Parents’ decision-making about the human papillomavirus vaccine for their daughters: I. Quantitative results

Abstract

Vaccination against the human papillomavirus (HPV) is an effective primary prevention measure for HPV-related diseases. For children and young adolescents, the uptake of the vaccine is contingent on parental consent. This study sought to identify key differences between parents who obtain (acceptors) and parents who refuse (non-acceptors) the HPV vaccine for their daughters. In the context of a free, universal, school-based HPV vaccination program in Qu ebec, 774 parents of 9-10 year-old girls completed and returned a questionnaire by mail. The questionnaire was based on the theoretical constructs of the Health Belief Model (HBM), along with constructs from other theoretical frameworks. Of the 774 parents, 88.2% reported their daughter having received the HPV vaccine. Perceived susceptibility of daughters to HPV infection, perceived benefits of the vaccine, perceived barriers (including safety of the vaccine), and cues to action significantly distinguished between parents whose daughters had received the HPV vaccine and those whose daughters had not. Other significant factors associated with daughter vaccine uptake were parents' general vaccination attitudes, anticipated regret, adherence to other routinely recommended vaccines, social norms, and positive media influence. The results of this study identify a number of important correlates related to parents' decisions to accept or refuse the HPV vaccine uptake for their daughters. Future work may benefit from targeting such factors and incorporating other health behavior theories in the design of effective HPV vaccine uptake interventions.

Parents’ decision-making about the human papillomavirus vaccine for their daughters: II. Qualitative results

“…In fact, some parents believed that "kids these days" are having sex at an earlier age and therefore wanted their daughters to be protected. The results of these qualitative analyses largely coincide with our quantitative findings, 33 therefore providing convergent validity. The parents' comments provide both nuance and breadth, with rich details of their subjective perspective on decision-making; such details are often lost in a purely quantitative analysis.…”

“…The quantitative results are presented in a separate manuscript. 33 Eight-hundred and thirty four parents responded and returned the questionnaire. Eight hundred and six answered the open-ended questions and 138 entered additional comments.…”

“…Furthermore, respondents are more likely to verbalize salient or immediate influences, while leaving out those that are more distant and less conspicuous. As an example, although past compliance to other childhood vaccinations had an effect on their decision to vaccinate, 33 parents rarely mentioned this as a reason when asked open-endedly. This example supports the utility and value of a mixed methods design.…”

Investigating Canadian parents' HPV vaccine knowledge, attitudes and behaviour: a study protocol for a longitudinal national online survey

“…Over the last decade, a number of studies have identified factors associated with HPV vaccination decision-making including demographics, knowledge, attitudes, social norms, logistics (eg, time, effort) and cost. [42][43][44][45][46][47][48][49][50][51][52][53] The evidence has indicated some common themes (eg, the importance of physician recommendation, perceived benefit, perceived safety, cost), and some contradictory evidence (eg, knowledge has been found to correlate both negatively and positively with vaccine acceptance). 48 49 54 The degree to which each of these factors contributes (ie, the effect size) and possible policy variations between jurisdictions remains largely unclear.…”

Expanding Free School-based Human Papilloma Virus (HPV) Vaccination Programs to Include School-aged Males in Nova Scotia, Canada

“…Studies conducted among a sample of the general Canadian population observed that 17.4% of surveyed parents did not feel they had adequate knowledge surrounding HPV vaccination (Gilbert et al 2016). Similarly, a study that looked at parents who accepted and declined HPV vaccination for their daughters in Québec indicated that parents did not feel they had adequate information about the HPV vaccine (Krawczyk et al 2015a;2015b). In Nova Scotia, school-based programs with public health nurses were found to be beneficial in increasing uptake and engagement (Whelan et al 2014), suggesting that school-based vaccination programs for HPV may help prevent the spread of HPV.…”