Central American Immigrant Parents’ Awareness, Acceptability, and Willingness to Vaccinate Their Adolescent Children Against Human Papillomavirus: A Pilot Cross-Sectional Study

Abstract

Despite increasing interest in understanding the factors influencing awareness and acceptability of the human papillomavirus (HPV) vaccine among Latino parents, to date limited information is available specific to Central American parents living in the United States (US). Therefore, this pilot cross-sectional study was designed to explore and assess Central American immigrant parents’ awareness, acceptability, and willingness to vaccinate their children against HPV, and interest in participating in future HPV-associated cancer prevention study. Fifty-six Central American parents, majority immigrant (96.4%; n = 54) from four countries, El Salvador—50% (n = 27); Guatemala—25.9% (n = 14); Honduras—22.2% (n = 12); and Panama—1.9% (n = 1) participated in this study. Participants completed an interviewer-administered questionnaire survey in their preferred language (i.e., Spanish or English). A little over half of the participants were mothers (57.1%; n = 32) and parents’ mean age was 43.2 years (SD = 6.4). The majority was married or cohabitating (76.8%, n = 43), and 39.3% (n = 22) reported having two children. Seventy-five percent (n = 42) of parents reported they had heard of the HPV vaccine. Fewer fathers were aware of the HPV vaccine (58.3%; n = 14 vs.87.5%, n = 28; p = 0.01) than mothers. Among parents who had heard of the HPV vaccine (n = 42), 85.7% (n = 36) reported their children had received at least one dose of the HPV vaccine. Fewer fathers reported their child had been vaccinated against HPV (64.3%, n = 9 vs. 96.4%, n = 27; p = 0.06) than mothers. Moreover, 90% of parents (n = 18) whose children were unvaccinated reported willingness to vaccinate their adolescent children against HPV if recommended by their child’s physician. Findings indicate parents’ low to moderate awareness of the HPV vaccine, and high willingness to vaccinate their adolescent children if recommended by their child’s physician. Findings also demonstrate fathers’ lower awareness and acceptability of the HPV vaccine than mothers. Despite limitations and the need for more research, findings of this pilot study serve as a valuable first step toward building a knowledge foundation that is needed for developing future studies and interventions targeting Central American immigrant parents living in the US. Future studies can build on the findings of this exploratory study with other research designs and address its limitations by having a larger sample size and accounting for additional factors associated with Central American immigrant parents’ HPV awareness, knowledge, beliefs, attitudes, and vaccine acceptability from other communities across the US.

Latino Fathers Report Low Awareness and Knowledge of the Human Papillomavirus Vaccine, but High Willingness to Vaccinate Their Children if Recommended by Primary Healthcare Provider: a Qualitative Study

“…These finding support the results of previous studies conducted with other racial and ethnic minority groups [23,31,[38][39][40][41][42] and Latinos [15][16][17][18]20,[23][24][25][26] documenting the unique and crucial influence of healthcare providers on fathers' acceptability and willingness to vaccinate their children against HPV. Although the vast majority of fathers participating in our study reported that their child's mother was the primary parent taking children to healthcare visits, fathers also mentioned close communication with their wives and/or partners about their children's health visits.…”

“…Latinos are the largest minority population in the United States, and evidence indicates higher HPV-associated cancer incidence and mortality among Latinos compared to non-Hispanic whites [12,13]. Despite an increasing number of studies conducted to identify HPV awareness and acceptability of the HPV vaccine among Latinos [14][15][16][17][18][19][20][21], only very limited research is specific to Latino fathers [22][23][24][25]. The extant literature has mainly focused on Latina mothers' awareness, acceptability, and uptake of the HPV vaccine for their adolescent children, leaving fathers underrepresented in HPV research [14][15][16][17][18][19][20][21].…”

Acceptance of the HPV Vaccine in a Multiethnic Sample of Latinx Mothers

“…Eligible mothers (a) had at least one child aged 11 to 19 years, (b) self-identified as Latinx, (c) lived in Massachusetts, and (d) if foreign-born, had lived in the United States for at least 12 months. We used convenience sampling techniques to identify Latinx mothers, which included (a) posting flyers in local Latinx businesses and community-based social and health services agencies, and (b) making announcements and using visibility strategies at predominantly Spanish-speaking churches (Lindsay, Delgado, et al, 2020; Lindsay, Pineda, et al, 2020). Participants also were recruited using a snowball sampling method that involved two approaches: (a) leveraging the personal and community networks of the Latinx research staff to recruit potential participants, and (b) asking early enrollees to recommend their eligible Latinx friends (Faugier & Sargeant, 1997; Lindsay, Delgado, et al, 2020; Lindsay, Pineda, et al, 2020).…”

Lessons Learned From Recruiting Latino Fathers in Child Health Research

“…The studies employed qualitative and quantitative research designs and included multiple data collection methods (i.e., focus groups, semistructured interviews, and surveys; Table 1). Additional details of the studies can be found elsewhere (Lindsay, Delgado, et al, 2020; Lindsay, Le, et al, 2020; Lindsay et al, 2017; Lindsay, Pineda, et al, 2020; Lindsay, Wallington, Muñoz, & Greaney, 2018).…”

“…Latino fathers were eligible to participate if they (1) self-identified as being of Hispanic ethnicity, (2) were ≥21 years, (3) had lived in the United States for 6 or 12 months depending on study, (4) had at least one child between 2 and 8 (early childhood studies) or 11 and 19 (HPV studies) years of age, and (5) had shared parental responsibilities for or cohabitated with said child (Lindsay, Delgado, et al, 2020; Lindsay et al, 2017; Lindsay, Le, et al 2020; Lindsay, Pineda, et al, 2020; Lindsay, Wallington, Muñoz, & Greaney, 2018). In addition, in two of the studies an additional eligibility requirement included having a child enrolled in a Latino family child care home (Lindsay et al, 2017; Lindsay, Wallington, Lees, & Greaney, 2018).…”