Why Do Low-Income Minority Parents Choose Human Papillomavirus Vaccination for Their Daughters?

Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA 02118, USA.
The Journal of pediatrics (Impact Factor: 3.79). 10/2010; 157(4):617-22. DOI: 10.1016/j.jpeds.2010.04.013
Source: PubMed


To explore low-income minority parents' attitudes, intentions, and actions with regard to human papillomavirus (HPV) vaccination for their daughters.
Semistructured interviews were conducted in English and Spanish with parents of girls aged 11-18 who were attending clinic visits in an urban medical center and a community health center. We assessed intention with formal scales, probed parents' attitudes regarding vaccination with open-ended questions, and reviewed medical records to determine vaccination rates. Data were analyzed using descriptive statistics and qualitative methods.
Seventy-six parents participated (43% African American, 28% Latino, and 26% Caucasian). Most were mothers, had completed high school, and described themselves as religious; nearly one-half were immigrants. Intention correlated highly with receipt of the vaccine; 91% of parents intended to vaccinate their daughters against HPV, and 89% of the girls received vaccination within 12 months of the interview. Qualitative analysis revealed that most parents focused on the vaccine's potential to prevent cervical cancer. Some parents expressed concerns about unknown side effects and promotion of unsafe sexual practices, but these concerns did not hinder acceptance in most cases.
The majority of the low-income minority parents surveyed viewed HPV vaccination as a way to protect their daughters from cancer, and thus chose to vaccinate their daughters.

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    • "Despite generally positive perceptions to the HPV vaccine, parents expressed worries concerning side-effects and safety [38,39,48,49,51,53,56,63,64]: “My first thought was, I am sendin’ my ten-year old to this clinic to put dead HPV cells in her. What if the HPV that they are shooting in her body…what if it comes to life?” [African American, mother, USA] [65]. "
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    ABSTRACT: Background Vaccination against Human Papillomavirus (HPV) is recommended for adolescent young women prior to sexual debut to reduce cervical cancer related mortality and morbidity. Understanding factors affecting decision-making of HPV vaccination of young women is important so that effective interventions can be developed which address barriers to uptake in population groups less likely to receive the HPV vaccine. Methods We undertook a qualitative systematic review and evidence synthesis to examine decision-making relating to the HPV vaccination of young women in high-income countries. A comprehensive search of databases from inception to March 2012 was undertaken to identify eligible studies reporting the perspectives of key stakeholders including policy makers, professionals involved in programme, parents, and young women. Factors affecting uptake of the vaccine were examined at different levels of the socio-ecological model (policy, community, organisational, interpersonal and intrapersonal). Results Forty-one studies were included. Whether young women receive the HPV vaccine is strongly governed by the decisions of policy makers, healthcare professionals, and parents. These decisions are shaped by: financial considerations; social norms and values relating to sexual activity, and; trust in vaccination programmes and healthcare providers. Financial constraints may be overcome through universal healthcare systems offering the HPV vaccine free at the point of delivery. In the healthcare setting, judgements by healthcare professionals about whether to recommend the vaccine may restrict a young woman’s access to the vaccine irrespective of her own beliefs and preferences. Parents may decide not to allow their daughters to be vaccinated, based on cultural or religious perceptions about sexual activity. Conclusions Barriers to the uptake of the HPV vaccine have implications for young women’s future sexual, physical and reproductive health. Interventions to address barriers to uptake of the vaccine should target appropriate, and multiple, levels of the socio-ecological model. Issues of trust require clear, accessible, and sometimes culturally appropriate, information about the HPV vaccination programme. Although young women are central to the HPV vaccination programme, their views are underrepresented in the qualitative literature. Future research should consider young women’s perceptions of, and involvement in, consent and decision-making.
    Full-text · Article · Jul 2014 · BMC Public Health
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    • "However, most existing studies are quantitative studies focusing on single vaccines, which limit understanding of how parental vaccination values and beliefs were shaped and interact, translating into vaccination decisions. Moreover, only fewer studies have involved minority groups in a community regarding parental VDM for children [21,22]. No study we could find has combined all three of these features targeting Chinese migrants. "
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    ABSTRACT: While immunization coverage rates for childhood routine vaccines in Hong Kong are almost 100%, the uptake rates of optional vaccines remain suboptimal. Understanding parental decision-making for children's vaccination is important, particularly among minority groups who are most vulnerable and underserved. This study explored how a subsample of new immigrant mothers from mainland China, a rapidly-growing subpopulation in Hong Kong, made decisions on various childhood and adolescent vaccines for their offspring, and identified key influences affecting their decision making. Semi-structured in-depth interviews were conducted with 23 Chinese new immigrant mothers recruited by purposive sampling. All interviews were audio-taped, transcribed and analyzed using a Grounded Theory approach. Participants' conversation revealed five underlying themes which influenced parents' vaccination decision-making: (1) Institutional factors, (2) Insufficient vaccination knowledge and advice, (3) Affective impacts on motivation, (4) Vaccination barriers, and (5) Social influences. The role of social norms appeared overwhelmingly salient influencing parents' vaccination decision making. Institutional factors shaped parent's perceptions of vaccination necessity. Fear of vaccine-targeted diseases was a key motivating factor for parents adopting vaccination. Insufficient knowledge about vaccines and targeted diseases, lack of advice from health professionals and, if provided, suspicions regarding the motivations for such advice were common issues. Vaccination cost was a major barrier for many new immigrant parents. Social norms play a key role influencing parental vaccination decision-making. Insight gained from this study will help inform healthcare providers in vaccination communication and policymakers in future vaccination programme.
    Full-text · Article · Feb 2014 · BMC Public Health
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    ABSTRACT: In the past, immunization programs worldwide mainly focused on the delivery of infant and early childhood vaccines. An increasing awareness of the importance of investing in adolescents' health has led to the introduction of new vaccines targeted specifically to adolescents over the last ten years: this has improved the adolescent's opportunities to protect from certain diseases for which they are at an increased risk. Safe and effective vaccines against human papilloma virus, Neisseria meningitides and Bordetella pertussis are recommended in many parts of the world; nevertheless, vaccination coverage in this age group is relatively low compared to coverage in infants. Barriers to adolescent immuniza-tion are believed to be complex and multifactorial but overcoming these barriers will be of primary importance for the future.
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