Strategic IT Planning Your 3-Step ProcessIntroductionStrateg.docx

Strategic IT Planning: Your 3-Step Process
Introduction
Strategic IT Planning is required to ensure your resources and
assets continue providing the results and the support your
organization needs.
What is a Strategic Plan?
It is a roadmap to achieving a goal. It may cover your entire
department or responsibility or it may focus on a specific issue
or element of your role. It can be long and involved or a simply
one-page document that provides guidance and steps you need
to implement to achieve a goal.
Making it Happen
There are a few things that are important to your success. While
it may seem that developing the Strategic Plan is the hardest
part, most plans fail because of the implementation. The key is
to keep it small and be successful, then build on that success for
the next initiative. Don’t bite off too much or try to be too
ambitious.
• Take your time and keep it manageable
• Link your plan to your company’s strategy
• Justify your initiative and get buy-in and support
• Don’t re-invent, rebuild
• Go slow, manage change
• Set aside time from your operational responsibilities to
make it happen
Without a Strategic Plan, you and your team won’t be effective
and you won’t be able to get results, get attention and get
ahead.
Why you need an IT Strategy:
Redirect from tasks to opportunities and result
· Switch from fighting fires to preventing fires
· Reduce risk with planning and a longer view
Most Strategic Plans never get written or they fail because they

are too involved and complex. Keep them simple and use these
three basic steps as your core approach. Ask yourself these
questions:
1. Why do you need to do it? What is your goal?
2. What are the things you need to get done to achieve your
goal?
3. How can you make those things happen?
By following the 3 steps above and writing them down, you will
have the outline of your Strategic IT Plan. Then, you establish
the tactical things that will help you implement your plan.
Implementation Plan
Once you have established your strategic plan using the 3-step
process, you need to develop your implementation plan. This
includes getting approval and resources as well as the steps you
need to take to achieve your strategic objective.
1. Set the objective for each step
2. Analyze internal/external factors
3. Develop solutions
4. Identify and eliminate barriers
5. Allocate resources (people, time, money)
6. Develop detailed tasks
7. Implement your plan!
Step Implementation
What Are The Roadblocks?
How Can You Overcome The Roadblocks?
What Resources Do You Need?
What Are The Timelines?
What Are The Main Steps To Implement Your Plan?
Parental Acceptance of a Mandatory Human
Papillomavirus (HPV) Vaccination Program
Daron Ferris, MD, Leslie Horn, BS, and Jennifer L. Waller, PhD

Objectives: The objective of this study was to determine factors
that influence parent’s acceptance of a
mandatory school-based human papillomavirus (HPV)
vaccination program.
Methods: A convenience sample of 325 parents, with children
aged 9 to 17 years old, completed a
53-item survey. Survey questions targeted their opinions about
HPV, the HPV vaccine, and a mandatory
HPV vaccination program. �2 tests were used to examine
relationships between survey items.
Results: Characteristics of parents who believed the HPV
vaccine should be mandated included lim-
ited financial resources (P � .03), history of HPV-related
disease (P � .04), understanding their child’s
susceptibility (P � .03), interest in HPV vaccination for their
child (P � .0001), and knowledge that the
vaccine reduces the risk of cervical cancer (P � .001). Parents
of children aged 12 to 14 years old (P �
.02) or who knew the vaccine reduced their child’s risk of
developing genital warts (P � .02) and cervi-
cal cancer (P � .001) would be more likely to comply with a
mandatory HPV vaccine program.
Conclusions: Certain characteristics define parents who support
a mandatory HPV vaccination pro-
gram. Greater education of parents and health care providers
should improve vaccination uptake, which
ultimately reduces morbidity and mortality from HPV related
diseases. ( J Am Board Fam Med 2010;23:
220 –229.)
Keywords: Human Papillomavirus, Health Care Surveys,
Attitude, Vaccination

Although the quadrivalent human papillomavirus
(HPV) vaccine has demonstrated robust efficacy
and reasonable safety, suboptimal vaccination rates
raise concern and questions.1– 6 A survey conducted
in 2007 by the Centers for Disease Control and
Prevention found that approximately 25% of 13- to
17-year-old girls had received at least one dose of
the HPV vaccine.5 Moreover, far fewer 9- to 12-
year-old and 18- to 26-year-old girls and women
have initiated the vaccination series. The poor rate
of HPV vaccine coverage for 9- to 12-year-old girls
is particularly worrisome because this has been
deemed the ideal age to vaccinate.7 In comparison,
coverage for school-entry vaccines during the
2007–2008 school year estimated by the Centers
for Disease Control and Prevention varied between
94% (varicella) and 96% (hepatitis B).8 The differ-
ences in these vastly contrasting rates of vaccina-
tion are likely because of many factors, including
cost, safety, knowledge, provider issues, access, and
controversy.9 –11 However, one simple explanation
is that school-entry vaccines are mandated and the
HPV vaccine is not.
Although discussion of mandating vaccines gen-
erates conflicting opinions, this approach has
proven very beneficial from a public health per-
spective. School-mandated vaccination programs
have increased coverage for other vaccines.12–15
However, such an approach for the HPV vaccine
has met some resistance by the medical commu-
nity.16 Further, only a minority of parents ap-
prove mandating the quadrivalent HPV vac-

cine.17,18 Loss of parental autonomy, cost,
insufficient data from clinical trials, and too
This article was externally peer reviewed.
Submitted 22 April 2009; revised 8 July 2009; accepted 13
July 2009.
From the Gynecologic Cancer Prevention Center (DF);
the Departments of Family Medicine and Obstetrics and
Gynecology (DF) and the Department of Biostatistics
(JLW), Medical College of Georgia (LH), Augusta, Geor-
gia.
Funding: Residual grant funds.
Conflict of interest: Dr. Ferris is an investigator for Glaxo-
SmithKline vaccine studies. He is also a consultant, investi-
gator, and speaker for Merck and Co., Inc. Ms. Horn and
Dr. Waller have no potential conflicts.
Corresponding author: Dr. Daron G. Ferris, Department of
Family Medicine, Medical College of Georgia, 1423 Harper
Street, HH-105, Augusta, GA 30912 (E-mail: [email protected]
mcg.edu).
See Related Commentary on
Page 149.
220 JABFM March–April 2010 Vol. 23 No. 2
http://www.jabfm.org
many side effects are the main reasons for lack of
parental support.17,18 In addition, critical ap-

praisal of parental acceptance of a mandatory
HPV vaccination program would be beneficial
before promoting required HPV vaccination for
children. The purpose of this study was to deter-
mine factors that influence parental acceptance of
a mandatory HPV vaccination program.
Materials and Methods
We asked parents of 9- to 17-year-old children to
participate in this study. A convenience sample of
eligible parents was recruited from waiting rooms
in family medicine, obstetrics and gynecology, and
pediatric clinics at the Medical College of Georgia,
Augusta, and from Women’s Health Associates,
Atlanta, Georgia. Patients were also recruited from
community sites, including Riverview Park, North
Augusta, South Carolina; Suwanee Academy of the
Arts, Suwanee, Georgia; and hair and nail salons in
Augusta and Atlanta. We excluded parents who
were unable to read English. This study was ap-
proved by the Human Assurance Committee at the
Medical College of Georgia.
The questionnaire has been described previ-
ously, but it consisted of 53 questions that collected
demographic data, opinions about HPV and vac-
cines, attitudes about the HPV vaccine, and issues
involving a mandatory HPV vaccination pro-
gram.17 The main outcome questions determined
parental reactions to a mandated HPV vaccination
program. Specifically, these questions were (1) Do
you think the HPV vaccine should be added to the
list of school entry vaccine requirements? and (2) If
the vaccine was mandatory for a child to attend
school, which of the following statements most
agrees with your view? (answer options for question

2 were “I would sign a waiver to prevent my child
from receiving the vaccine”; “I would have my child
vaccinated”; or “I would do whatever my doctor
recommends.” Questions were structured as yes/no
and multiple choice. Some pertinent questions
from previously developed questionnaires were in-
cluded.19 –21
Parents were asked to participate in a study
about their opinions of the HPV vaccine and man-
datory vaccination programs. Eligible parents who
agreed to participate were given a 1-page cover
letter that described HPV and the HPV vaccine.
Subjects then completed the self-administered,
anonymous survey and returned it in an envelope to
the investigators.
Descriptive statistics, including means and
standard deviations, frequencies, and percent-
ages, were calculated for responses to each ques-
tion. �2 tests were used to examine the relation-
ship between various questionnaire items. All
statistical analyses were performed using SAS
software version 9.1.3 (SAS Institute, Inc., Cary,
NC) and statistical significance was assessed us-
ing an � level of 0.05.
Results
We asked 365 parents to participate in the study;
325 parents enrolled in the fall of 2008. The re-
sponse rate was 89%, with insufficient time and
length of the questionnaire being the main reasons
for parents’ refusal to participate. Complete demo-
graphic data based on the 325 parents have been
published previously.17 In summary, subjects

tended to be female, 30 to 39 years old, white,
protestant, have a family income between $20,000
and $50,000, have some college education, and
have private health insurance. Personal history of
HPV-related problems included 13% with a previ-
ous HPV infection, 5% with condyloma, and 37%
had a previous abnormal Papanicolaou test result.
Associations between demographic variables and
agreement with adding the HPV vaccine to school
entry requirements are seen in Table 1. Those with
incomes �$20,000, those with no health insurance,
Medicaid, or Tricare insurance, or those who have
ever had HPV were more likely to agree that the
HPV vaccine should be added to school entry re-
quirements. Sex, race, and age of children did not
predict support for an HPV vaccine mandate.
Associations between various other variables and
agreement with mandating the HPV vaccine were
also examined (Table 2). Subjects who were not
familiar or very familiar with HPV felt it very likely
that their child could contract HPV and thought it
was very important for their child to receive the
HPV vaccine; those who thought that the HPV
vaccine reduced the risk of cervical cancer more
frequently thought that the HPV vaccine should be
added to school entry requirements. Parents who
supported government-mandated vaccines thought
a mandatory HPV vaccine program would be very
helpful, and those who want the federal govern-
ment to help pay for the HPV vaccine more often
supported school entry requirements.
doi: 10.3122/jabfm.2010.02.090091 Parental Acceptance of a
Mandatory HPV Vaccination Program 221

Table 1. Association between Demographic Variables and
Parent’s Agreement with Adding the Human Papilloma
Virus Vaccine to School Entry Requirements
Variable
Do you Think the HPV Vaccine should be
Added to the List of School Entry Vaccine
Requirements?
P*No (n �%�) Yes (n �%�)
Gender .47
Male 19 (51.4) 18 (48.7)
Female 163 (57.6) 120 (42.4)
Age (years) .19
18–29 30 (53.6) 26 (46.4)
30–39 81 (55.9) 64 (44.1)
40–49 49 (54.4) 41 (45.6)
50� 22 (75.9) 7 (24.1)
Race .50
White 103 (56.6) 79 (43.4)

African American 67 (54.9) 55 (45.1)
Asian 1 (50.0) 1 (50.0)
Hispanic 9 (75.0) 3 (25.0)
Other 2 (100.0) 0 (0.0)
Ages of Children, 9–11 .91
No 75 (57.3) 56 (42.8)
Yes 107 (56.6) 82 (43.4)
No 126 (60.9) 81 (39.1)
Yes 56 (49.6) 57 (50.4)
No 112 (57.4) 83 (42.6)
Yes 70 (56.0) 55 (44.0)
Income .03
�$20,000 17 (37.8) 28 (62.2)
$20,001-$50,000 77 (57.9) 56 (42.1)
$50,001-$100,000 54 (64.3) 30 (35.7)
�$100,000 34 (58.6) 24 (41.4)

Education .09
�High school 5 (38.5) 8 (61.5)
High school or GED 63 (51.6) 59 (48.4)
�College 114 (61.6) 71 (38.4)
Health insurance .01
None 9 (50.0) 9 (50.0)
Private 135 (61.6) 84 (38.4)
Medicaid 26 (40.6) 38 (59.4)
Medicare 2 (100.0) 0 (0.0)
Other 9 (75.0) 3 (25.0)
Tricare 1 (20.0) 4 (80.0)
Ever had HPV .04
Yes 18 (42.9) 24 (57.1)
No 155 (60.3) 102 (39.7)
Not sure 9 (42.9) 12 (57.1)
Ever had genital warts .78
Yes 8 (53.3) 7 (46.7)
No 174 (57.1) 131 (43.0)

Abnormal Papanicolaou test (women only) .55
Yes 67 (56.8) 51 (43.2)
No 98 (58.7) 69 (41.3)
Not sure 17 (48.6) 18 (51.4)
*�2 test.
HPV, human papillomavirus; GED, General Educational
Development test.
Table 2. Association of Parental Attitudes, Beliefs, and
Agreement with Adding the Human Papillomavirus Vaccine
to School Entry Requirements
Variable
Do You Think the HPV Vaccine
Should be Added to the List of School
Entry Vaccine Requirement?
P*No (n �%�) Yes (n �%�)
Support government-mandated vaccine requirements �.0001
No 33 (97.1) 1 (2.9)
Yes 148 (51.9) 137 (48.1)
Familiar with HPV .02
Not familiar 20 (45.5) 24 (54.6)

Somewhat familiar 117 (63.6) 67 (36.4)
Very familiar 45 (48.9) 47 (51.1)
Likelihood of child to contract HPV .03
Not at all likely 85 (57.8) 62 (42.2)
Somewhat likely 93 (59.6) 63 (40.4)
Very likely 4 (25.0) 12 (75.0)
Important for child to receive HPV vaccine �.0001
Not at all important 42 (84.0) 8 (16.0)
Somewhat important 96 (72.7) 36 (27.3)
Very important 43 (31.6) 93 (68.4)
Concerned about side effects of HPV vaccine .56
Not at all concerned 20 (60.6) 13 (39.4)
Somewhat concerned 75 (53.6) 65 (46.4)
Very concerned 86 (59.3) 59 (40.7)
HPV vaccine reduces risk of cervical cancer .001
No 30 (83.3) 6 (16.7)
Yes 117 (51.5) 110 (48.5)
No girls 32 (60.4) 21 (39.6)
HPV vaccine reduces risk of genital warts .06
No 74 (63.8) 42 (36.2)
Yes 104 (52.8) 93 (47.2)
Want child to receive HPV vaccine �.0001
No 55 (90.2) 6 (9.8)
Yes 123 (48.2) 132 (51.8)
Child has received HPV vaccine .008
No 166 (59.7) 112 (40.3)
Yes 16 (38.1) 26 (61.9)
Physician supports HPV vaccine .07

No 4 (50.0) 4 (50.0)
Yes 43 (47.3) 48 (52.8)
Not Discussed 135 (61.1) 86 (38.9)
Most influences decision to get HPV vaccine .006
Doctor 97 (51.1) 93 (49.0)
Spouse 14 (82.4) 3 (17.7)
Child 13 (48.2) 14 (51.9)
Parent 2 (28.6) 5 (71.4)
Mandatory school requirement 14 (70.0) 6 (30.0)
None 41 (70.7) 17 (29.3)
Comfortable with mandated HPV vaccine �.0001
Not comfortable 87 (97.8) 2 (2.3)
Somewhat comfortable 87 (53.4) 76 (46.7)
Very comfortable 7 (10.5) 60 (89.6)
We then examined parents’ possible reactions to
a mandatory HPV vaccine program: signing a
waiver to prevent their child from receiving the
HPV vaccine, having their child vaccinated, or do-
ing what their doctor recommends (Table 3). Par-
ents with a child aged 12 to 14 years who were not
familiar or very familiar with HPV thought it was
very likely their child could contract HPV and
thought the HPV vaccine reduced the risk of cer-
vical cancer and genital warts. Those whose physi-
cian supported the HPV vaccine more frequently
agreed with the statement that they would have
their child vaccinated with the HPV vaccine. Sub-
jects who were very comfortable with a mandatory

HPV vaccine program thought the federal govern-
ment should pay for a mandatory HPV vaccine
program and were very interested in the HPV vac-
cine for their child; these parents were more likely
to have their child vaccinated.
Several associations with government interven-
tion in HPV vaccination were also examined. Par-
ents who wanted their child to receive the HPV
vaccine (45.5%) were more likely than those who
did not want their child to receive the vaccine
(8.2%) to want their government representative to
make a law requiring the HPV vaccine (P � .0001).
Subjects who thought the HPV vaccine should be
added to the list of school-entry vaccine require-
ments (84.1%) were more likely to want their gov-
ernment representative to make a law requiring the
HPV vaccine than those who do not think it should
be added to the school-entry vaccine requirements
(28%; P � .0001). Individuals with incomes
�$20,000 were more likely to want the state of
Georgia (P � .004) and the federal government
(P � .003) to pay for the HPV vaccine for school
children than parents at all other income levels
(84.4% and 86.7%, respectively).
Conclusions
Our study identified numerous factors that increase
the likelihood of parents accepting a mandatory
HPV vaccination program. Parents with a personal
history of HPV-related disease (HPV infection or
genital warts) were more likely to support such a
mandated program. Parents who had greater famil-
iarity with the adverse consequences of HPV infec-
tion were also more apt to approve a school-based

mandate. Interestingly, mothers with a history of a
previous abnormal Papanicolaou test were not
more inclined to support a mandatory program.
Many women were unaware of the viral cause for
abnormal cervical cytology. A greater number of
parents with the lowest income would also comply
with a mandatory vaccination program; because
Table 2. (Continued)
Variable
Do You Think the HPV Vaccine
Should be Added to the List of School
Entry Vaccine Requirement?
P*No (n �%�) Yes (n �%�)
Mandatory HPV vaccine program helpful �.0001
Not helpful 45 (97.8) 1 (2.2)
Somewhat helpful 125 (64.1) 70 (35.9)
Very helpful 12 (15.2) 67 (84.8)
Mandatory HPV vaccine program important �.0001
Not important 47 (94.0) 3 (6.0)
Somewhat important 123 (67.2) 60 (32.8)
Very important 12 (13.8) 75 (86.2)
Federal government to pay for HPV vaccine �.0001
No 90 (82.6) 19 (17.4)
Yes 91 (43.3) 119 (56.7)
Interested in HPV vaccination for child �.0001
Not interested 52 (91.2) 5 (8.8)
Somewhat interested 100 (66.2) 51 (33.8)

Very interested 30 (26.8) 82 (73.2)
*�2 test.
HPV, human papillomavirus.
Table 3. Association of Parental Attitudes, Beliefs, and Possible
Responses to a Mandatory Human Papillomavirus
Vaccine
Variable
If the HPV Vaccine was Mandatory to Attend School, Which of
the
Following Statements Most Agrees with Your View?
P*
Would Sign a Waiver to
Prevent my Child from
Receiving the Vaccine
(n �%�)
Would have My Child
Vaccinated (n �%�)
Would do Whatever
My Doctor
Recommends
(n �%�)

Gender .95
Male 6 (16.2) 25 (67.6) 6 (16.2)
Female 52 (18.4) 186 (65.7) 45 (15.9)
Age (years) .84
18–29 11 (19.6) 36 (64.3) 9 (16.1)
30–39 23 (15.9) 95 (65.5) 27 (18.6)
40–49 17 (18.9) 61 (67.8) 12 (13.3)
50� 7 (24.1) 19 (65.5) 3 (10.3)
Race .40
White 40 (22.0) 114 (62.6) 28 (15.4)
African American 18 (14.8) 84 (68.9) 20 (16.4)
Asian 0 (0.0) 1 (50.0) 1 (50.0)
Hispanic 0 (0.0) 10 (83.3) 2 (16.7)
Other 0 (0.0) 2 (100.0) 0 (0.0)
Ages of children, 9–11 .91
No 25 (19.1) 86 (65.7) 20 (15.3)
Yes 33 (17.5) 125 (66.1) 31 (16.4)
No 39 (18.8) 127 (61.4) 41 (19.8)
Yes 19 (16.8) 84 (74.3) 10 (8.9)
No 41 (21.0) 123 (63.1) 31 (15.9)
Yes 17 (13.6) 88 (70.4) 20 (16.0)
Income .54
�$20,000 6 (13.3) 33 (73.3) 6 (13.3)
$20,001-$50,000 22 (16.5) 88 (66.2) 23 (17.3)
$50,001-$100,000 21 (25.0) 49 (58.3) 14 (16.7)
�$100,000 9 (15.5) 41 (70.7) 8 (13.8)

Education .84
�High school 2 (15.4) 9 (69.2) 2 (15.4)
High school or GED 20 (16.4) 85 (69.7) 17 (13.9)
�College or more 36 (19.5) 117 (63.2) 32 (17.3)
Health insurance .06
None 2 (11.1) 10 (55.6) 6 (33.3)
Private 47 (21.5) 139 (63.5) 33 (15.1)
Medicaid 5 (7.8) 51 (79.7) 8 (12.5)
Medicare 0 (0.0) 2 (100.0) 0 (0.0)
Other 3 (25.0) 5 (41.7) 4 (33.3)
Tricare 1 (20.0) 4 (80.0) 0 (0.0)
Ever had HPV .19
Yes 10 (23.8) 30 (71.4) 2 (4.8)
No 46 (17.9) 165 (64.2) 46 (17.9)
Not sure 2 (9.5) 16 (76.2) 3 (14.3)
Ever had genital warts .22
Yes 3 (20.0) 12 (80.0) 0 (0.0)
No 55 (18.0) 199 (65.3) 51 (16.7)
Variable
the

P*
(n �%�)
Would have My Child
Would do Whatever
My Doctor
Recommends
(n �%�)
Abnormal Papanicolaou test (women
only)
.62
Yes 23 (19.5) 80 (67.8) 15 (12.7)
No 31 (18.6) 106 (63.5) 30 (18.0)
Not sure 4 (11.4) 25 (71.4) 6 (17.1)
Support government mandated vaccines
requirements
�.0001
No 17 (50.0) 10 (29.4) 7 (20.6)
Yes 40 (14.0) 201 (70.5) 44 (15.4)
Familiar with HPV .02

Not familiar 7 (15.9) 30 (68.2) 7 (15.9)
Somewhat familiar 30 (16.3) 115 (62.5) 39 (21.2)
Very familiar 21 (22.8) 66 (71.7) 5 (5.4)
Likelihood of child to contract HPV �.0001
Not at all likely 36 (24.5) 76 (51.7) 35 (23.8)
Somewhat likely 20 (12.8) 120 (76.9) 16 (10.3)
Very likely 2 (12.5) 14 (87.5) 0 (0.0)
Important for child to receive HPV
vaccine
�.0001
Not at all important 29 (58.0) 10 (20.0) 11 (22.0)
Somewhat important 23 (17.4) 81 (61.4) 28 (21.2)
Very important 5 (3.7) 119 (87.5) 12 (8.8)
Concerned about side effects of HPV
vaccine
.08
Not at all concerned 8 (24.2) 20 (60.6) 5 (15.2)
Somewhat concerned 16 (11.4) 102 (72.9) 22 (15.7)
Very concerned 34 (23.5) 87 (60.0) 24 (16.6)
HPV vaccine reduces risk of cervical
cancer
�.0001
No 20 (55.6) 10 (27.8) 6 (16.7)
Yes 25 (11.0) 169 (74.5) 33 (14.5)
No girls 11 (20.8) 30 (56.6) 12 (22.6)

HPV vaccine reduces risk of genital
warts
.02
No 30 (25.9) 70 (60.3) 16 (13.8)
Yes 26 (13.2) 136 (69.0) 35 (17.8)
Want child to receive HPV vaccine �.0001
No 35 (57.4) 10 (16.4) 16 (26.2)
Yes 21 (8.24) 199 (78.0) 35 (13.7)
Child has received HPV vaccine .001
No 57 (20.50) 173 (62.2) 48 (17.28)
Yes 1 (2.4) 38 (90.5) 3 (7.1)
Physician supports HPV vaccine .0004
No 3 (37.5) 2 (25.0) 3 (37.5)
Yes 7 (7.7) 75 (82.4) 9 (9.9)
Not discussed 48 (21.7) 134 (60.6) 39 (17.7)
this vaccine is fairly expensive, one could assume
that mandating vaccination might have equaled free
availability in their minds. In fact, the Vaccines for
Children Program provides free HPV vaccines to
indigent children 18 years old or younger. This is a
voluntary federal vaccination program that is prob-
ably underutilized. The sex, age, race, education,
and type of health insurance parents had did not
influence their opinion about the importance of a
mandated vaccine program. In fact, fewer college-

educated parents thought a mandatory HPV vac-
cine program should be implemented.
Parents who understood the true vulnerability of
their child and the possibility of their contracting
HPV supported a mandatory HPV vaccine pro-
gram. Tragically, most parents do not know the
ubiquitous nature of HPV21 and awareness of this
principle is an important cornerstone for vaccine
acceptance. Moreover, no one can advise parents
about how their child’s immune system might re-
Variable
the
P*
(n �%�)
Would have My Child
Would do Whatever
My Doctor
Recommends

(n �%�)
Most influences decision to get HPV
vaccine
�.0001
Doctor 20 (10.5) 137 (72.1) 33 (17.4)
Spouse 5 (29.4) 8 (47.1) 4 (23.5)
Child 2 (7.4) 21 (77.8) 4 (14.8)
Parent 0 (0.0) 5 (71.4) 2 (28.6)
Mandatory school requirement 4 (20.0) 15 (75.0) 1 (5.0)
None 27 (46.6) 24 (41.4) 7 (12.1)
Somewhat comfortable 8 (4.91) 128 (78.5) 27 (16.6)
Very comfortable 0 (0.00) 64 (95.5) 3 (4.5)
Mandatory HPV vaccine program
helpful
�.0001
Not helpful 31 (67.4) 9 (19.6) 6 (13.0)
Somewhat helpful 27 (13.9) 127 (65.1) 41 (21.0)
Very helpful 0 (0.0) 75 (94.9) 4 (5.1)
Mandatory HPV vaccine program
important
�.0001
Not important 32 (64.0) 12 (24.0) 6 (12.0)
Somewhat important 25 (13.7) 118 (64.5) 40 (21.9)
Very important 1 (1.2) 81 (93.1) 5 (5.8)
Federal government to pay for HPV
vaccine

�.0001
No 42 (38.5) 48 (44.0) 19 (17.4)
Yes 16 (7.6) 162 (77.1) 32 (15.2)
Interested in HPV vaccination for child �.0001
Not interested 41 (71.9) 7 (12.3) 9 (15.8)
Somewhat interested 16 (10.6) 102 (67.6) 33 (21.9)
Very interested 1 (0.9) 102 (91.1) 9 (8.0)
HPV vaccine should be added to the
list of school entry vaccine
requirements
�.0001
No 57 (31.3) 86 (47.3) 39 (21.4)
Yes 1 (0.7) 125 (90.6) 12 (8.7)
*�2 test.
HPV, human papillomavirus; GED, General Educational
Development test.
spond to HPV infection, eg, spontaneous clearance
or persistence that may increase the risk for devel-
oping a malignancy. Parents who knew that the
HPV vaccine reduced the risk of their child devel-
oping cervical cancer were more inclined to con-
done a mandatory program. Further education
about HPV and its potential consequences are

needed to improve HPV vaccine uptake. Such ed-
ucation could influence response to a mandated
program.
Parents whose health care providers supported
the HPV vaccine were not more likely to support a
mandatory vaccination program. Yet other studies
have demonstrated the value of medical advice with
respect to HPV vaccine acceptance.19,21,22 The
opinion of a trusted health care provider is partic-
ularly important with respect to preventive medical
care. The dialogue between parent and health care
provider probably has centered around action (get-
ting the vaccine) and not the particular process
(voluntary vs mandatory).
Many other variables indicated that parents
thought the HPV vaccine should be added to the
list of school-entry vaccine requirements. Parents
with no insurance or federally financed insurance
more often agreed that the HPV vaccine should be
required. Reliance on government-funded heath
insurance may have an affect on parental auton-
omy. These parents may be more willing to abdi-
cate these health decisions to the medical legislative
process. However, others caution that such a man-
datory program for the HPV vaccine would place a
financial burden on existing government health
programs, thereby potentially reducing coverage
rates for other vaccines.23
To parents we posed a realistic scenario: that the
HPV vaccine was required for school. They could
choose to sign a waiver to prevent their child from
receiving the HPV vaccine, have their child vacci-
nated, or follow the recommendation of their

health care provider. Most parents (66%) would
simply select to allow their child to receive the
vaccination. Those parents who supported manda-
tory vaccination programs knew the potential
harms from HPV, realized their child was very
susceptible to HPV infection, and wanted their
child to receive the vaccine readily accepted com-
pliance with an HPV vaccination mandate. Once
again, knowledge about the problem seemed con-
ducive to parents accepting mandatory health pro-
grams designed to prevent unnecessary morbidity
and mortality.
The remaining parents were fairly divided be-
tween the other 2 options. A certain number of
parents want to retain the autonomy of making
health decisions for their children. In our country
and the state in which our study was conducted,
opting out of vaccination for religious, medical, or
philosophical reasons is allowed. However, some
argue that society should protect innocent children
who may be hurt by the choices of their parents.24
The issue has been conceptualized as conflict be-
tween autonomy and utilitarianism.25 Other par-
ents place the decision in the hands of their health
care provider. Education of these influential people
is critically necessary to assure proper guidance is
given.
Our study was limited by regional sampling,
greater participation by mothers, and limited Asian
and Hispanic involvement. A national sample in-
cluding more fathers and minorities may have al-
tered our findings. Our study was also conducted

immediately after unjust negative publicity from
the national media. The HPV vaccine controversy
is clouded by too many unproven assumptions and
unknown factors.26 Although acceptance of a man-
datory policy for the HPV vaccine may improve in
the future, additional research may be beneficial to
assess changing and evolving attitudes.
References
1. Villa LL, Costa RLR, Petta CA, et al. Prophylactic
quadrivalent human papillomavirus (types 6, 11, 16
and 18) L1 virus-like particle vaccine in young
women: a randomized double-blind placebo-con-
trolled multicentre phase II efficacy trial. Lancet
Oncol 2005;6:271– 8.
2. FUTURE II Study Group. Quadrivalent vaccine
against human papillomavirus to prevent high-grade
cervical lesions. N Engl J Med 2007;356:1915–27.
3. Ault KA, FUTURE II Study Group. Effect of pro-
phylactic human papillomavirus L1 virus-like-parti-
cle vaccine on risk of cervical intraepithelial neopla-
sia grade 2, grade 3 and adenocarcinoma in situ: a
combined analysis of four randomised clinical trials.
Lancet 2007;369:1861– 8.
4. Garland SM, Hernandez-Avila M, Wheeler CM, et
al. Quadrivalent vaccine against human papillomavi-
rus to prevent anogenital diseases. N Engl J Med
2007;356:1928 – 43.
5. Associated Press. 1 in 4 U.S. girls received HPV
vaccine. October 9, 2008. Available at http://

www.msnbc.msn.com/id/27103121/ns/health-kids_
and_parenting/. Accessed 6 July 2009.
6. Springer K. Why are HPV vaccine rates so low? 25
February 2008. Available at http://www.newsweek.
com/id/115329/output/print. Accessed 6 July 2009.
7. Markowitz LE, Dunne EF, Saraiya M, Lawson HW,
Chesson H, Unger ER. Quadrivalent human papil-
lomavirus vaccine: recommendations of the Advisory
Committee on Immunization Practices (ACIP).
MMWR Recomm Rep 2007;56:1–24.
8. CDC. Coverage estimates for school entry vaccina-
tions, 2007–2008 school year. Available at http://
www2.cdc.gov/nip/schoolsurv/nationalavg.asp. Ac-
cessed 6 July 2009.
9. Ford CA, English A, Davenport AF, Stinnett AJ. In-
creasing adolescent vaccination: barriers and strate-
gies in the context of policy, legal and financial is-
sues. J Adolesc Health 2009;44:568 –74.
10. Kahn JA, Rosenthal SL, Jin Y, Huang B, Namaky-
doust A, Zimet GD. Rates of human papillomavirus
vaccination, attitudes about vaccination, and human
papillomavirus prevalence in young women. Obstet
Gynecol 2008;111:1103–10.
11. Keating KM, Brewer NT, Gottlieb SL, Liddon N,
Ludema C, Smith JS. Potential barriers to HPV

vaccine provision among medical practices in an area
with high rates of cervical cancer. J Adolesc Health
2008;43:S61–7.
12. Morita JY, Ramirez E, Trick WE. Effect of a school-
entry vaccination requirement on racial and ethnic
disparities in hepatitis B immunization coverage lev-
els among public school students. Pediatrics 2008;
121:547–52.
13. Fogarty KJ, Massoudi MS, Gallo W, Averhoff FM,
Yusuf H, Fishbein D. Vaccine coverage levels after
implementation of a middle school vaccination re-
quirement, Florida, 1997–2000. Public Health Rep
2004;119:163–9.
14. Olshen E, Mahon BE, Wang S, Woods ER. The
impact of state policies on vaccine coverage by age
13 in an insured population. J Adolesc Health 2007;
40:405–11.
15. Wilson TR, Fishbein DB, Ellis PA, Edlavitch SA.
The impact of a school entry law on adolescent
immunization rates. J Adolesc Health 2005;37:511– 6.
16. Gostin LO, DeAngelis CD. Mandatory HPV vacci-
nation, public health vs private wealth. JAMA 2007;
297:1921–3.
17. Horn L, Howard C, Waller JL, Ferris DG. Opinions
of parent’s about school-entry mandates for the hu-
man papillomavirus vaccine. J Lower Genit Tract
Dis 2010;14:53– 8.
18. Hopson K. Majority of U.S. parents not in favor of
HPV vaccine mandates. 22 May 2007. Available at

http://www2.med.umich.edu/prmc/media/newsroom/
details.cfm?id�532. Accessed 12 January 2010.
19. Ferris DG, Waller JL, Miller J, et al. Variables as-
sociated with human papillomavirus (HPV) vaccine
acceptance by men. J Am Board Fam Med 2009;22:
34 – 42.
20. Ferris DG, Waller JC, Owen A, Smith J. Human
papillomavirus vaccine acceptance among mid-adult
women. J Am Board Fam Med 2008;21:31–7.
21. Davis K, Dickman ED, Ferris D, Dias JK. Human
papillomavirus vaccine acceptability among parents
of 10- to 15-year-old adolescents. J Lower Gen
Tract Dis 2004;8:188 –94.
22. Ferris DG, Waller JL, Miller J, et al. Men’s attitudes
toward receiving the Human papillomavirus vaccine.
J Lower Gen Tract Dis 2008;12:276 – 81.
23. Javitt G, Berkowitz D, Gostin LO. Assessing man-
datory human papillomavirus vaccination: who
should call the shots? J Law Med Ethics 2008;36:
384 –95.
24. Colgrove J. The ethics and politics of compulsory
human papillomavirus vaccination. N Engl J Med
2006;355:2389 –91.
25. Field RI, Caplan AL. A proposed ethical framework
for vaccine mandates: Competing values and the case
of human papillomavirus. Kennedy Inst Ethics J
2008;18:111–24.
26. Haber G, Malow RM, Zimet GD. The human pap-

illomavirus vaccine mandate controversy. J Pediatr
Adolesc Gynecol 2007;20:325–31.
DISEASES and the VACCINES THAT PREVENT THEM
Updated December 2016
H
P
V us
a
p
il
lo
m
a
vi
r
H
u
m
a
n

P
al
so
k
no
w
n
as
As parents, you do everything you can to protect
your children’s health for now and for the future.
Today, there is a strong weapon to prevent several
types of cancer in our kids: the HPV vaccine.
HPV and Cancer
HPV is short for Human Papillomavirus, a common
virus. In the United States each year, there are
about 17,500 women and 9,300 men affected by
HPV-related cancers. Many of these cancers could be
prevented with vaccination. In both women and
men, HPV can cause anal cancer and mouth/throat
(oropharyngeal) cancer. It can also cause cancers of
the cervix, vulva and vagina in women; and cancer of
the penis in men.
For women, screening is available to detect most cases
of cervical cancer with a Pap smear. Unfortunately,
there is no routine screening for other HPV-related
cancers for women or men, and these cancers can
cause pain, suffering, or even death. That is why a
vaccine that prevents most of these types of

cancers is so important.
More about HPV
HPV is a virus passed from one person to another
during skin-to-skin sexual contact, including vaginal,
oral, and anal sex. HPV is most common in people
in their late teens and early 20s. Almost all sexually
active people will get HPV at some time in their lives,
though most will never even know it.
Most of the time, the body naturally fights off HPV,
before HPV causes any health problems. But in some
cases, the body does not fight off HPV, and HPV can
cause health problems, like cancer and genital warts.
Genital warts are not a life-threatening disease, but
they can cause emotional stress, and their treatment
can be very uncomfortable. About 1 in 100 sexually
active adults in the United States have genital warts at
any given time.
HPV vaccination is recommended
for preteen girls and boys at age
11 or 12 years
All preteens need HPV vaccination so they can be
protected from HPV infections that cause cancer.
Teens and young adults who didn’t start or finish
the HPV vaccine series also need HPV vaccination.
Young women can get HPV vaccine until they are 27
years old and young men can get HPV vaccine until
they are 22 years old. Young men who have sex with
other men or who have weakened immune systems
can also get HPV vaccine until they are 27.
HPV vaccination is a series of shots given over several
months. The best way to remember to get your child
all of the shots they need is to make an appointment

for the remaining shots before you leave the doctor’s
office or clinic.
Is the HPV vaccine safe?
Yes. HPV vaccination has been studied very carefully
and continues to be monitored by CDC and the
Food and Drug Administration (FDA). No serious
safety concerns have been linked to HPV vaccination.
These studies continue to show that HPV
vaccines are safe.
The most common side effects reported after HPV
vaccination are mild. They include pain and redness
in the area of the arm where the shot
was given, fever, dizziness, and
nausea. Some preteens and
teens may faint after getting
a shot or any other medical
procedure. Sitting or lying
down for about 15 minutes
after getting shots can help
prevent injuries that could
happen if your child were
to fall while fainting.
Why does my child need this now?
HPV vaccines offer the best protection to girls and boys who
complete the
series and have time to develop an immune response before they
begin
sexual activity with another person. This is not to say that your
preteen is
ready to have sex. In fact, it’s just the opposite—it’s important
to get your
child protected before you or your child have to think about this

issue. The
immune response to this vaccine is better in preteens, and this
could mean
better protection for your child. ❖
C
S
H
C
VG
15
-P
TT
-1
11
1
2/
16
/2
01
6
DISTRIBUTED BY:
Serious side effects from HPV vaccination are rare. Children

with severe allergies to yeast or latex shouldn’t get certain HPV
vaccines. Be sure to tell the doctor or nurse if your child has
any
severe allergies.
Help paying for vaccines
The Vaccines for Children (VFC) program provides vaccines
for children ages 18 years and younger who are uninsured,
Medicaid-eligible, or American Indian/Alaska Native. Learn
more about the VFC program at
www.cdc.gov/Features/VFCprogram/
Whether you have insurance, or your child is VFC-eligible,
some doctors’ offices may also charge a fee to give the
vaccines.
Jacquelyn’s story: “I was healthy—and got cervical cancer.”
When I was in my late 20’s and early 30’s, in the years
before my daughter was born, I had some abnormal Pap
smears and had to have further testing. I was told I had the
kind of HPV that can cause cancer and mild dysplasia.
For three more years, I had normal tests. But when I got my
first Pap test after my son was born, they told me I needed
a biopsy. The results came back as cancer, and my doctor
sent me to an oncologist. Fortunately, the cancer was at an
early stage. My lymph nodes were clear, and I didn’t need
radiation. But I did need to have a total hysterectomy.
My husband and I have been together for 15 years, and we
were planning to have more children. We are so grateful for
our two wonderful children, but we were hoping for more—
which is not going to happen now.
The bottom line is they caught the cancer early, but the

complications continue to impact my life and my family.
For the next few years, I have to get pelvic exams and Pap
smears every few months, the doctors measure tumor
markers, and I have to have regular x-rays and ultrasounds,
just in case. I have so many medical appointments that are
taking time away from my family, my friends, and my job.
Worse, every time the phone rings, and I know it’s my
oncologist calling, I hold my breath until I get the results.
I’m hopeful I can live a full and healthy life, but cancer is
always in the back of my mind.
In a short period of time, I went from being healthy and
planning more children to all of a sudden having a radical
hysterectomy and trying to make sure I don’t have cancer
again. It’s kind of overwhelming. And I am one of the lucky
ones!
Ultimately I need to make sure I’m healthy and there for my
children. I want to be around to see their children grow up.
I will do everything to keep my son and daughter from going
through this. I will get them both the HPV vaccine as soon
as they turn 11. I tell everyone—my friends, my family—to
get their children the HPV vaccine series to protect them
from this kind of cancer.❖
What about boys?
HPV vaccine is for boys too! This vaccine can help prevent
boys from getting
infected with the types of HPV that can cause cancers of the
mouth/throat,
penis and anus. The vaccine can also help prevent genital warts.
HPV
vaccination of males is also likely to benefit females by

reducing the spread
of HPV viruses.
Learn more about HPV and HPV vaccine at www.cdc.gov/hpv
For more information about the vaccines recommended for
preteens and teens:
800-CDC-INFO (800-232-4636)
www.cdc.gov/vaccines/teens
https://www.cdc.gov/vaccines/teens
https://www.cdc.gov/Features/VFCprogram/
https://www.cdc.gov/hpv
Running Head: THE SCIENTIFIC METHOD APPLIED TO
DIGITAL FORENSICS 1
THE SCIENTIFIC METHOD APPLIED TO DIGITAL
FORENSICS 7
The Scientific Method Applied To Digital Forensics
by student name

Professor D. Barrett
University
Course
Todays date
Abstract
Computer forensics is the process of digital investigation
combining technology, the science of discovery and the
methodical application of legal procedures. Judges and jurors
often do not understand the inner workings of computers and
rely on digital forensics experts to seek evidence and provide
reliable, irrefutable testimony based on their findings. The
scientific method is the process of diligent, disciplined
discovery where a hypothesis is formed without bias, and
analysis and testing is performed with the goal of effectively
proving or disproving a sound hypothesis. When investigative
teams do not follow standard investigative procedures it can
lead to inappropriate and inaccurate evidentiary presentations
that are extremely difficult for non-technical participants to

refute. The practitioners of digital forensics can make strides to
measure and improve the accuracy of their findings using the
scientific method. This paper includes a summary of the
scientific method as applied to the emerging and growing field
of digital forensics and presents details of a specific case where
both the prosecution and defense would have benefitted greatly
from the use of this proven method of discovery and analysis.
Findings can only be deemed reasonably conclusive when the
scientific process is correctly applied to an investigation,
findings are repeatable and verifiable, and where both the
evidence collected and the tools used are subject to the utmost
scrutiny.
The Scientific Method Applied To Digital Forensics
The forensic analyst and investigator must use a unique
combination of technical, investigative, and scientific skills
when approaching a forensic case. Most adults remember the
Scientific Method from their middle school science class as a
set of six steps beginning with stating a problem, gathering
information, forming a hypothesis, testing the hypothesis,
analyzing the data and drawing conclusions that either support
or do not support the hypothesis. Peisert, Bishop, & Marzullo
(2008) note that the term computer forensics has evolved to
mean “scientific tests of techniques used with the detection of
crime” yet note that many academic computer scientists also use
the term to refer to the “process of logging, collecting, auditing
or analyzing data in a post hoc investigation”. The necessity to
maintain chain of custody requires methodical and detailed
procedures, as does the formulation of a legitimate and unbiased
hypothesis and conclusion using the scientific method. Since
many judges and jurors assume that computer forensic evidence
is as “reliable and conclusive” as it is depicted on television,
the legal system is unaware of the volatile nature of computer
forensics investigations and the significance of a scientific
approach to evidence gathering and analysis (Peisert et al.,

2008).
The Scientific Process as Applied to Computer Forensics
Peisert et al. (2008) discuss in detail the need for the use of the
scientific method in forensic investigations, not only for the
process of discovery and analysis of evidence, but for
measuring the accuracy of the forensic tools used in an
investigation. Casey (2010) agrees, and cautions that evidence
must be compared to known samples so that investigators better
understand the scope and context of the evidence that is
discovered or presented and to better understand the output of
forensic tools. Casey (2010) further elaborates that the
scientific method is a powerful tool for forensic investigators
who must be neutral fact finders rather than advocates for one
side of a case or the other.
The process of creating a hypothesis and completing
experiments to prove or disprove them allows an investigator to
gain a concrete understanding of the digital evidence or mere
traces of evidence under analysis. Casey (2010) also notes that
while there is no ethical requirement to do so and may be
impractical, a thorough investigative practice would consider
investigation of alternate scenarios presented by defense.
Forensic examination tools can contain bugs, or behave
differently with various types of data and forensic images.
Casey (2010) recommends that investigators examine evidence
at both the physical and logical layers since both methods can
provide unique perspectives, and the physical layer may not
yield deleted, corrupted or hidden data. Suspects with limited
technical experience can rename image files with different
extensions not used for images, and those with more technical
knowledge can use advanced steganography techniques to
embed data within other data in an attempt to defy detection.
The 2004 case of State of Connecticut v. Julie Amero in
Norwich, Connecticut is one where the scientific method was
clearly missing from both the defense and prosecution.
Eckelberry, Dardick, Folkerts, Shipp, Sites, Stewart, & Stuart
(2007) completed a comprehensive post-trial analysis of the

evidence as provided to the defense and discovered very
different evidentiary results using a structured scientific
approach to their investigation. Amero was a substitute
elementary teacher accused of displaying pornographic images
that appeared on pop-up’s to her students from what ultimately
was proven to be a spyware-infected school computer. The
credibility of the legal system was compromised and the
prosecution made a numerous incorrect assumptions based on
results provided from inadequate forensic tools and poor
investigative techniques (Eckelberry et al., 2007).
The computer that Amero was using in her classroom was a
Windows 98 machine running Internet Explorer 6.0.2800 and a
trial version of Cheyenne AntiVirus that had not received an
update in several years. The content filtering at the school had
expired several months prior to the incident. The prosecution
presented non-factual statements that may easily have been
misconstrued by a non-technical jury and that likely caused a
guilty verdict. The false testimony made by the school IT
specialist indicated that the virus protection was updated
weekly when in fact they were not since computer logs and the
signatures clearly showed that virus updates were no longer
supported by the vendor. The updates may have been performed
but against files that had no new updates for many months. The
IT Manager who testified also incorrectly claimed that adware
was not able to generate pornography and especially not
“endless loop pornography”. This information was received as
a fact by the non-technical jury and incredibly not refuted by
the defense. The detective for the prosecution also stated that
his testimony was based completely on the product
ComputerCop which the vendor admits is incapable of
determining if a website was visited purposefully or
unintentionally. The forensic detective astoundingly admitted
that he did not examine the computer for the presence of adware
(Eckelberry et al., 2007, p. 7-10).
The case against Amero was largely based on testimony
stating that she deliberately visited the offensive pornographic

websites and that the sites visited subsequently showed the links
in red. The post-trial investigative team quickly verified that
the ‘sites visited’ color setting in Internet Explorer on the
suspect machine was set to “96,100,32” which is a greenish-
gray color. One of the web pages that the defendant allegedly
visited had an HTML override to highlight one of the links
presented in red and was not colored based on a deliberate visit
to the site. According to Eckelberry et al. (2007) the page in
question was not discovered in “any of the caches or Internet
history files or the Internet History DAT files. The post-trial
investigative team through meticulous investigation and use of
the scientific method were able to present facts that were
“exculpatory evidence showing that the link was never clicked
on by the defendant” or any other person, and disproved most of
the statements made by the forensics examiner and the
witnesses for the prosecution (Eckelberry et al., 2007, p. 12-
14).
The prosecution testimony stated that there was no
evidence of uncontrollable pop ups found on the suspect
machine, however, the post-trial investigative team discovered
irrefutable evidence that the page in question was loaded
twenty-one times in one second using a computer forensics tool
called X-Ways Trace. Eckleberry et al. (2007) detail many
other instances where testimony was haphazard and discovered
that a Halloween screen saver was the source of the adware that
presented the continuous stream of pornographic sites. The
chain of custody was also compromised in that the disk image
was from a Dell PC but the defense witness saw a Gateway PC
stored at the police station. The officer reportedly seized a
computer but the police report contradicts this and states that
only a drive was taken (Eckelberry et al., 2007, p. 14-17).
The case described and investigated by Eckelberry et al.
(2007) resembles a staged blunder designed as a humorous
sample case for beginning forensic students to discuss. The
case was however very real and even though the defendant was
eventually acquitted she suffered lasting harm from the

notoriety based on the initial conviction of contributing to the
delinquency of minors. If the prosecution or defense had
investigated the evidence using the scientific method and
maintained a credible chain of custody, or at least used clear
critical thinking while performing a thorough forensic
investigation this case may never have gone to trial. It wasted
the time and resources of judge, jury, and countless other
participants in the trial and permanently damaged an innocent
victim (Eckelberry et al., 2007).
Conclusion
The scientific method is a process that allows confidence
in a hypothesis when it can be subjected to repeated identical
tests. The use of the scientific method not only provides a
methodical structure to a forensic investigation, it lends
credibility to a case in the very nature of the steps used to
document and diligently test any given hypothesis. The case
independently investigated post-trial by Eckelberry et al. (2007)
was performed by a team of trained experts who were well
aware of the necessity of the methodical requirements and
necessity of the scientific method of discovery. Their findings
proved that the suspect was in fact a victim of poorly
maintained computers by a local Connecticut school system,
that the forensic expert and witnesses who testified in the case
were untrained and uninformed and used inadequate tools for
the investigation. Cases such as State of Connecticut v. Julie
Amero illustrate the importance of using the scientific method,
and the necessity of proper training in the art and science of
digital forensics.
References
Carrier, B. (2002, October). Open Source Digital Forensics
Tools: The Legal Argument. In @ Stake Inc. Retrieved
September 8, 2011, from
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.19.78
99&rep=rep1&type=pdf

Casey, E. (Ed.). (2010). Handbook of Digital Forensics and
Investigation (Kindle ed.). Burlington, MA: Elsevier, Inc.
Eckelberry, A., Dardick, G., Folkerts, J., Shipp, A., Sites, E.,
Stewart, J., & Stuart, R. (2007, March 21). Technical Review of
the Trial Testimony of State of Connecticut vs. Julie Amero.
Retrieved September 9, 2011, from http://www.sunbelt-
software.com/ihs/alex/julieamerosummary.pdf
Nelson, B., Phillips, A., & Steuart, C. (2010). Guide to
Computer Forensics and Investigations (4th ed.). Boston, MA:
Course Technology, Cengage Learning.
Peisert, S., Bishop, M., & Marzullo, K. (2008, April).
Computer Forensics in Forensis. Retrieved September 8, 2011,
from
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.140.3
949&rep=rep1&type=pdf

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