{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T10:30:22Z","timestamp":1788690622157,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012393","name":"Midwest Nursing Research Society","doi-asserted-by":"publisher","award":["GR135140"],"award-info":[{"award-number":["GR135140"]}],"id":[{"id":"10.13039\/100012393","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["sigmapubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Worldviews Ev Based Nurs"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Human papillomavirus (HPV) is a major contributor to several preventable cancers. Although the HPV vaccine is recognized by the Centers for Disease Control and Prevention (CDC) as safe and effective, uptake among U.S. adolescents remains below optimal levels. Disparities in vaccination rates are shaped by both individual characteristics and social determinants of health (SDOH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review and synthesize the literature examining individual factors and social determinants of health associated with HPV vaccine initiation and completion among adolescents aged 9\u201318\u2009years in the U.S.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted in accordance with PRISMA guidelines, yielding 37 eligible studies from an initial pool of 2092 articles. The STROBE checklist was used to assess methodological quality, and the Levels of Evidence framework by Melnyk and Fineout\u2010Overholt guided appraisal of study strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across included studies, initiation and completion rates averaged 47% and 40%, respectively. Key predictors of higher vaccine uptake included provider recommendation, health insurance coverage, urban residence, older age, and higher parental education. Disparities were most evident among adolescents living in rural areas and those from minority or low\u2010income backgrounds. Barriers reported in several studies included parental safety concerns and logistical challenges. Evidence regarding parental knowledge and attitudes was mixed: smaller studies suggested an influence, whereas the largest population\u2010based study reported no significant effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Addressing HPV vaccination disparities requires a multifaceted approach, including improving healthcare access in underserved regions, strengthening provider\u2013parent communication, and implementing policy interventions such as school\u2010based vaccination programs and state mandates. Normalizing HPV vaccination as part of routine adolescent care is essential for reducing HPV\u2010related cancer morbidity and mortality. These findings also have implications for catch\u2010up vaccination in young adults aged 15\u201326 and shared clinical decision\u2010making up to age 45, which remain important strategies for increasing protection across the lifespan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/wvn.70120","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:19:52Z","timestamp":1771478392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Factors Influencing\n                    <scp>HPV<\/scp>\n                    Vaccination Uptake in Adolescents: Evidence to Guide Clinical Practice"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9308-7285","authenticated-orcid":false,"given":"Taylor","family":"Mullin","sequence":"first","affiliation":[{"name":"College of Nursing The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane Von","family":"Ah","sequence":"additional","affiliation":[{"name":"Center for Healthy Aging, Self\u2010Management and Complex Care, College of Nursing The Ohio State University  Columbus Ohio USA"},{"name":"Co\u2010Leader of Cancer Control Program The Ohio State University James Comprehensive Cancer Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900\u2010022\u201001136\u2010x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2016.10.016"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2015.07.002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10111912"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2021.0507"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiy682"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12079"},{"key":"e_1_2_9_9_1","unstructured":"CDC.2023.\u201cHow Many Cancers Are Linked With HPV Each Year?\u201dCenters for Disease Control and Prevention.https:\/\/www.cdc.gov\/cancer\/hpv\/statistics\/cases.htm."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922815610629"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/003335491613100304"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2014.03.005"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2023.08.007"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pvr.2016.02.002"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.07.045"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022\u2010058794"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010017\u20104567\u20102"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922815616245"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900\u2010016\u20100284\u20105"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10903\u2010014\u20100003\u20101"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2016.11.028"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/phn.12223"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015\u20101631"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.12.024"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.04.031"},{"key":"e_1_2_9_26_1","volume-title":"Evidence\u2010Based Practice in Nursing and Healthcare: A Guide to Best Practice","author":"Melnyk B. 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