Date of Conferral
8-12-2026
Date of Award
August 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Jill Sanko
Abstract
Human papillomavirus (HPV) vaccination is an effective strategy for preventing HPV-related cancers; however, vaccination initiation and series completion remain suboptimal among adolescents, particularly those from low-income and underserved populations. This Doctor of Nursing Practice project addressed an evidence-to-practice gap involving the absence of a standardized clinical practice guideline (CPG) for HPV vaccination in a family practice setting serving predominantly low-income adolescents. The purpose of the project was to develop and validate an evidence-based CPG to standardize provider recommendations and support improvement in HPV vaccination initiation and series completion. Evidence was appraised and synthesized using the Johns Hopkins Evidence-Based Practice Model, and the resulting CPG was evaluated by a four-member interprofessional expert panel using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Two rounds of expert appraisal were conducted across six guideline quality domains. During Round 1, AGREE II domain scores ranged from 72.4% to 84.7%, with three panelists recommending adoption with modifications and one recommending adoption without modification. Targeted revisions were made based on quantitative scores and qualitative feedback. Following revision, Round 2 domain scores improved to 95.8%–100.0%, and all four expert panelists unanimously recommended the guideline for use without modification. The finalized CPG includes 10 actionable recommendations addressing vaccination assessment, provider communication, standing orders, reminder-recall systems, staff education, and ongoing monitoring. Findings demonstrate that a systematic evidence-based development and expert appraisal process can produce a high-quality CPG for HPV vaccination in low-income adolescent populations. Implementation of the guideline may reduce practice variability, strengthen evidence-based nursing practice, promote vaccination equity, and support efforts to reduce HPV-related morbidity, mortality, and cancer disparities in underserved communities.
Recommended Citation
Bundu, Jariatu Fatu, "Development of a Clinical Practice Guideline for HPV Vaccination in Low-Income Adolescents Using the AGREE II Framework" (2026). Walden Dissertations and Doctoral Studies. 20658.
https://scholarworks.waldenu.edu/dissertations/20658
