, the program planners will have selected a school in which
to launch the pilot program. 

• By July 1, 2018, the program planners will have created a skeleton curriculum
for the pilot program. 

• After completion of the program, 80% of program participants will be able to

list three risk factors for their child contracting HPV. 
• After completion of the program, 80% of program participants will be able to
identify the correct age for a child to be vaccinated against HPV. 

• After completion of the program, 70% of program participants will have the
first round of the HPV vaccine administered to their child. 

• By 2025, the amount of vaccinated African American children age 11-12 will
have increased by 5% in Allendale County. 

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Program Resources
Resources
• Developing Pilot Program (our focus): 

• Contact the school board, Principal, and Parent-Teacher-Student

Association (PTSA) of Allendale-Fairfax Middle school to allow us to
administer the program 

• Create the curriculum, tailored to the community and target population,

with video supplementation, corresponding pamphlets 
• Media campaign and town hall more than 3 months before the program
start to determine cultural boundaries 

• Cement sponsorships to organize financial allocations   

Needed to get off the ground:

• Small office space (no more than 500 sq. ft) 

• Dell computer and monitor 

• Landline phone 

• Landline/Internet service 

• Printer/copier/scanner 

• Skeleton curriculum 

• Donated resource agreements (e.g. vaccination materials, incentives, etc.) 

• Office equipment (e.g. paper, pens, printer ink, etc.) 


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Materials
• Physical locations – With the full support of the principal, we will have
classes in the cafeteria from 8:00-10:00 am and 6:30-8:30 pm on weekdays
and Saturday from 1:00-3:00 pm. In the morning the children will be in class,
and on the weeknights and Saturday we will have the children be watched by
volunteers in the gymnasium. 

• Volunteers - They will help watch the children, and be aides to the
professional teachers. There will be a maximum of 23 volunteers needed over
the week, assuming that every volunteer can only help for one shift. There will
be a volunteer in each class as well as two every time the children are being
watched. There will be another 20 volunteers needed every kick-off party
and vaccination day to help run the clinic, as well as help to run the party for
the children who get vaccinated. 

• Health Educators - They will administer the program and answer any
question on the day of Trained Vaccination Nurses - 10 nurses every
vaccination day will be needed to administer the vaccines. 

• Food incentives – Muffins for the morning class, cookies in the afternoon and
evening, vendors for the party after each vaccination day. 

• Training materials – Three portable projectors (two for the program, one to
entertain kids), video aides, pamphlets, writing utensils, surveys, worksheets
to follow along with the presentation, gymnasium equipment (provided by
the school), quiz to be administered at the beginning and end of the class. 
• Vaccination Materials – Vaccine, vaccine administration equipment, personal
protection equipment, biohazard container, lollipops, fun band-aides, HPV
vaccination promotional stickers, swag bag of coupons of local businesses for
the parents, postcard reminders to be mailed out as well as brought home by
the children. 
• Curriculum – This will be original so that we can tailor it to our exact goal and
target population.


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Personnel


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Implementation
Theory
We have decided to use the Health Belief Model (HBM) as the theoretical
foundation of our vaccination program, as it commonly used in vaccination
programs (Fall, Izaute, & Charkoun-Biggioni, 2017). This model emphasizes the
effects of perceived susceptibilities, perceived barriers, perceived seriousness,
perceived benefits, likelihood of taking action, and calls to action. It is
important for parents to perceive their child's susceptibility to HPV and how
barriers to getting their child the vaccination can be overcome. The effect of
perceived susceptibility is crucial to mobilize parents and the community to
take action.  

*Indicates which concepts are being adapted to HPV in this

program

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Intervention Strategy
Best Experiences: We have chosen not to use Best Practices because we did not
discover adequate curriculums.  Instead, we will use Best Experiences by
involving members of the school board, PTA Association, and local respected
medical practitioners.   

Health Education: We aim to change the knowledge of these parents to

encourage them to vaccinate.  We have created a curriculum tailored for
this community.  

Community Services: We are providing the vaccine at the end of the program.
 It is offered to any child who comes with their parents, who can consent to the
vaccination.  

Gantt Chart

*See extended Gantt chart in Appendix C

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Intervention
Kick-off: 
During the school's meet-the-teacher night, we will address the parents of the
student body and introduce ourselves and remind them of the program, as well
as direct them to our informational booth we'll have set up in the gym. We will
raffle off a few prizes with the promise of more to come in order to incentivize
attendance to the educational sessions.  

Educational Sessions: 
We will provide educational sessions for the parents from 8:00-10:00 am and
from 6:30-8:30 pm during weekdays, and on 1:00-3:00 on Saturday. Child care
will be provided at all of the sessions. The morning sessions will provide bagels
and coffee, both caffeinated and de-caffeinated. The evening and Saturday
sessions will provide cookies and coffee, both caffeinated and de-caffeinated as
well.  

Once the parents arrive, they will check in by giving their name and contact
information; they will also be given a consent form to fill out asking for
permission to use the data collected from the study to be published
anonymously. The educational session will start with every parent taking a pre-
test about their knowledge on HPV. The pre-test will consist of a question
asking the recommended age for children receiving the HPV vaccine, and a
second question asking them to state three risk factors associated with
contracting HPV. The health educator will then give their educational
presentation on HPV and the HPV vaccine. After the presentation, the parents
will take a post-test that is identical to the pre-test. This is to see if there was
any change in knowledge from before the session to after the session. As the

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parents leave they will receive a goody bag for their attendance, with a
reminder about the vaccination day that we will be hosting.  

Vaccination Day: 
We will host two vaccination days. One to administer the first round of the HPV
vaccine, and another to administer the second round. When the families
arrive, they will check in and fill out a vaccination consent form for every child
receiving the vaccine. The families will then proceed to the vaccination station
to receive the vaccine. After the vaccine has been administered the families can
partake in the fun vaccination day activities. These actives include a video game
truck, snow cone machine, dunk tank, and other fun carnival like activities.


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Logic Model
 Inputs

Inputs •Physical locations

•Volunteers
Outputs
•Trained professionals

•Food incentives 

•Training materials Outcomes

•Vaccination materials

•Curriculum

•Sponsorships with Low Country Health Care Systems Inc.,

Staples, Guardasil, South Carolina Federal Credit Union and
Winningham Foundation 
Outputs • Contact the school board, Principal, and Parent-Teacher-
Student Association (PTSA) of Allendale-Fairfax Middle
school to allow us to administer the program 
• Create the curriculum, tailored to the community and
target population, with video supplementation,
corresponding pamphlets 

• Media campaign and town hall more than 3 months before

the program start to determine boundaries 
• Cement sponsorships to organize financial allocations 
Outcomes Short term

Change in Knowledge about HPV Vaccine recommended age

and availability

Mid-term

Increases in Vaccination in the County

Long term

Decreases in HPV incidence in the county

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Marketing
Number of participants: The majority number of our target population is 136
parents, which is 68% of our 200 parents, assuming one parent per household
attends (though both are welcome).  The form at the bottom of the pre-test and
post-test (see Appendix B) will help us estimate the number of children
attending the Vaccination Day, as well as inform us on how much the program
changes parents’ intent to vaccinate.   

Marketing plan
• Promotional items include brochures given out at school, pamphlets sent
home with children, and calls home from school officials.   Calls home from
the school are the least expensive and the most dependable because it is the
most direct.  Pamphlets and brochures home are not direct and depend on
the children's ability to transfer the information to the parent, but are great
physical reminders of the program. 
• During the school's Meet-the-Teacher night, we will give a quick intro to the
program and also have a booth set up for parents to come ask questions. We
will also include some educational literature in the Meet-the-Teacher night
packet that all parents will receive. 

• We believe that this multichannel marketing plan will yield the best results.  

• We intend to market to the entire population to reach our majority. 

• Our program will have the slogan, "You can't protect them from everything,
but you can start here". This slogan will be the letterhead of our pamphlets,
brochures, memos, and training materials.  Our logo is a teal ribbon wrapped
around a white medical cross.  
• During this pilot test, we are focused on being effective at the cost of
efficiency.  To motivate our population, we will use raffles and give-aways. As
we phase in our program, we will gradually increase the efficiency until we
find the critical point of effectiveness and efficiency. 

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• This program is completely mobile so that we can travel across the state in
later phases.  

• Our program if focused on increasing knowledge, so we believe that our

marketing plan does not need to be differentiable.   

Captions in Clockwise Order

A. Example promotional flyer.

B. Example promotional refrigerator magnet, but ours will have just two
date that we write in in remind them of the second vaccination.
C. Example folder of information to be given out at the Kick-off Meet-the-
Teacher night

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Budget
Personnel 93,700
Educators Paid per class Health Education Specialist x 2,200
1
Administrative Staff Full-time Administrative staff member Provided by Parent
Organization

~35,000
Program Planners Paid a flat fee Program Planners x 5 50,000
Medical Staff Trained Medical Vaccination Administrative In-Kind by Low
Nurses for two days x10 County Health Care
Systems Inc.

~6,500

Space 8,015
Office 500 square foot office space in Columbia, SC 5,000
Program Sessions Cafeteria and gymnasium space x 11 In-Kind by Middle
sessions at Allendale- Fairfax Middle School School

~3,000
Technology Domain for Website 15

Equipment 7,820
Printer HP printer/copier/scanner 750
Desktop Computer Dell computer and monitor 800
Landline Landline hardware, internet modem, and 770
monthly
Program Equipment Projector x3, projector screen x3 1,500
Medical Equipment Vaccine-Administration equipment, biohazard In-Kind by Low
containers, Country Health
Care Systems Inc.

~2,000

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Supplies 15,715
Refreshments Food/beverages x11 sessions at Allendale- 3,500
Fairfax Midle School, Kick-off Party, Vaccine-
Administration Days x2
Office Materials Paper, ink, pens, staplers, staples, post-its In-Kind by Staples

~500
Training Materials Paper, ink, pens, CDs, flash drives, visual In-Kind by Staples

aides ~750
Vaccination Supplies Vaccine In-Kind by
Guardasil

~6,000
Promotional Paper, ink, phone service, promotional In-Kind Staples

Materials objects ~1,500

Child Entertainment Movie, gym equipment, event entertainment, 2,500
Materials video game truck, dunk tank
Incentives $50 Public gifts cardsx10, other donated 500
incentives
Discretionary Fund 465

Total Expenditures 125,250

In-Kind Donations Low Country Health Care Systems Inc. 8,500
received
Allendale-Fairfax Middle School 3,000
Staples 2,750
Guardasil 6,000
Parent Organization 35,000
South Carolina Federal Credit Union 10,000
Funds requested from 60,000
the Winningham
Foundation

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Budget cont.


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Evaluation
For our evaluation, we will be using quantitative evaluation.  We chose this
evaluation method because it will best show the increase in knowledge in our
program participants through their scores on the pre- and post-test. We are
also able to numerically determine how many children we vaccinated at the end
of the program.   

Objectives Evaluations

Impact By August 1, 2018, the By August 1, 2018 the program

program planners will have planners will have a
selected a school in which to Memorandum of Agreement
launch the pilot program. with the selected pilot school
to host the program. 
Impact After completion of the The post test scores will show
program, 80% of program that 80% of the program
participants will be able to participants are able to
identify the recommended age identify the recommended age
for a child to be vaccinated for a child to be vaccinated
against HPV.  against HPV.   
Outcome By 2025, the amount of The CDC reports that by 2025,
vaccinated African American HPV vaccinations will have
children age 11-12 will have increased by 5% in African
increased by 5% in Allendale American children age 11-12 in
County.  Allendale county.

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Appendix
Example Consent Form
Consent Form
Part A:
We invite you to take part in educational sessions surrounding HPV and the risks of contracting
the virus. These sessions will be hosted at Allendale-Fairfax Middle School starting on
September 10th, 2018. Participating in this program is completely voluntary.

The purposes of this program are to inform parents of Allendale-Fairfax Middle School students
about HPV and the negative health affects faced by those who become infected. We are
providing the first two rounds of Gardasil free of charge to all students. Parents are being
offered this opportunity in order to help reduce the rates of those who contract this disease.

An estimated 100 parents will participate in this program. The duration of this program will last
until December 8th, 2018. Pre-test results, post-test results, attendance numbers on vaccination
days, as well as any other useful information may be used in future programs regarding HPV
vaccines. However, this data will remain completely anonymous.

By signing below, you agree to take part in the program.

Name: Signature: Date: j

Part B:
I am aware that my child, , will be receiving both the first and
second round of the Gardasil vaccination. I am aware that on the dates, September 22nd, 2018
and December 8th, 2018, there will be professionally trained nurses at Allendale-Fairfax
Middle School to administer these vaccines. I have been made aware of the risks and benefits of
my child receiving, and not receiving, these vaccines.

Signature of Parent/Guardian: Date: j

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Pre-Test/Post-Test:

What Do You Know About HPV?

1. What is the recommended age for a child, boy or girl, to be vaccinated against HPV?

_______________________________________________________________________

2. List three risk factors related to contracting HPV?

a. _________________________________________________________________

b. _________________________________________________________________

c. _________________________________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X CUT X - - - - -

Please indicate whether or not you think you will attend our vaccination days with your child,

knowing that you may change your mind at any time:

☐ Yes, at this time my child and I will be attending the vaccination days.
☐ No, at this time my child and I will not be attending the vaccination days.

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Gantt Chart Extended


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 References
Banister, C.E., Messersmith, A.R., Chakraborty, H., Wang, Y., Spiryda, L.B.,

Glover, S.H., …Creek, K.E. (2013). HPV prevalence at enrollment and

baseline results from the Carolina women’s care study, a longitudinal

study of HPV persistence in women of college age. International Journal

of Women’s Health, 5, 379-388. doi: 10.2147/IJWH.S45590  

Centers for Disease Control and Prevention. (2016a). HPV also known as

Human Papillomavirus. Diseases and the Vaccines That Prevent Them,

Retrieved from https://www.cdc.gov/vaccines/parents/diseases/teen/

hpv-indepth-color.pdf  

Centers for Disease Control and Prevention. (2016b). The link between HPV

and cancer. Retrieved from https://www.cdc.gov/hpv/parents/

cancer.html  

Centers for Disease Control and Prevention. (2017a). Human papillomavirus.

Retrieved from https://www.cdc.gov/hpv/index.html  

Centers for Disease Control and Prevention. (2017b). HPV- associated cancer

rates by rates and ethnicity. Retrieved from https://www.cdc.gov/cancer/

hpv/statistics/race.htm  

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Centers for Disease Control and Prevention. (2017c). HPV-associated cancer

rates by state. Retreived from https://www.cdc.gov/cancer/hpv/

statistics/state/index.htm 

Centers for Disease Control and Prevention. (2017d). HPV vaccine coverage

maps – infographic. Retrieved from https://www.cdc.gov/hpv/

infographics/vacc-coverage.html  

Centers for Disease Control and Prevention. (2017e). HPV vaccination coverage

data. Retrieved from https://www.cdc.gov/hpv/hcp/vacc-coverage.html  

Centers for Disease Control and Prevention. (2017f). HVP vaccination for

preteens and teens. Retrieved from https://www.cdc.gov/vaccines/

parents/diseases/teen/hpv.html  

Centers for Disease Control and Prevention. (2017g). What is HPV? Retrieved

from https://www.cdc.gov/hpv/parents/whatishpv.html  

Centers for Disease Control and Prevention. (2017h). HPV vaccines:

Vaccinating your preteen or teen. Received from https://www.cdc.gov/

hpv/parents/vaccine.html  

Delaney, Chelsea. (2015, June 18). My glamorous life with HPV [Blog post].

Retrieved from http://www.care2.com/greenliving/my-glamorous-life-

with-hpv.html  

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Fall, E., Izaute, M., Chakroun-Baggioni, N. (2017). How can the health belief

model and self-determination theory predict both influenza vaccination

and vaccination intention? A longitudinal study among university

students. Psychol Health, online publication not yet in print, 1-24. doi:

10.108/08870446.2017.1401623 

Hollings Cancer Center. (2016). Facts about HPV-associated caners in South

Carolina. Received from http://www.hollingscancercenter.org/about-

hollings/newscenter/press-releases/2016/hpv-facts.html  

United States Census Bureau. (2016). QuickFacts. Retrieved from https://

www.census.gov/quickfacts/fact/table/allendalecountysouthcarolina,SC/

PST045216 

University of South Carolina. (n.d.) Immunization requirements. Retrieved

from https://www.sa.sc.edu/shs/imm/immunizations/  

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