{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:36:45Z","timestamp":1777768605327,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Nursing"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the impact of Turkey's 2020 policy shift from school\u2010based to family physician\u2010based individual vaccination for the adolescent Tetanus\u2010Diphtheria (Td) vaccine and to assess the effectiveness of a multi\u2010component intervention (education, reminders, and on\u2010site vaccination) in improving vaccine uptake among initially unvaccinated adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study consisted of two phases: first, a cross\u2010sectional analysis comparing Td vaccination coverage rates from 2018 to 2024 before and after the policy change; second, a quasi\u2010experimental intervention involving 1007 high school students in Haliliye district during the 2023\u20132024 academic year. The intervention included structured educational sessions, monthly reminders, and on\u2010site vaccination services. Data were analyzed using descriptive statistics, Cochran's\n                      <jats:italic>Q<\/jats:italic>\n                      test, and McNemar tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Following the shift to family physician\u2010based individual vaccination in 2020, Td coverage initially decreased from 71.3% to 64.3% but increased gradually to 79.3% by 2024. The multi\u2010component intervention increased vaccination coverage from 77.8% to 98.4% (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Major barriers overcome included lack of awareness (51.3%) and reluctance or time constraints (27.7%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Transitioning from school\u2010based to family physician\u2010based individual vaccination increased coverage gradually but left many adolescents unvaccinated. A multi\u2010component intervention significantly improved vaccine uptake, supporting a hybrid school\u2010 and physician\u2010based model.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/phn.70076","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T13:19:28Z","timestamp":1769692768000},"page":"533-542","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing Adolescent Vaccine Acceptance: A Multi\u2010Component Intervention Study on 13\u2010Year\u2010Old Tetanus\u2010Diphtheria Vaccination"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2663-8307","authenticated-orcid":false,"given":"Ufuk","family":"Acar","sequence":"first","affiliation":[{"name":"Department of Public Health Harran University Faculty of Medicine  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burcu","family":"Beyazg\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Public Health Harran University Faculty of Medicine  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0130brahim","family":"Koruk","sequence":"additional","affiliation":[{"name":"Department of Public Health Harran University Faculty of Medicine  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"School\u2010Based Immunization Programs: An Effective Strategy for Achieving High Vaccination Rates","author":"Adedzi K. A.","year":"2021"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010021\u201012443\u20108"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/aphw.12528"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvacx.2023.100273"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746\u2010023\u201000912\u2010w"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.10.033"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2016.07.005"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.176628"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60091550"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003941.pub3"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/63527"},{"key":"e_1_2_13_13_1","volume-title":"Child and Adolescent Health and Development","author":"LaMontagne D. S.","year":"2017"},{"key":"e_1_2_13_14_1","unstructured":"National Association of School Nurses (NASN); Association of Immunization Managers (AIM).2021.School Nurse Planning Checklist: School\u2010Located Vaccination [Internet]. [cited 2025 May 08].https:\/\/www.immunizationmanagers.org\/content\/uploads\/2021\/10\/School\u2010Vaccination\u2010Nurse\u2010Plan\u2010Checklist.pdf."},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihz120"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/children10101679"},{"key":"e_1_2_13_17_1","unstructured":"Republic of Turkey Ministry of Health General Directorate of Public Health.2020.Change in Vaccination Schedule [Internet]. [cited 2025 May 06].https:\/\/hsgm.saglik.gov.tr\/tr\/haberler\u20105\/asilam\u2010takviminde\u2010degisiklik.html."},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2023.2251815"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.60558"},{"key":"e_1_2_13_20_1","unstructured":"World Health Organization; United Nations Children's Fund (UNICEF).2020.At Least 80 Million Children Under One at Risk of Diseases Such as Diphtheria Measles and Polio as COVID\u201019 Disrupts Routine Vaccination Efforts.World Health Organization."}],"container-title":["Public Health Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/phn.70076","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/phn.70076","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/phn.70076","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:03:46Z","timestamp":1777478626000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/phn.70076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/phn.70076"],"URL":"https:\/\/doi.org\/10.1111\/phn.70076","archive":["Portico"],"relation":{},"ISSN":["0737-1209","1525-1446"],"issn-type":[{"value":"0737-1209","type":"print"},{"value":"1525-1446","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]},"assertion":[{"value":"2025-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}