Article

The Multidimensional Nature of Perceived Barriers: Global Versus Practical Barriers to HPV Vaccination

Health Psychology (Impact Factor: 3.95). 11/2011; 32(4). DOI: 10.1037/a0026248
Source: PubMed

ABSTRACT Objective: Perceived barriers are one of the strongest determinants of health behavior. The current study presents a novel conceptualization of perceived barriers by testing the following hypotheses: (a) perceived barriers are multidimensional and thus should cluster into distinct factors; (b) practical barriers should be salient for individuals intending to engage in a particular health behavior, whereas global barriers should be salient for individuals not intending to enact the behavior; and (c) whereas global barriers should be negatively associated with behavioral intentions, practical barriers should be positively related to intentions. Methods: The context for this investigation was young adult women's perceived barriers to human papillomavirus (HPV) vaccination. Two months after viewing an educational video about HPV vaccination, women (aged 18-26) who had not received any doses of the HPV vaccine (n = 703) reported their perceived barriers to HPV vaccination and intentions to receive the vaccine. Results: Relative to the conventional single-factor approach, a five-factor model provided a better fit to the data and accounted for a larger proportion of variance in vaccination intentions. The relative salience of different perceived barriers varied as a function of women's intentions. Participants who were not intending to get vaccinated cited global concerns about vaccine safety and low perceived need for the vaccine. In contrast, participants intending to get vaccinated cited practical concerns (cost, logistical barriers) related to carrying out their intentions. Moreover, whereas global perceived barriers were associated with lower intentions, practical barriers were associated with higher intentions. Conclusions: Perceived barriers are multidimensional and vary systematically as a function of people's behavioral intentions. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

0 Bookmarks
 · 
140 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Routine administration of the quadrivalent human papillomavirus (HPV) vaccine has been recommended for 11-12-year-old males since 2011, but coverage remains low. In a U.S. national sample of parents of 11-17-year-old males (n=779), 78.6% of parents reported their sons had not received the HPV vaccine. The most common reason for non-vaccination (56.7%) was "My doctor or healthcare provider has not recommended it." Parents citing only logistical reasons for non-vaccination (e.g., lack of recommendation, access, or education, n=384) reported significantly higher vaccine acceptability than parents reporting a combination of attitudinal (e.g., concerns about vaccine safety or efficacy) and logistical barriers (n=92), while parents citing only attitudinal barriers (n=73) reported the lowest level of vaccine acceptability. In sum, many parents are willing but have not vaccinated sons due to logistical barriers, most commonly lack of healthcare provider recommendation. These findings have important implications for increasing HPV vaccination coverage among adolescent males.
    Vaccine 05/2014; DOI:10.1016/j.vaccine.2014.05.035 · 3.49 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although the Human Papillomavirus (HPV) vaccine is registered in Australia for females aged 9 to 45 years, females aged 27 to 45 years have shown limited vaccine uptake. Our study explored general practitioners' (GPs) views concerning HPV vaccination of females in this age group, with particular focus on the barriers and the facilitators to the delivery of the HPV vaccine.
    BMC Women's Health 07/2014; 14(1):91. DOI:10.1186/1472-6874-14-91 · 1.66 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The development of Human Papillomavirus (HPV) vaccines provides new opportunities in the fight against cervical cancer. Many acceptability studies have revealed high interest in these vaccines, but acceptance is only a precursor of behavior, and many factors, at personal, community and provider level, may inhibit the translation of willingness to vaccinate into actual uptake. Through a longitudinal study in Eldoret, Kenya, HPV vaccine acceptability was measured before a vaccination program (n = 287) and vaccine uptake, as reported by mothers, once the program was finished (n = 256). In between baseline and follow-up, a pilot HPV vaccination program was implemented via the GARDASIL Access Program, in which parents could have their daughter vaccinated for free at the referral hospital. The program was promoted at schools: Health staff informed teachers who were then asked to inform students and parents. Even though baseline acceptance was very high (88.1%), only 31.1% of the women reported at follow-up that their daughter had been vaccinated. The vaccine was declined by 17.7%, while another 51.2% had wanted the vaccination but were obstructed by practical barriers. Being well-informed about the program and baseline awareness of cervical cancer were independently associated with vaccine uptake, while baseline acceptance was correlated in bivariate analysis. Side effects were of great concern, even among those whose daughter was vaccinated. Possible partner disapproval lowered acceptance at baseline, and women indeed reported at follow-up that they had encountered his opposition. In Kenya, women prove to be very willing to have their daughter vaccinated against cervical cancer. However, in this study, uptake was more determined by program awareness than by HPV vaccine acceptance. School-based vaccination might improve coverage since it reduces operational problems for parents. In addition, future HPV vaccination campaigns should address concerns about side effects, targeting men and women, given both their involvement in HPV vaccination decision-making.
    PLoS ONE 10/2014; 9(10):e109353. DOI:10.1371/journal.pone.0109353 · 3.53 Impact Factor