A potential means to help the HPV vaccine penetrate the Japanese public while under the continued suspension of governmental recommendation

Figures & data

Figure 1. The leaflet used in this project

Table 1. Characteristics of the mothers who were investigated for their attitudes toward their daughters’ HPV vaccination (Survey #1)

Characteristics
Age; median (range)	43 (33–53)
Past history of cervical cancer screening
Once	7 (12%)
Irregularly	22 (37%)
Regularly	25 (42%)
Never	5 (8%)
Intention to receive future cervical cancer screening
Willing to receive within 2 years	43 (73%)
Willing to receive sometime after 2 years	5 (8%)
Won’t to receive	1 (2%)
Unsure	7 (12%)
No answer	3 (5%)

Table 2. Decision-making capacity of the mothers

Questions	Number (%)
Do you usually feel it is difficult to make decisions in your daily life?
Not at all (Score: 7)	2 (4%)
Usually not (Score: 6)	11 (20%)
Relatively not (Score: 5)	14 (25%)
Neither yes nor no (Score: 4)	11 (20%)
Relatively yes (Score: 3)	15 (27%)
Usually yes (Score: 2)	3 (5%)
Completely yes (Score: 1)	0 (0%)
Does it take time for you to decide something?
Not at all (Score: 7)	1 (2%)
Usually not (Score: 6)	9 (16%)
Relatively not (Score: 5)	14 (25%)
Neither yes nor no (Score: 4)	15 (27%)
Relatively yes (Score: 3)	15 (27%)
Usually yes (Score: 2)	2 (4%)
Completely yes (Score: 1)	0 (0%)
Do you try to avoid making any decisions as much as possible?
Not at all (Score: 7)	6 (11%)
Usually not (Score: 6)	15 (27%)
Relatively not (Score: 5)	14 (25%)
Neither yes nor no (Score: 4)	16 (29%)
Relatively yes (Score: 3)	5 (9%)
Usually yes (Score: 2)	0 (0%)
Completely yes (Score: 1)	0 (0%)
Do you tend to leave decisions to others?
Not at all (Score: 7)	10 (18%)
Usually not (Score: 6)	10 (18%)
Relatively not (Score: 5)	16 (29%)
Neither yes nor no (Score: 4)	12 (21%)
Relatively yes (Score: 3)	7 (13%)
Usually yes (Score: 2)	1 (2%)
Completely yes (Score 1)	0 (0%)
Do you often change your decision later?
Not at all (Score: 7)	1 (2%)
Usually not (Score: 6)	7 (13%)
Relatively not (Score: 5)	21 (38%)
Neither yes nor no (Score: 4)	16 (29%)
Relatively yes (Score: 3)	9 (16%)
Usually yes (Score: 2)	2 (4%)
Completely yes (Score: 1)	0 (0%)

Table 3. Preconditions the mothers have for their daughters’ HPV vaccination at the time of entry to the study versus the decision-making capacity of the mothers

Preconditions	Decision-making capacity		Total
	High (≧23)	Low (≦22)
Already vaccinated	1	0	1 (2%)
Willing to vaccinate soon without any specific conditions	2	1	3 (5%)
Will vaccinate if the governmental recommendation is restarted	12	12	24(43%)
Will vaccinate after friends or acquaintances have been inoculated	1	0	1 (2%)
Will vaccinate after many girls of same generation have been inoculated	4	9	13 (23%)
Unsure	4	3	7 (13%)
Won’t inoculate	3	4	7 (13%)

p-value (Chi-square test) 0.20

Table 4. After receiving an explanation using the leaflet, change in mothers’ intention to get their daughters vaccinated

Change of intention	Number (%)
Increased willingness: vaccinate immediately, without any specific conditions	21 (40%)
Increased willingness: vaccinate if the governmental recommendation is restarted	9 (17%)
Increased willingness: unsure to vaccinate	20 (38%)
Unchanged intention: unsure to vaccinate	3 (6%)
Decreased willingness	0 (0%)
Already decided not to vaccinate	0 (0%)

Table 5. Multivariate analysis for the factors that influenced the change in mothers’ willingness to get their daughters vaccinated immediately after receiving an explanation using the leaflet

Variable	Adjusted OR	95% CI	p-value
Age of the daughters (years)
12, 13, 14, 15	1
16*	1.34	0.06–29.76	0.85
Anxiety of cervical cancer
Weak	1
Strong	1.97	0.60–6.49	0.27
Preconditions required for their daughters’ HPV vaccination at the time of entry into the study
Additional preconditions**	1
Restart of governmentalrecommendation alone	4.51	1.28–15.93	0.019
Decision-making capacity
Low (≦22)	1
High (≧23)	2.47	0.71–8.64	0.16

*: The highest targeted age for HPV vaccination

**: If the governmental recommendation is restarted, after friends or acquaintances have been inoculated, after many girls of her same generation have been inoculated

Table 6. Reasons for the mothers having taken their daughters to the clinic to get HPV vaccinated

Reasons	Number (%)
Leaflet from a local government	8 (50%)
Explanation by a doctor in the present project	7 (44%)
Acquaintances got vaccinated	1 (6%)