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 Québec, 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.

Keywords:

• Human papillomavirus
• papillomavirus vaccine
• cancer vaccine
• decision-making
• social determinants of health
• quantitative research
• vaccine attitudes

Abbreviations:

• HPV, Human Papillomavirus
• STI, Sexually Transmitted Infection
• CAIQ, Commission d’Accès à l’Information du Québec
• HBM, Health Belief Model
• OR, Odds Ratio
• GW, Genital Warts
• RAMQ, Régie de l’Assurance Maladie du Québec
• HL, Hosmer-Lemeshow
• CI, Confidence Interval
• US, United States

Disclosure of Potential Conflicts of Interest

Dr. Rosberger reports personal fees outside the submitted work as a consultant at a workshop on behavioral science issues for Merck in November 2012. All other authors declare no additional conflict of interest.

Acknowledgments

The authors would like to thank Ellen Stephenson, Elsa Lau, Christopher Brown and Leonora King for their many important contributions to this project.

Funding

This study was funded by grant # 94479 from the Canadian Institutes for Health Research (CIHR) to Dr. Rosberger.