|ANF Scholar Nop Ratanasiripong evaluates a patient
on a medical mission trip in Thailand in June 2012.
A student at the University of Missouri-Kansas City, Nop Ratanasiripong, PhD,
MSN, RN, received a 2011 American Nurses Foundation (the Foundation) research grant made
possible by the Clinton Foundation. She was selected as the Virginia Kelley
Scholar, named in honor of President Clinton’s late mother, who was a certified
registered nurse anesthetist. The Foundations’s work with scholars helps nurses like
Ratanasiripong contribute to the profession. In this interview, she explained
how the Foundation has helped her achieve her research goals.
How did you become interested in studying college women’s knowledge
about human papillomavirus (HPV) and the HPV vaccine ?
My interest started 17 years ago, when I was taking care of
cervical cancer patients in Thailand. When I saw the hopeless eyes of those
women, I wanted to do something to prevent cervical cancer.
When the HPV vaccine became available, I thought that all young girls would
get the vaccine. Surprisingly, the vaccine uptake rate was low, and there were
many controversies over the vaccine. One of them is the belief that women may
participate in higher risk sexual behaviors after they get the vaccine. So, I
wanted to study what factors influence young women’s decisions to receive the
vaccine, and if there are any sexual behavior changes after women have received
What are some of the things that have surprised you in your work to
date in this area?
While more than 95 percent of college women are aware of HPV and the HPV
vaccine, and more than 90 percent of them know that HPV causes cervical cancer,
they still do not obtain the vaccine. My study showed that only 47 percent of
college women have received at least one dose of the vaccine.
Another surprise is that more than 90 percent of women, in both vaccinees and
non-vaccinees, know that they need to obtain a routine Pap test after the
vaccination. They also know that HPV vaccine does not provide protection from
all sexually transmitted diseases (STDs). So, concerns by parents and advocates
that young women may misunderstand that they do not need Pap tests and to use
condoms after vaccination may be disregarded.
What does a nursing perspective bring to this area
I believe that nursing care does not start at an outpatient clinic or a
hospital. Nursing care needs to take a holistic approach, and it needs to start
before a disease begins. Nurses can have more freedom, authority and creativity
in health promotion roles. My research is a reflection of what nurses can do to
take care of patients and the community. Nurses, as a part of a health care
provider team, can influence young women to obtain the vaccine (based on my
What do you hope to do with your findings?
I hope to publish and present my findings so that they can be applied for
larger populations. The key points I want to share are that college women
already have good HPV and HPV vaccine knowledge, so an intervention focused on
increasing knowledge may not help increase the vaccine uptake rate. Also,
college women support the mandatory vaccine option. However, they do not support
calling it an anti-cancer or STD vaccine. Additionally, there are indifferences
in sexual behaviors between non-vaccinated and vaccinated women and the number
of sexual partners before and after vaccination. This may help dispel the myth
that vaccinated women practice riskier sexual behaviors.
Now, I am ready to expand my role into HPV/cervical cancer prevention for
young women in the United States, and bring knowledge and research to Thailand,
where cervical cancer is still the second killer among all cancers in Thai
What would you like nurses to know about HPV based on your
Nurses are the key factor to help increase the HPV vaccine uptake rate. In
particular, public health and school nurses are in an ideal position to take an
active role in the development and implementation of HPV and cervical cancer
— Kate Judge is the executive director of the
American Nurses Foundation.