Effect of the decision-making process in the family on HPV vaccination rates among adolescents 9–17 years of age

Figures & data

Table 1. Sample characteristics of mothers with a 9–17-y-old child (n = 1256))

	n (%)^a
Age
<30	180 (14.3)
30–39	751 (59.8)
40 or above	325 (25.9)
Race/ethnicity
White	240 (19.1)
Black	357 (28.4)
Hispanic	642 (51.1)
Other	17 (1.4)
Marital status
Single, never married	249 (19.9)
Married or cohabitating	689 (55.1)
Separated/divorced/widowed	312 (25.0)
Education
Did not graduate high school	547 (43.6)
High school graduate or GED	392 (31.2)
College degree or some college	316 (25.2)
Education of partner
Did not graduate high school	435 (35.0)
High school graduate or GED	346 (27.9)
College degree or some college	188 (15.1)
Does not have a partner	273 (22.0)
Employment status
Does not work	689 (54.9)
Employed (full/part time)	566 (45.1)
Annual household income
Less than $15,000	496 (40.1)
$15,000-$29,999	542 (43.8)
$30,000 or above	200 (16.2)
Current smoker	282 (22.5)
Ever diagnosed with a STI	188 (15.1)
Ever diagnosed with HPV	93 (7.5)
Ever had abnormal pap smears	372 (29.8)
Ever diagnosed with precancerous cervical cells/cervical cancer	117 (9.4)

^a Numbers do not add up to 1256 due to missing data; GED, General Education Diploma; HPV, human papillomavirus; STI, sexually transmitted infection.

Table 2. The initiation and completion of HPV vaccine among 9–17 y old children by family decision making process^a

Decision making process as reported by mother	9–17 y old daughters (n = 783)				9–17 y old sons (n = 759)
	Received 1 dose n (%)	P value^b	Completed 3-dose series n (%)	P value^b	Received 1 dose n (%)	P value^b	Completed 3-dose series n (%)	P value^b
Decided/will decide jointly with partner/husband	18 (10.3)	<0.001	11 (6.3)	0.012	10 (4.3)	<0.001	3 (1.3)	0.003
Decided/will decide by mother herself	94 (30.1)		51 (16.4)		49 (16.7)		21 (7.1)
Decided/will decide jointly with daughter/son	49 (20.3)		27 (11.2)		18 (9.7)		8 (4.3)
Other formats^c	10 (18.2)		6 (10.9)		0 (0.0)		0 (0.0)

^a Number of women with daughter and son do not add up to 1256 as many of them had both daughter and son; ^bBased on chi square or the Fisher exact test; ^cHusband/partner alone, daughter/son alone, parents and daughter/son together, or grandmother alone

Table 3. Odds ratios (OR) of HPV vaccine initiation and completion among 9–17 y old children by family decision making process

Decision making process as reported by mother	Received 1 dose^a				Completed 3-dose series^a
	Unadjusted		Adjusted		Unadjusted		Adjusted
	OR (95% CI)	P value	OR (95% CI)	P value	OR (95% CI)	P value	OR (95% CI)	P value
For 9–17 y old daughters
Decided/will decide jointly with partner/husband	Reference		Reference		Reference		Reference
Decided/will decide by mother herself	3.74 (2.17–6.44)	<0.001	3.55 (2.00–6.31)	<0.001	2.90 (1.47–5.72)	0.002	2.34 (1.14–4.81)	0.020
Decided/will decide jointly with daughter	2.20 (1.23–3.93)	0.008	1.73 (0.94–3.21)	0.080	1.86 (0.90–3.86)	0.095	1.22 (0.56–2.65)	0.618
Other formats (e.g., daughter alone, husband alone)	1.93 (0.83–4.47)	0.127	1.73 (0.72–4.16)	0.219	1.81 (0.64–5.16)	0.264	1.46 (0.49–4.32)	0.493
For 9–17 y old sons
Decided/will decide jointly with partner/husband	Reference		Reference		Reference		Reference
Decided/will decide by mother herself	4.42 (2.19–8.94)	<0.001	3.93 (1.86–8.28)	<0.001	5.85 (1.72–19.85)	0.005	5.80 (1.64–20.58)	0.006
Decided/will decide jointly with son	2.38 (1.07–5.29)	0.033	1.78 (0.77–4.08)	0.279	3.423 (0.90–13.14)	0.071	2.94 (0.74–11.63)	0.125
Other formats (e.g., son alone, husband alone)	-^b		-^b		- ^b		-^b

^a Sociodemogrpahic variables (age category, race/ethnicity, education, partner’s education, work status, awareness about HPV vaccine, and history of abnormal Pap smears) with a P value < 0.1 based on bivariate logistic regression analysis where vaccine initiation and completion in daughters and sons were dependent variables in separate models were included in the multivariate models. However, variables with a P value > 0.1 in the initial multivariate model were removed from the final multivariate models (education, partner’s education, work status, and history of abnormal Pap smears). Age categories and race/ethnicity were forced in the models if the P value did not achieve significance at <0.1 level. ; ^bVaccine initiation or completion were not observed in this category of decision making.