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Study Objectives-To develop an educational protocol about HPV and Pap tests for adolescents, to evaluate the protocol for understandability and clarity, and to evaluate the protocol for its effectiveness in increasing knowledge about HPV.Design-In phase 1, investigators and adolescents developed the protocol. In phase 2, adolescents evaluated the protocol qualitatively, investigators evaluated its effectiveness in increasing HPV knowledge in a sample of adolescents, and the protocol was revised. In phase 3, investigators evaluated the effectiveness of the revised protocol in an additional adolescent sample. Setting-Urban, hospital-based teen health center.Participants-A total of 252 adolescent girls and boys in the three study phases.Main Outcome Measures-Pre-and post-protocol knowledge about HPV, measured using a 10-or 11-item scale.Results-Scores on the HPV knowledge scale increased significantly (p<.0001) among adolescents who participated in phases 2 and 3 after they received the protocol. Initial differences in scores based on race, insurance type and condom use were not noted post-protocol. Conclusion-The protocol significantly increased knowledge scores about HPV in this population, regardless of sociodemographic characteristics and risk behaviors. Effective, developmentally appropriate educational protocols about HPV and Pap tests are particularly important in clinical settings as cervical cancer screening guidelines evolve, HPV DNA testing is integrated into screening protocols, and HPV vaccines become available. In-depth, one-on-one education about HPV may also prevent adverse psychosocial responses and promote healthy sexual and Pap screening behaviors in adolescents with abnormal HPV or Pap test results. Synopsis-The investigators developed an educational protocol about HPV and Pap tests and evaluated its effectiveness in increasing knowledge about HPV among adolescents.

Purpose-Pediatricians will play a critical role in human papillomavirus (HPV) vaccine delivery. The objectives of this research were to examine pediatricians' views about key issues related to HPV vaccine delivery and identify their strategies for effective vaccine delivery.Methods-A diverse sample of practicing pediatricians was recruited from a three-state region using a purposeful sampling strategy. Participants completed in-depth, semi-structured interviews. Qualitative data were analyzed using framework analysis.Results-The mean age of the 31 participants was 47 (range 30-78) years, 17 (55%) were female, 9 (29%) black, and 4 (13%) Latino. Participants noted that cultural issues, including a family's religious and ethnic background, were important considerations when recommending an HPV vaccine. Almost all participants believed that vaccination should be universal rather than targeted, but opinions regarding legislative mandates for vaccination varied. Those in favor of mandates cited their potential to maximize the public health impact of immunization, while those opposed noted that HPV is not transmitted casually and were concerned about limited data on the long-term safety and efficacy of HPV vaccines. Pediatricians noted that specific strategies for effective vaccine delivery would be needed for an STI vaccine targeted toward adolescents, especially considering the poor public understanding of HPV. These included provision of HPV vaccines in alternative settings, guidance for pediatricians as to how to address parental concerns, and specific educational initiatives.Conclusions-The views of pediatricians, who have extensive experience administering vaccines to children and adolescents, will be valuable as HPV vaccine delivery strategies are designed.

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