PICOT Question: Identified Risks and Benefits
A PICO Clinical Inquiry into the HPV Vaccine and the Prevention of Cervical Cancer
The PICO method is the tool that is used to facilitate clinical inquiry into evidence that may be available to support evidence-based practice or EBP. EBP is what is described as best practice, as opposed to common practice that does not have evidentiary backing for efficacy (Melnyk & Fineout-Overholt, 2019). The process involves stating a PICO question, searching research databases for current peer-reviewed research studies that show evidence of the efficacy of the intervention in question, disseminating the findings to the target population of healthcare professionals so that they can be made aware of the findings, and lastly translation into practice. Translation into practice is concerned with adoption of the EBP recommendations from the clinical inquiry and implementation of the same in practice going forward. This paper is about such a clinical inquiry concerning the HPV vaccine and the risks and benefits that were identified in carrying out the same.PICOT Question: Identified Risks and Benefits
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The PICO Question
The identified clinical problem for this clinical inquiry is the lack of knowledge about and acceptance of the human papillomavirus or HPV vaccine in the prevention of cervical cancer. The target population is female adolescents between the ages of 12 and 19 years, the intervention is health education for teenage girls and their parents in this population demographic, the comparison or alternative intervention is the usual health education at the women’s health clinic, and the expected outcome is acceptance of the HPV vaccine for teenage girls as an important preventive intervention for the prevention of future cervical cancer. The PICO question for this project is therefore as follows:PICOT Question: Identified Risks and Benefits
In non-pregnant female teenagers aged 12-19 years who have not had the HPV vaccine (P), does providing education to them and their parents (I) compared to the usual routine educational ritual at the women’s health clinic (C) increase their knowledge of the risk factors and acceptance of the benefits of the HPV vaccine injection in the prevention of cervical cancer (O)?
How the PICO Project Will be Carried Out
First the main terms of evidence search will be defined to ease the task of searching for current peer-reviewed literature in reputable research databases. It is these search terms and phrases that will be combined with Boolean operators to produce the required results from the database searches (MIT Libraries, n.d.). In this case, the search terms and phrases will be “cervical cancer,” “HPV vaccine,” “Gardasil injection,” “cervical cancer prevention,” and “teenage girls.” Then the type of literature (level of evidence) will be decided before embarking on a systematic search of research databases for scholarly evidence. In this case, the choice will be systematic reviews and meta-analyses. These have been chosen because they carry the highest and best level of evidence (level I) for a proposed clinical intervention (Melnyk & Fineout-Overholt, 2019). After this, the research databases to be used for the evidence search will be defined. In this case they will be (i) Cochrane Database of Systematic Reviews, (ii) CINAHL Plus with Full Text, (iii) PubMed, and (iv) Embase. Lastly, the filtering parameters will be decided. In this case they will be (i) publication within the last five years (since 2016), and (ii) English language articles only.
The Risks and Benefits Identified So Far
The Institutional Review Board or IRB is concerned with ensuring that all research carried out by scholars conforms to the ethical principles of nonmaleficence (avoidance of harm to human research subjects), autonomy (obtaining informed consent for participation in research studies), and justice (treating the human subjects fairly). Because a PICO inquiry is a form of scholarly research, two identified risks in this case are that (i) some of the teenagers may get adverse reactions after getting injected by the HPV vaccine even though the risk is minimal, and (ii) the teenagers and their parents may overestimate the protective power of the HPV vaccine such as Gardasil and erroneously think that the girls are also protected against sexually transmitted infections (STIs). This way, the girls may become reckless with their sexual behavior and end up getting infected by serious STIs such as HIV. On the other hand, the benefits that have been identified so far are that (i) the clinical inquiry will improve clinical practice, and (ii) the intervention will greatly reduce future morbidity and mortality as a result of neoplasms. PICOT Question: Identified Risks and Benefits
References
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
MIT Libraries (n.d.). Database search tips: Boolean operators. https://libguides.mit.edu/c.php?g=175963&p=1158594
PICO Worksheet and Search Strategy
- Define your question using PICO: Population, Intervention, Comparison, and Outcome.
Population: Non- pregnant female teenagers aged 12-19 years
Intervention: Educating parents and teens about HPV vaccine.
Comparison: The usual educational practice at the women’s health clinic
Outcome: The education will have more teens accepting the injection at the WHC to prevent cervical cancer.
- Write out your question: In non-pregnant females teens aged 12-19 who have not had HPV vaccine, does providing education to the parents and teens compare to the usual educational practice at the women’s health clinic increase knowledge of the risk factors and benefits of the injection to prevent cervical cancer?
- List the main topics and terms from your question that you can use to search.
Gardasil injection, Cervical cancer, HPV vaccine, Cervical cancer prevention, cervical cancer prevalence
- Check any limit that may pertain to your search:PICOT Question: Identified Risks and Benefits
Age 5 Years; Language English; Year of publication from 2016
- Type of study/publication you want to include in your search: (From Step 2 of tutorial)
| Systematic Review or Meta-Analysis |
|
| Published Education:
Impact of health education on HPV vaccination. · By Bhavya Arvind Rao, · Jyothi G. Seshadri & · Chethana Thirthahalli (2017).
|
- Check the databases you searched:
| Cochrane Library
|
|
- What information did you find to help answer your question?
cervical cancer
vaccination
prevention
Education
This form is adapted from: Syrene A. Miller, PICO Worksheet and Search Strategy, National Center for Dental Hygiene Research
PICOT Question: Identified Risks and Benefits